UNDERSTAND: Uplifting the New generation through DBT Education and Resilience for Social Triggers, Anxiety, Negativity, and Depression

Overview

Many college students experience depression and anxiety together, which compounds both symptom severity and functional impairment. Treatments like CBT and DBT work, but they are delivered on a schedule. The skill a student needs is taught in a session on Tuesday and required at 2am on Saturday, and the gap between those two moments is where the intervention fails.

UNDERSTAND closes that gap with three components.

Sensing. Wearables and phones carry signals that precede and accompany distress: physiological arousal, sleep and activity disruption, changes in social behavior and interaction patterns. We instrument these continuously and in daily life, so that the system is reading the situation as it develops rather than reconstructing it afterwards from self-report.

AI. Machine learning models turn those raw streams into an estimate of when someone is struggling and when they are receptive, which is the harder of the two questions. Large language models then generate the support itself, and our work constrains that generation so the model stays inside the skills and principles of DBT rather than producing generic encouragement that sounds therapeutic without being it.

Just-in-time adaptive intervention. The decision of what to deliver, when, and whether to deliver anything at all is the intervention. JITAI makes that decision continuously from the sensed context, offering a DBT skill at the moment it applies, and staying silent when an interruption would do more harm than good.

By targeting transdiagnostic mechanisms such as emotional dysregulation, interpersonal difficulty, and cognitive distortion, the approach is designed to generalize across populations with comorbid mood and anxiety disorders rather than to a single diagnosis.

Funding and External Collaborations

UNDERSTAND is funded by the National Institute of Mental Health (NIMH) at NIH, with the funded project starting 1 August 2026. It is a collaboration between the HXI Lab and the UC San Diego Department of Psychiatry and the Herbert Wertheim School of Public Health, bringing together expertise in DBT, clinical psychology, digital mental health, and ubiquitous sensing.