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My Cosmos preliminary evaluation shows positive usability and acceptance among university students and mental health professionalsA Video Game That Helps You Manage Anxiety and Depression

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Key Takeaway
Consider My Cosmos as a preliminary tool with positive usability; clinical effectiveness remains unproven in this early evaluation.

This preliminary evaluation assessed the development, clinical protocol, and usability of My Cosmos, a gamified transdiagnostic digital CBT platform delivered via a secure digital environment. The study population included 124 university students and 19 mental health professionals. No comparator group was reported, and no primary clinical outcomes were measured at this stage.

Results regarding usability and acceptance were positive. Help-seekers characterized the intervention as intuitive, engaging, and emotionally supportive. Mental health professionals provided moderate but overall positive evaluations of the system. No adverse events, serious adverse events, discontinuations, or specific tolerability data were reported in this preliminary phase.

Key limitations include the fact that this is a preliminary usability and acceptance evaluation only. No clinical effectiveness data regarding anxiety or depression are available yet. The study was not powered to assess engagement or health-economic outcomes. Findings currently inform ongoing optimisation and support progression toward beta/feasibility testing and a planned randomised controlled trial.

The practice relevance lies in the blended-care positioning where the programme complements, rather than replaces, the therapeutic relationship. Clinicians should interpret these results as early signals of acceptability pending future trials that will evaluate clinical effectiveness, engagement, and health-economic outcomes.

Anxiety and depression are incredibly common. Millions of people seek help every year.

A proven treatment is Cognitive Behavioral Therapy, or CBT. It teaches you to identify and change unhelpful thought patterns. It works, but accessing a therapist can be difficult and expensive.

Digital CBT programs bring these lessons to your phone. They are a vital tool. Yet, a major problem persists: people often start them but don’t finish.

The challenge isn’t just having the tool. It’s making people want to use it.

The Surprising Shift

The old way of thinking was simple. Make the therapy program. Give it to the user. Hope they complete it.

But here’s the twist. Researchers realized the design of the program is just as important as the therapy inside it. If it feels like a chore, people will disengage.

What if the program itself could motivate you?

This is the core idea behind a new platform called My Cosmos. It doesn’t just deliver CBT lessons. It wraps them in an experience designed to feel more like a supportive game than a textbook.

How It Works: Therapy Meets Game Design

Think of your mind like a garden. Unhelpful thoughts are weeds. CBT gives you the tools to pull those weeds.

My Cosmos aims to make using those tools more rewarding. It uses “gamification.” This means it adds elements from games—like earning points, completing levels, and collecting virtual items—to the therapy process.

These aren’t just for fun. They act as little boosts of motivation.

For example, after you complete a lesson on managing worry, you might “unlock” a calming breathing exercise tool. That tool becomes yours to use anytime. It turns abstract skills into tangible, collected items. This helps bridge the gap between learning a skill in the app and using it in real life.

A Snapshot of the First Test

Before testing if My Cosmos improves mental health, researchers had to answer a simpler question: Do people like using it?

They asked 124 university students and 19 mental health professionals to try the platform and give their honest feedback. This wasn’t about curing symptoms yet. It was about checking the design.

The response was promising. The students, the people who might one day use it for help, described My Cosmos as intuitive and engaging. They said it felt emotionally supportive. Crucially, they highlighted how it helped with “self-regulation”—the ability to manage difficult emotions on their own.

The mental health professionals were cautiously optimistic. They saw real value in using a platform like this to support their work. They liked that it could give patients structured “homework” between sessions and provide a clear way to track progress.

Both groups agreed on one vital point.

This tool is meant to complement therapy, not replace the human connection at its heart.

The Expert Perspective

The feedback creates a clear picture. A tool like My Cosmos fits best in a “blended care” model. This means a therapist might assign modules in the app for you to work on during the week. Then, you’d discuss your experiences and progress in your next session.

It turns isolated homework into an interactive part of your care team. The professionals in the study emphasized that for this to work, the tool must be easy for them to use and integrate smoothly into their practice.

What This Means For You Today

It is essential to understand that My Cosmos is not currently available to the public. You cannot download it or sign up for it.

This research was a crucial first step: a usability study. It tells developers the design is on the right track. It does not tell us if the program actually reduces symptoms of anxiety or depression.

The study’s main limitation is its purpose. It was designed to test engagement and design, not clinical effectiveness. The participants were also a specific group (university students and their therapists), so we don’t know how others might experience it.

The positive feedback is a green light for the next phases of research. The team behind My Cosmos now plans to move into “beta” testing with a small group in a real-world setting.

After that, the gold-standard test is a randomized controlled trial. This is where hundreds of people would be randomly assigned to either use My Cosmos or a different tool. Researchers would then measure over several months to see which group had better mental health outcomes.

This process is meticulous and takes time—often years. It’s necessary to ensure the program is both safe and truly helpful. The goal is to build a tool that is not only smart but also sticky enough to support people through their entire journey to better mental health.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
BackgroundDigital cognitive–behavioural therapy (dCBT) has been shown to be effective for anxiety and depression, yet sustaining engagement remains a key challenge that limits real-world impact. Gamification and extended reality (XR) elements may support motivation and skill transfer, but few interventions integrate these features within a clinician-compatible, clinically grounded framework. My Cosmos is an internet-delivered, mobile-first transdiagnostic dCBT programme that embeds first-wave CBT alongside selected second- and third-wave approaches within a game-inspired structure designed to support adherence and self-regulation.MethodsMy Cosmos was developed through evidence mapping, co-design with potential users and mental health professionals, iterative prototyping, and implementation of GDPR-compliant pseudonymised data flows. The programme assigns users to Anxiety, Depression, or Mixed tracks based on baseline PHQ-9, GAD-7, and SF-36 scores. Each track follows a six-module CBT pathway enriched with gamified Rehabilitation Objects and supported by a secure clinician web dashboard to enable blended care. Preliminary usability and acceptance were assessed through participatory workshops with university students (N = 124) and mental health professionals (N = 19), using standardised questionnaires (SUS, MAUQ, UTAUT2) and inductive qualitative analysis of open-ended feedback.ResultsHelp-seekers described My Cosmos as intuitive, engaging, and emotionally supportive, emphasising its usefulness for self-regulation and structured reflection. Mental health professionals reported more moderate but overall positive evaluations, recognising the platform’s value for supporting homework, monitoring progress, and enhancing continuity between sessions, while highlighting the importance of clear onboarding, transparent communication about data protection, and flexible clinical integration. Both groups converged on a blended-care positioning in which the programme complements, rather than replaces, the therapeutic relationship.ConclusionsThis paper presents the development, clinical protocol, and early-stage usability evaluation of My Cosmos, a gamified, modular, transdiagnostic dCBT programme implemented within a secure digital environment. Findings inform ongoing optimisation and support progression toward beta/feasibility testing and a planned randomised controlled trial to evaluate clinical effectiveness, engagement, and health-economic outcomes.
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