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The smartphone application delivers recovery-oriented cognitive therapy (CT-R) through gamified augmented reality (AR) experiences. The primary objective was to assess acceptability and feasibility of a single-session prototype. Secondary aims were to generate descriptive findings on defeatist beliefs, self-esteem, and attitudes toward goal-oriented activities. 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Tang1,2,3,4 | Moein Foroughi3,4 | Aaron P. Brinen1,5 | Michael L. Birnbaum1,6,7 | Sarah A. Berretta1,8 | Leily M. Behbehani1,9 | John M. Kane1,2,3,4 | Edward Yoon1 | William F. Cronin1   \n1North Shore Therapeutics, Inc. , Rochester, Minnesota, USA | 2Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York,  \nUSA | 3Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA | 4Donald and Barbara Zucker School of Medicine, Hempstead, New York, USA | 5Vanderbilt University Medical Center, Nashville, Tennessee, USA | 6Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA | 7New York State Psychiatric Institute, New York, New York, USA | 8School of Behavioral and Brain Sciences, University of Texas at  \nDallas, Richardson, Texas, USA | 9Department of Psychology, Yale University, New Haven, Connecticut, USA Correspondence: Sunny X. Tang ([sunny@northshore.health](sunny@northshore.health))  \nReceived: 29 December 2024 | Revised: 12 August 2025 | Accepted: 9 December 2025  \nKeywords: app | augmented reality | CBT | CT-R | digital health | negative symptoms | schizophrenia  \nABSTRACT  \nBackground: NST-SPARK is a novel digital therapeutic targeting negative symptoms in schizophrenia spectrum disorders (SSD). It is a smartphone application delivering recovery-oriented cognitive therapy (CT-R), via gamified augmented reality (AR) experiences. The primary objective was to determine the acceptability and feasibility of a single-session prototype. Secondary objectives were to generate descriptive findings for changes in defeatist beliefs, self-esteem and attitudes toward goal-oriented activities.  \nMethods: Twenty participants with schizophrenia or schizoaffective disorder enrolled. Participants completed self-reports on the acceptability and feasibility of NST-SPARK v.1.5 and provided open-ended feedback. Self-report scales on defeatist beliefs, self-esteem and attitudes toward goal-oriented activities were completed before and after participants were introduced to NSTSPARK, and at 1-week follow-up.  \nResults: Participants found NST-SPARK to be feasible and acceptable, with an average response of ‘Agree’, indicating that the intervention met with the participants' approval and seemed implementable. Almost all participants (19 of 20) used the app on their own prior to the 1-week follow up despite not being incentivised. We also observed changes in defeatist beliefs, self-esteem and attitudes toward goal attainment consistent with intended improvements in these targeted areas. Participants made substantive progress toward identified goals in 90% of cases. The most common positive feedback was appreciation that the app got them going, and the most common negative feedback pointed out technical aspects that did not function properly.  \nConclusions: This preliminary, single-arm, unblinded study of a single-module prototype for NST-SPARK found that the approach is generally acceptable and feasible for people with SSD and negative symptoms.  \n\n| Abbreviations: AIM, acceptability of intervention measure; AR, augmented reality; ATT, attitudes toward behavioural change; BSES, Beck Self-Esteem Scale; CT-R, recovery-oriented cognitive therapy; DBS, Defeatist Belief Scale; FDA, United States Food and Drug Administration; FIM, feasibility of intervention measure; NST, North Shore Therapeutics; SANS, Scale for the Assessment of Negative Symptoms; SCID-5, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; SSD, schizophrenia spectrum disorder; VR, virtual reality. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction ","cbCaim4hUujHT2qM","https://ap.wps.com/l/cbCaim4hUujHT2qM","pdf",487813,12,"English","# Introduction\n## Background and unmet need for negative symptoms\n## Overview of NST-SPARK digital therapeutic approach","[{\"question\":\"What is NST-SPARK and what does it target?\",\"answer\":\"NST-SPARK is a smartphone-based digital therapeutic targeting negative symptoms in schizophrenia spectrum disorders. It delivers recovery-oriented cognitive therapy through gamified augmented reality experiences.\"},{\"question\":\"How was the preliminary prototype evaluated?\",\"answer\":\"A single-session prototype was assessed for acceptability and feasibility using self-report measures and open-ended feedback. Participants also completed scales on targeted constructs before and after use, plus a 1-week follow-up.\"},{\"question\":\"What were the key preliminary outcomes reported?\",\"answer\":\"Participants generally found NST-SPARK feasible and acceptable, with most using the app before the 1-week follow-up. The study also reported changes consistent with improvements in defeatist beliefs, self-esteem, and attitudes toward goal attainment.\"}]","Preliminary Findings From an Augmented Reality (AR) App Delivering Recovery-Oriented Cognitive Therapy for Negative Symptoms in Schizophrenia | PDF",1790738973]