# Counteract Anhedonia! Introducing an Online-Training to Enhance Reward Experiencing – A Pilot Study

## TL;DR

This pilot study introduces T-REx, an online training to improve reward experiences in people with anhedonia, showing it may help reduce depression and increase activity.

## Contribution

The study introduces T-REx, a novel self-help intervention for anhedonia based on savoring and mental imagery.

## Key findings

- T-REx was found to be feasible and well-accepted by participants.
- T-REx showed greater reductions in depressive symptoms and increases in active behavior compared to gratitude writing.
- Individuals with more severe anhedonia benefited more from T-REx.

## Abstract

Anhedonia is a risk factor for a severe course of depression but is often not adequately addressed in psychotherapy. This study presents the Training to Enhance Reward Experience (T-REx), a novel self-help approach that uses savoring and mental imagery to target impairments in reward experience associated with anhedonia. We aimed to examine feasibility and acceptability of T-REx and exploratively investigated its effects on anhedonia and other clinical variables.

In an online, randomized controlled trial, 79 subjects participated for five days in T-REx or the active control condition Gratitude Writing (GW). We assessed changes in anhedonia, depression, and active behavior at inclusion, after the waiting period, post-intervention and at follow-up. The intervention effects were examined for the full sample and an anhedonic sub-sample.

T-REx and GW were equally feasible and clearly accepted by the sample. Both interventions significantly reduced depressive symptoms and increased behavioral activation. Although there was no significant main effect of the interventions, between-group differences were observed for depressive symptoms and active behavior at post-intervention and follow-up, favoring T-REx. Further, within-group changes for T-REx were larger than for GW. The observed effects had a greater magnitude in the anhedonic sub-sample, suggesting that individuals with more pronounced anhedonic symptoms derived greater benefit from the interventions.

This first study of T-REx provides promising results that should prompt further investigations of T-REx in clinical samples. The results suggest that T-REx has a positive effect on depression symptoms and active behavior. Further, its potential as a valuable adjunct to behavioral activation interventions is discussed.

We theoretically deduced, developed, and examined a novel treatment option for anhedonia based on savoring and mental imagery.The Training to Enhance Reward Experience (T-REx) reduces depression and increases active behavior.T-REx proves to be a promising extension of behavioral activation or other CBT treatments.

We theoretically deduced, developed, and examined a novel treatment option for anhedonia based on savoring and mental imagery.

The Training to Enhance Reward Experience (T-REx) reduces depression and increases active behavior.

T-REx proves to be a promising extension of behavioral activation or other CBT treatments.