Mobile Cognitive Behavioral Therapy in Early Stroke Recovery

This study aims to pilot "Maya," a mobile cognitive behavioral therapy app, for use in adults with stroke experiencing depression and/or anxiety. This study will assess the acceptability, feasibility, and preliminary efficacy of Maya within the acute rehabilitation period.

Inclusion Criteria: * Age 18-79 * Positive screen on the Hospital Anxiety and Depression Scale (HADS), either the HADSD (depression, score \>= 8) and/or HADS-A (anxiety, score \>= 8). * Stroke that occurred within 1 month prior to study initiation. * Capacity to provide consent as determined by the UCSD Brief Assessment for Capacity to Consent (UBACC) * Montreal Cognitive Assessment (MoCA) score greater than or equal to 18, indicating no more than mild cognitive difficulties * Ability to use iPhone or iPad independently or through the assistance of a caregiver (participants will use their own iPhone if they have one, otherwise they will be loaned an iPad by the study team) * Able to adhere to all study requirements and willingness to participate in the full study duration Exclusion Criteria: * Aphasia or neglect that would interfere with use of the app, as determined through evaluation by speech-language pathology and occupational therapy conducted as part of standard clinical care * Non-fluency in English * History of a major neurologic disorder or of serious mental illness (bipolar or psychotic disorder, alcohol or substance use disorder as assessed through chart review) * Active suicidal ideation requiring a higher level of care * Severe depression and/or anxiety based on the initial evaluation and clinical judgment of the PI, which warrants a higher level of care and/or immediate referral to psychiatric services * Any other clinical or medical reason in the initial evaluation that suggests the study is not appropriate for the participant