Square2 Systems, Inc.

We were founded by internationally recognized leaders in the development, evaluation, and implementation of science-based, technology-delivered therapeutic tools. Located in Hanover, NH our headquarters are a stone's throw from Dartmouth College and Dartmouth-Hitchcock Hospital.

Everyday actions can have a huge impact on our physical health, emotional well-being and overall happiness. Most of us can think of something we'd rather be doing, or should be doing, but so far have lacked the wherewithal to make it happen.

Fortunately, the principles and processes of effective behavior change are well understood. Unfortunately, the tools to apply these principles in our everyday lives are in short supply.

We created Square2 to put scientifically-validated and cost-effective behavior change tools into the pockets of anyone who is looking to change their life for the better.

How we got here


2015

Square2 Launched

Square2 is the culmination of over 15 years of research in computer-assisted, self-directed behavior change. We’ve adapted and modernized our technology and approaches to take advantage of the capabilities of today’s mobile devices, tapping the research for the common principles and processes of effective behavior change and crafted them into tools you can take with you.

2012: Launch of randomized clinical trial evaluating the effectiveness and cost-effectiveness of a mobile intervention for substance use disorder treatment compared to standard addiction treatment

2011-2013: Study demonstrating preliminary effectiveness of mōtiv8 in increasing walking in sedentary adults

Citation:

Kurti, A.N., & Dallery, J. (2013). Internet-based contingency management increases walking in sedentary adults. Journal of Applied Behavior Analysis, 46, 568-81. PMID: 24114220.

2011-2013: Randomized clinical trial demonstrating effectiveness of mōtiv8 in promoting smoking cessation

Citation:

Dallery, J., Raiff, B.R., & Grabinski, M.J. (2013). Internet-based contingency management to promote smoking cessation: A randomized, controlled study. Journal of Applied Behavior Analysis, 46, 750-64. PMID: 24114862. PMCID: PMC4570245.

2010

National 10-site Clinical Trial

2010-2014: Randomized clinical trial showing that partially replacing clinician-delivered counseling with TES improves patient outcomes among diverse populations with substance use disorders

Citation for randomized, controlled trial:

Campbell AN, Nunes EV, Matthews AG, Stitzer M, Miele GM, Polsky D, Turrigiano E, Walters S, McClure EA, Kyle TL, Wahle A, Van Veldhuisen P, Goldman B,Babcock D, Stabile PQ, Winhusen T, Ghitza UE. (2014). Internet-delivered treatment for substance abuse: a multisite randomized controlled trial. American Journal of Psychiatry. Jun;171(6):683-90. doi: 10.1176/appi.ajp.2014.13081055.

2010-2015: Randomized clinical trial demonstrating the feasibility and initial efficacy of mōtiv8 in promoting smoking cessation among adolescent smokers living in rural locations

Citation:

Reynolds, B., Harris, M., Slone, S.A., Shelton, B.J., Dallery, J., Stroops, W., & Lewis, R. (2015). A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia. Experimental and Clinical Psychopharmacology, August 17, 2015. [Epub ahead of print]. PMID: 26280592.

2010-2015: “Moving Forward” program developed and randomized clinical trial demonstrating effectiveness of program in reducing alcohol abuse among veterans

Citations for randomized, clinical trial:

Possemato, K., Acosta, M., Fuentes, J., Lantinga, L., Marsch, L.A., Maisto, S., & Rosenblum, A. (2015). A web-based self-management program for recent combat veterans with PTSD and substance misuse: Program development and veteran feedback. Cognitive and Behavioral Practice. 22, 345-58. PMID: 26120269; PMCID: PMC4480783.

Acosta, MC, Possemato, K., Maisto, SA., Marsch, LA, Barrie, K., Lantinga, L, Fong, C., Xie, H., Grabinski, M., & Rosenblum, A. (2017). Web-delivered CBT reduces heavy drinking in OEF-OIF Veterans in Primary care with symptomatic substance use and PTSD. Behavior Therapy. PMID: 28270335

2010-2013: “Take Charge of Pain” program developed and Randomized clinical trial demonstrating effectiveness of program in controlling aberrant opioid-taking behavior and reducing emergency room visits among chronic pain patients

Citations:

Moore, S.K., Guarino, H., Acosta, M.C., Marsch, L.A., Rosenblum, A., Aronson, I., Grabinski, M., Cruciani, R., & Turk, D.C. (2013). Patients as collaborators: Using focus groups and feedback sessions to develop an interactive, web-based self-management intervention for chronic pain. Pain Medicine, 14, 1730-40. PMID: 23859438; PMCID: PMC3834126.

Guarino, H., Fong, C., Marsch, L.A., Acosta, M.C., Syckes, C., Moore, S.K., Cruciani, R.A., Portenoy, R.K., Turk, D.C., Grabinski, M., & Rosenblum, A. (Under Review).
Web-based cognitive behavior therapy for chronic pain patients with aberrant opioid medication-taking behavior: Outcomes from a randomized, controlled trial. Pain Medicine.

2010-2013: Randomized clinical trial showing TES produces comparable addiction treatment outcomes to clinician-delivered behavioral therapy

Citation for randomized, controlled trial:

Chaple, M., Sacks, S., McKendrick, K., Marsch, L.A., Belenko, S., Leukefeld, K., Prendergast, M., & French, M. (2013). Feasibility of a Computerized Intervention for Offenders with Substance Use Disorders: A research note. Journal of Experimental Criminology,1-23. PMID: 24634641; PMCID: PMC3945711.

Chaple, M., Sacks, S., McKendrick, K., Marsch, L.A., Belenko, S., Leukefeld, C., Prendergast, M., & French, M. (2016). A Comparative Study of the Therapeutic Education System (TES) for Incarcerated Substance Abusing Offenders. The Prison Journal. doi:10.1177/0032885516636858.

2009

First Mobile Phone-based Intervention Developed

Our first foray into mobile behavioral interventions featured a minimal set of self-management tools and skills training modules. The program proved to be effective and highlighted the power of even minimal “in the moment” interventions. Later versions took advantage of enchanced capabilities afforded by smart-phones versus the feature phones in common use in 2009.

2009-2015: Randomized clinical trial showing comparable HIV prevention outcomes from TES compared to clinician-delivered care

Citation for randomized, controlled trial:

Marsch, L.A., Guarino, H., Grabinski, M.J., Melnikow, C., Dillingham, E.T., Xie, H., Crosier, B.S. (2015). Comparative Effectiveness of web-based vs. educator-delivered HIV prevention for adolescent substance users. Journal of Substance Abuse Treatment. PMID: 26293644.

2009-2015: “Step Up” program developed and Randomized clinical trial demonstrating feasibility, acceptability, and preliminary effectiveness of program in the treatment of adolescent substance use disorders

Citation:

Acosta, M.C., Marsch, L.A., Grabinski, M.J., Xie, H., Kim, S.J., Kaminer, Y., & Godley, S. (Under Review). The Step Up Program: development and evaluation of a web-based psychosocial treatment for adolescents with substance use disorders. Journal of Substance Abuse Treatment.

2009-2015: Study demonstrating increased drug abstinence and increased treatment retention when mobile phone based behavior change tool is added to outpatient addiction treatment

Citation:

Guarino, H., Acosta, A., Marsch, L.A., Xie, H., & Aponte-Melendez, Y. (2016). A Mixed-methods Evaluation of the Feasibility and Acceptability of a Mobile Phone-based Intervention for Methadone Maintenance Clients. Psychology of Addictive Behaviors. PMID: 26618796 PMCID: PMC4924621

2009-2011: Study demonstrating feasibility and acceptability of embedding Social Media support in mōtiv8

Citation:

Meredith, S.E., Grabinski, M.J., & Dallery, J., (2011). Internet-based group contingency management to promote abstinence from cigarette smoking: A feasibility study. Drug and Alcohol Dependence, 118, 23-30. PMID: 21414733.

2009-2010: Study demonstrating feasibility, acceptability, and preliminary effectiveness of mōtiv8 in the self-monitoring of blood glucose among teens with diabetes

Citation:

Raiff, B.R., & Dallery, J. (2010). Internet-based contingency management to improve adherence to blood glucose testing recommendations for teens with Type 1 diabetes. Journal of Applied Behavior Analysis, 43, 487-91. PMCID: PMC2938951

2006-2014: Randomized clinical trial showing that partially replacing clinician-delivered counseling with TES produces better patient outcomes in opioid addiction treatment

Citation for randomized, controlled trial:

Marsch, L.A., Guarino, H., Acosta, M., Aponte-Melendez, Y., Cleland, C., Grabinski, M., Brady, R., & Edwards, J. (2014). Web-based Behavioral Treatment for Substance Use Disorders as a Partial Replacement of Standard Methadone Maintenance Treatment. Journal of Substance Abuse Treatment. PMID:24060350; PMCID: PMC3839618

2006-2014: Randomized clinical trial showing TES was effective for even persons with a history of multiple addiction treatment episodes

Citation:

Kim, S.J., Marsch, L.A., Acosta, M.C., Guarino, H., & Aponte-Melendez, Y. (2016). Can persons with a history of multiple addiction treatment episodes benefit from technology delivered behavior therapy? A moderating role of treatment history at baseline. Addictive Behaviors. PMID: 26657820; PMCID: PMC4713265.

2006-2014: Randomized clinical trial showing that TES was effective for even the most challenging of patients (including those who were highly anxious and ambivalent about substance use)

Citation:

Kim, S.J., Marsch, L.A., Guarino, H., Acosta, M.C., & Aponte-Melendez, Y. (2015). Predictors of outcome from computer-based treatment for substance use disorders: Results from a randomized clinical trial. Drug and Alcohol Dependence. PMID: 26433562; PMCID: PMC4663155.

2005

Mōtiv8 Applied to Smoking Cessation

2006-2009: Study Demonstrating the feasibility and short-term efficacy of mōtiv8 as a smoking cessation intervention among rural smokers

Citation:

Stoops, W.W., Dallery, J., Fields, N.M., Nuzzo, P.A., Schoenberg, N.E., Martin, C.A., Casey, B., & Wong, C.J. (2009). An Internet-based abstinence reinforcement smoking cessation intervention in rural smokers. Drug and Alcohol Dependence, 105, 56-62. PMCID: PMC2743786

2006-2008: Study demonstrating preliminary effectiveness of mōtiv8 in adolescent smoking cessation

Citation:

Reynolds, B., Dallery, J., Shroff, P., Patak, M., & Leraas, K. (2008). A web-based contingency management program with adolescent smokers. Journal of Applied Behavior Analysis, 41, 597-601. PMCID: PMC2606598

2005-2007: Study demonstrating mōtiv8 was more effective than the nicotine patch in promoting smoking cessation

Citation:

Glenn, I.M., & Dallery, J. (2007). Effects of Internet-based Voucher Reinforcement and a Transdermal Nicotine Patch on Cigarette Smoking. Journal of Applied Behavior Analysis. 40, 1-13. PMCID: PMC1868814

2005-2007: Study demonstrating mōtiv8’s feasibility and promise of effectiveness in promoting smoking cessation

Citation:

Dallery, J., Glenn, IM, & Raiff, BR. (2007). An Internet-based abstinence reinforcement treatment for cigarette smoking. Drug and Alcohol Dependence, 86, 230-8. PMID: 16930854.

2010-2014: Randomized, controlled trial demonstrating effectiveness of Motiv8 in promoting smoking cessation across the U.S.

Citation for randomized, controlled trial:

Dallery, J., Raiff, B.R., Kim, S.J., Marsch, L.A., Stitzer, M., & Grabinski, M.J. (2016). Nationwide access to an internet-based contingency management intervention to promote smoking cessation: A randomized, controlled trial. Addiction. PMID: 27923264.

2003-2014: Randomized clinical trial showing TES improves addiction treatment outcomes beyond the effects of medication and incentives

Citation for randomized, controlled trial:

Christensen, D.R., Landes, R.D., Jackson, L., Chopra, M.P., Marsch, L.A., Mancino, M. & Bickel, W.K. (2014). The Effects of an Internet-Delivered Therapy When Added to Buprenorphine and Contingency Management in the Treatment of Opioid Dependence Journal of Consulting and Clinical Psychology. PMID:25090043. PMCID:PMC4244262.

2002-2011: Randomized clinical trial showing TES outcomes improves HIV prevention outcomes beyond clinician-delivered care

Citation for randomized, controlled trial:

Marsch, L.A., Grabinski, M.J., Bickel, W.K., Desrosiers, A., Guarino, H., Muehlbach, B., Solhkhah, R., Talfique, S., & Acosta, M. (2011). Computer-Assisted HIV Prevention for Youth with Substance Use Disorders. Substance Use and Misuse, 46, 46-56. PMID: 21190405; PMCID: PMC3091163.

2000

Therapeutic Education System (TES) Developed

Built on the mōtiv8 back-end, TES is composed of over 65 interactive, multimedia modules focused on cognitive behavioral skills training and a broad range of life skills. TES is a self-directed program that includes a module teaching patients how to use the system and a "customization module" to build an individualized treatment plan for patients.

Square2 benefits from insights and experience gained in over 15 years of developing and studying TES.

2000-2008: Randomized clinical trial showing TES with minimal therapist time is as effective as science-based clinician-delivered therapy for addiction treatment

Citation for randomized, controlled trial:

Bickel, W.K., Marsch, L.A., Buchhalter, A., & Badger, G. (2008). Computerized behavior therapy for opioid dependent outpatients: A randomized, controlled trial. Experimental and Clinical Psychopharmacology, 16, 132-143. PMID:18489017; PMCID: PMC2746734.

1998

Mōtiv8 Platform Developed

Mōtiv8 began as a web-based platform to facilitate positive behavior change by delivering customized motivational incentives in response to a user’s objectively measured actions. The techniques employed in mōtiv8 are the basis for Square2’s motivational system.

The ability to collect verified, video-based samples in 2004 lead to its application in changing a range of health behaviors, including smoking cessation utilizing home monitoring of breath carbon monoxide (CO) levels, diabetes management via blood glucose monitoring and promoting increased activity levels among sedentary adults.

In 2008, we embedded a group reward system and social-media communication features bringing to bear powerful social contingencies for promoting and sustaining healthy behaviors.

Who We Are

Meet the team that makes it happen

Dr. Lisa Marsch

Founder & CEO

Michael Grabinski

Founder & CTO

Mohit Jain

Principal Developer

Madison Dickson

Mobile & Web UX/UI
Take your first step.