Anti-Anxiety Apps Adapting Evidence-Based Psychotherapies

5 Anti-Anxiety Apps that Might Put Relief in the Palm of Your Hand

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Traditional self-help resources to help people with anxiety have included resources such as published books, and then online materials. The most useful of these resources are arguably those that (1) can bring evidence-based treatments to individuals who do not have access to specialized care, (2) can be used in conjunction with ongoing treatment, or (3) can promote continued progress after the conclusion of a course of psychotherapy.

With the advent of smartphone technology and the rising popularity of interactive apps, there are more self-help options than ever before. Apps that may be appropriate for an individual with generalized anxiety disorder (GAD) or subclinical anxiety fall into one of two categories.

The first set of apps target anxiety symptoms by providing easy access to relaxation, meditation and mindfulness exercises. The second set of apps, which are reviewed in this post, are closely allied with popular empirically supported psychotherapies. These programs target core cognitive symptoms of GAD – uncontrollable worry, distorted negative thoughts, for example – as well as associated physical symptoms. They typically have self-monitoring capacity as well.

The following list of apps reflects some of the more popular available options for programs based upon evidence-based approaches. Note that this list is not comprehensive, inclusion does not imply endorsement, and none of the options described below are advised as a stand-alone treatment for moderate to severe anxiety.

If your anxiety persists or worsens while using these programs, seek consultation with a medical and/or mental health professional.

1. Worry Watch

Platform: iPhone, iPad

Cost: $1.99 per individual, $1.99 for families, $0.99 for educational institutions

What it offers: This application allows individuals to document their worry, track real outcomes, and rate whether the worry was as bad as what happened.

Other features include the ability to: identify the worry domain (e.g., health, social, financial), monitor emotional and behavioral responses to the outcome, track worry trends graphically over time (including the intensity of particular cognitive distortions). Information can be put into the app even when offline. This program is targeted for people with chronic worry and GAD. It is a good compliment to traditional cognitive behavioral therapy (CBT).

2. Mindshift

Platform: iPhone, Android

Cost: free

What it offers: This app is specifically targeted for adolescents and young adults with a range of anxiety problems – GAD, social anxiety, panic attacks, performance anxiety, and specific phobias. As GAD is among the most commonly experienced psychiatric problems in youngsters, and many young people understand how important mental health is to overall wellbeing, this program that aims to provide basic skills and enhance insight about symptoms is potentially appropriate for many individuals. Information provided is consistent with a CBT treatment approach.

The app includes lists of coping strategies for different types of anxiety, and users can mark the methods that work for them for easy, future access. Information is conveyed using simple, clear language. Important concepts are displayed in catchy way. For example, the “Chill Out” category includes text and audio options for breathing exercises, mindfulness meditations, and mental imagery. Of note, this app does not offer tracking features.

3. ACT Coach

Platform: iPhone, Android

Cost: free

What it offers: ACT Coach serves as a companion tool for individuals in treatment using an Acceptance and Commitment Therapy (ACT) approach. The app guides users on core concepts of the treatment: identification of core values, commitment to action based on values, useful coping strategies for unpleasant thoughts and emotional states, and willingness to practice.  Mindfulness exercise materials include audio-guided sessions as well as instructions for self-guided sessions. It offers a tracking function for “ACT Moments” so that users can review how well they are handling painful moods and emotions.

4. Pacifica

Platform: iPhone, Android, Web

Cost: free

What it offers: This app is appropriate for adults and teens with anxiety and mood disorders. It introduces core CBT concepts – such as biased thought patterns and how to challenge them – and teaches deep breathing, progressive muscle relaxation, and mindfulness meditation. Users can track (and chart) mood, anxiety, and health habits that might have an impact on these (such as exercise, alcohol intake, eating behavior, sleep patterns, etc.). The app also encourages users to think and measure “small,” daily goals; this effectively encourages problem-solving.

5. CBT-i Coach

Platform: iPhone, Android

Cost: free

What it offers: This app is well suited for individuals who are experiencing a significant disruption in sleep due to anxiety. Intended for people in CBT treatment for insomnia, or those who have experienced sleep problems and would like to improve their sleep hygiene, the program teaches users (1) basic education about sleep, (2) features of a healthy sleep routine and environment, (3) how to use a sleep diary to record patterns and track symptom changes. It includes different exercises for quieting an anxious mind, and allows users to set reminder messages or set up alarms to help modify sleep habits.

[CBT-i Coach was developed in collaboration with VA’s National Center for PTSD, Stanford School of Medicine, and DoD’s National Center for Telehealth and Technology. Its content is is based on the therapy manual, Cognitive Behavioral Therapy for Insomnia in Veterans, by Rachel Manber, Ph.D., Leah Friedman, Ph.D., Colleen Carney, Ph.D., Jack Edinger, Ph.D., Dana Epstein, Ph.D., Patricia Haynes, Ph.D., Wilfred Pigeon, Ph.D. and Allison Siebern, Ph.D.]

Picking the Right App for You

The rate at which new apps are being created is astonishing, and the appropriateness for a given problem can vary widely. It is very important to be an educated consumer, especially when it comes to apps that purport to align themselves with evidence-based treatment approaches. Look for apps that have been created by or reviewed by reputable organizations, such as the U.S. Department of Defense’s National Center for Tele-health and Technology and the Anxiety and Depression Association for America.

Remember that an app cannot replace face-to-face treatment. And if you are currently in treatment, ask your provider for apps that they recommend for you, knowing your particular symptoms and circumstances.

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