AnxietyZAINAB ALIDINA, SHAUNA AYRES,

LAURIE HURSTING, ANNE SCHMIDT, & LINDA YANG

“Cognitive Behavior Therapy via the Internet: a systematic review of applications, clinical efficacy and cost–effectiveness”

Main objective: to determine the applications, clinical efficacy, and cost-effectiveness of Internet-based Cognitive Behavior Therapy

108 articles reviewed103 clinical efficacy studies8 cost-effectiveness studies

APPLICATIONSDepression and Anxiety (used with 25 disorders)

CLINICAL EFFICACYLarge effects sizes At least as good as traditional CBT

COST EFFECTIVENESSYes, as compared to wait lists and/or no treatment

Hedman, E., Ljótsson, B., & Lindefors, N. (2012). Expert review of pharmacoeconomics & outcomes research, 12(6), 745-764.

“Smartphones for Smarter Delivery of Mental Health Programs: A Systematic Review”

Main objective: to systematically review the efficacy of mental health apps for mobile devices (such as smartphones and tablets) for all ages

4997 abstracts examined8 papers (5 apps) met inclusion

criteria 4 apps provided support from a

mental health professional

APPLICATIONSDepression (3)Anxiety (3)Substance use (1)

RESULTSSignificant reduction in depression, anxiety, substance useLarge effect sizes

Donker, T., Petrie, K., Proudfoot, J., Clarke, J., Birch, M. R., & Christensen, H. (2013). Journal of medical Internet research, 15(11), e247.

Limitations (generally)

Technical problems

Limited, low-quality studies

Outdated technology by end of study

Isolate one disorder or componenet at a time

SamApp

1. Working with SAM2. Help for anxiety NOW3. How’s my anxiety right now? 4. Self-help with SAM5. Things that make me anxious6. My Anxiety Toolkit7. Anxiety Tracker8. Social Cloud

SamApp

ProsCan set reminders for “Things that make me anxious”

Self-help section provides exercises that range in activity type

Can save favorite exercises to a personal tool-kit for quick access

ConsMust register for social cloud from within the app

Some external links are broken

Many tabs that are not self-explanatory

No prompts to use

Koko

Started at the MIT Media Lab as a web-based version that was evaluated in a RCT

Anonymous crowdsourcing

Based in cognitive behavioral therapy

KoKo

ProsSimple to use

Reading and re-thinking others’ problems helps provide perspective

Anonymous postings

Community suggestions can be upvoted or flagged

Provides positive feeling in knowing that you’re helping others

ConsNo prompts to use; easy to forget

The name

What’s Up

Start up tutorial

1. Help Right Now2. Coping Strategies3. Information4. Personal

What’s Up

ProsHas a help right now feature

Tracking ability of anxiety level

Many self-help tools and educational information

Get grounded games are quite fun

Can set a password

ConsNo easy opt out mid-game

Lots of text

No prompts to use the app

Difficult to navigate

No feedback

KOKO-Solely positive reappraisal, monitored

-w/o Registration only info

-Registration for posting-Anonymous social forum

-Self-reflection focus-Evidence/Practice based

-Guided tutorial

WHAT’S UP-Education based-Mood tracker

-Exercises

-PersonalToolkit

SAMAPP

Compare Contrast

And the Winner is…

Simplicity

Different options

Low health literacy level required

Intensity of self-help 12 3

Recommendations for Future Mental Health Apps

Comprehensive: self-monitoring social forum education exercises

Text messaging prompts (instead of push notifications)

Aesthetically pleasing (non-clinical)

SimplicityTutorials