Practical Apps 14: Anxiety in Adults

author

Dr. Matthew Cruickshank
Toronto, Ontario

Bio

Dr. Matthew Cruickshank is a practicing family physician in Toronto. He holds an undergraduate degree in Computer Engineering from Queen’s University where he developed skills in the development and implementation of technology products and an understanding of how they can enhance traditional systems. He studied medicine at University of Western Ontario and completed his residency at University of Toronto. During his medical education he developed an interest in practice optimization with novel uses of technology. Matthew is currently practicing family medicine at a community-based family practice in Toronto that has a focus on technology integration in family practice to optimize the patient and physician experience.

Apps Reviewed:

Patient Experiences

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Pacifica

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Pacifica was created with the goal of bringing well-proven therapies for stress, anxiety and depression to individuals who are not able to access traditional therapy because of barriers such as cost and stigma. One of the founders has suffered with anxiety himself and has experienced firsthand improvement with effective treatment. The Pacifica team has a clinical psychologist on staff and a scientific advisory board to help ensure the app is driven by evidence-based treatments. The app includes CBT tools as well as mindfulness and wellness tools in a well-planned and well-organized way to help users treat their anxiety disorders. The app encourages users to set goals and work to accomplish them, but otherwise it does not offer more involved exposure therapy tools. Pacifica could be a great app for most individuals with anxiety disorders who are willing to take the time to engage with the app.

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Headspace

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Headspace is a guided meditation app created by Andy Puddicombe, an ordained Buddhist monk. Andy Puddicombe created the platform with the goal of teaching meditation and mindfulness to as many people as possible because he believes they will help improve the health and happiness of the world. The app has millions of users so it may in fact be helping with this ambitious goal. The app is a comprehensive and media-rich approach to guided meditation and is perfect for both introducing meditation to users not previously familiar with the practice and for users with previous mindfulness experience who are looking to deepen their skills. Although this app probably could not be used as a standalone treatment for most individuals with an anxiety disorder, it is a great tool to supplement other treatments.

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AnxietyCoach

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AnxietyCoach was developed by Dr. Stephen Whiteside and Dr Jonathan Abramowitz, both clinical psychologists with expertise in anxiety treatment. The focus of the app is providing users with an interface for self-guided exposure therapy. It does this by helping users create ‘To Do Lists’ of exposures and then helps to step them through their list. Once an exposure is started it continues until a reduction in anxiety takes place. Once an item on the list has been completed a user is then ready to move onto the next item on their list, gradually proceeding to more intensive exposures. The efficacy of exposure therapy, a form of CBT, has been well established in helping to reduce inappropriate anxiety responses [3]. The app has the potential to benefit users but it is not clear how willing individuals with significant anxiety would be to undertake exposure therapy with this app alone as their guide. The app would benefit from a formal evaluation of its effectiveness. It has a dated appearance with text formatting issues and is overdue for an update. It would also benefit from a multi-media approach to help engage users. This app could be useful to individuals who are proceeding with exposure therapy with a therapist who are looking for a way to help track their progress. It may also be useful to individuals wanting to try exposure therapy on their own.

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Companion

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Companion is an app created by a psychologist and by someone who had previously benefited from cognitive behaviour therapy for anxiety. The app was created to give users mobile tools to help manage their anxiety whenever it is needed the most. The app offers a basic thought-reframing tool based on cognitive behaviour therapy principles. The tool is designed to help users recognize their negative thoughts and reframe them in a more positive way. The app offers a few relaxation tools including two audio-guided meditations. It offers a learning section with text based overview of anxiety and treatment options for it. The app is limited in the scope of its tools and only scratches the surface of cognitive behaviour therapy. The app may be useful as a companion for individuals undertaking more formalized cognitive behaviour therapy or for individuals with mild anxiety disorders. It would not be suitable as a stand-alone tool for individuals with moderate to severe anxiety disorders.

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References:

  1. Katzman, Martin A., et al. “Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders.” BMC psychiatry 14.1 (2014): S1.
  2. Sareen, Jitender, et al. “Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.” Archives of internal medicine 166.19 (2006): 2109-2116.
  3. Kaczkurkin, Antonia N., and Edna B. Foa. “Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.” Dialogues in clinical neuroscience 17.3 (2015): 337.
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