Practical Apps 15: Child & Adolescent Anxiety

author

Dr. Niraj Mistry
Toronto, Ontario

Bio

Niraj is a practicing pediatrician in Toronto. He completed an MD at the University of Toronto and Pediatrics residency at the Hospital for Sick Children (SickKids). During his fellowship in Academic General Pediatrics he completed a Masters in eHealth (Health Informatics) at McMaster University. Niraj is currently a staff pediatrician at SickKids, St. Michael’s Hospital, Toronto Western Hospital and Scarborough Centenary. Niraj is currently focused on the user-centred design, development and implementation of novel technologies to improve the application of the best available evidence at the point of care, to enhance care delivery and optimize the patient and family experience.

Apps Reviewed:

Patient Experiences

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Anxiety Coach by Mayo Clinic

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Editor’s note: Anxiety Coach was reviewed for adult anxiety on December 19, 2017 by Dr. Matthew Cruickshank.

Anxiety Coach is an amazing anxiety self-management app. It is thoughtfully designed based on a review of existing mobile apps for childhood anxiety by clinical psychologist Dr. Stephen Whiteside (Mayo Clinic) [3]. This app has multiple strengths. There is an extensive list of common fears including child and adolescent-specific anxiety (e.g. social, separation and specific phobias) and accompanying exposure hierarchies. The exposure-based CBT treatment approach is consistent with the literature [4]. The app provides detailed step-by-step instructions on how to prepare and conduct each exposure activity in the real world. The Mayo Clinic is a reliable cutting-edge U.S.-based organization. I would highly recommend this app to any patient with anxiety, especially if they are intrinsically motivated to address their anxieties. The only criticism of this app is it is fairly text heavy and could benefit from more multimedia and interactivity. This app is like having a psychologist in your pocket!

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MindShift

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MindShift is an anxiety self-management app developed by the Anxiety Disorders Association of British Columbia (AnxietyBC) and BC Children’s Hospital, both trustworthy sources. It is specifically designed to address everyday anxiety faced by adolescents and young adults (AYA) including worry, test anxiety, social anxiety, performance anxiety, dealing with conflict, panic and perfectionism. MindShift empowers AYA to “face challenging situations and take charge of your life” through anxiety-coping skills — Chill Out Tools — including audio-guided relaxation exercises, visualizations and mindfulness strategies. Users can customize the app to their specific problem areas and preferred anxiety-reducing skills and preventative strategies. Other strengths of this app include privacy as no user data is collected or transmitted, ease of use, visual appeal and free access. The app could benefit from more multimedia content and interactivity. Specifically, there are multiple YouTube videos of adolescents using MindShift accessible from the AnxietyBC website, but not within the app. Compared to Anxiety Coach, MindShift scores slightly lower due to a lack of supporting evidence, but does a better job of appealing to AYA. I would highly recommend his app to any AYA with anxiety.

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thinkFull

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thinkFull is a general stress management app launched by Telus and developed by content partners Canadian Mental Health Association (CMHA) BC Division, teenmentalhealth.org, heretohelp.bc.ca and mindyourmind.ca. While designed specifically for AYA, anyone can use this app to record, track and share his or her daily stressors and levels of stress. The greatest strength of this app is the extensive database of tips for relieving stress, solving problems and living well in general. Users can favourite, upvote or downvote tips with a swipe, enabling the app to learn and customize to each user. Users are incentivized to record their daily stress and complete tips to earn stars. thinkFull is very easy to use, visually pleasing and accessible. It is free. The app is very text-heavy and could greatly benefit from more multimedia content and interactivity. Compared to Anxiety Coach and MindShift, I would recommend thinkFull to any AYA looking to better understand and manage their stress, whether anxiety-related or not.

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Breathe, Think, Do with Sesame By Sesame Street

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Breathe, Think, Do is an app developed by Sesame Workshop, the non-profit educational organization behind Sesame Street that aims to use the educational power of media to help children everywhere reach their highest potential. This app is very engaging as children help a familiar blue monster, Mondo, sequentially work through everyday frustrations like struggling putting on shoes, saying goodbye to mommy, stacking blocks, waiting in line or being afraid of the dark. Strengths of this app include directly appealing to young children using familiar characters in animations and interactions. There is excellent re-iteration and deliberate practice opportunities of a single concept. Other strengths include a parent’s section with more tips to help kids develop resilience and privacy as no personal information is collected. The app is perhaps too narrow in only offering one strategy to help calm the child, and some of the animations and activities may be too long to hold a child’s attention. I would recommend this app to parents of young children having difficulty with one of the addressed examples.

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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. Bernstein, Gail A. and Kailie Shaw. “Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders.” Journal of the American Academy of Child & Adolescent Psychiatry 36.10 (1997): 69S-84S.
3. Whiteside, Stephen PH. “Mobile device-based applications for childhood anxiety disorders.” Journal of child and adolescent psychopharmacology 26.3 (2016): 246-251.
4. James, A. A. C. J., Angela Soler and R. Weatherall. “Cognitive behavioural therapy for anxiety disorders in children and adolescents.” Cochrane database of systematic reviews 4 (2005).
5. Whiteside, Stephen PH, et al. “Case examples of enhancing pediatric OCD treatment with a smartphone application.” Clinical Case Studies 13.1 (2014): 80-94.
6. ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). 2014 Jul 29. Identifier NCT02205177, Youth Mayo Clinic Anxiety Coach Pilot Study; 2017 Apr 4 [cited 2017 Aug 19];. Available from: http://clinicaltrials.gov/ct/show/NCT02205177

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