None listed
Conditions
Brief summary
Previous research has focused on guided self-help programs (GSH) - those that include scheduled contact with a mental health professional - or internet-based programs that differ from the 'app' platform in two ways. Firstly, with regard to GSH, 'app' based programs provide no additional contact point for users, and secondly internet-based programs were not readily convenient to users as access is restricted to a personal computer, whereas 'apps' can be used anywhere at the individual's convenience on their mobile phones. Additionally, the focus of past research has been on depression or anxiety in conjunction with another disorder such as panic disorder, which has lesser incidence compared to social anxiety. Therefore, the proposed study will focus on specifically on Social Anxiety Disorder (SAD) due to its higher prevalence and because of the nature of the disorder the lower likelihood of people with the disorder seeking professional treatment. The very nature of SAD makes it highly unlikely people will seek professional help as the treatment environment embodies the social situations they fear and research has shown that the majority of people who meet the diagnostic criteria for SAD fail to seek treatment or delay seeking treatment. This is where 'app' self-help programs become relevant as they provide a less stressful treatment option. During tertiary studies is a very stressful period for young adults. During this time, students are given new freedoms and exposed to things such as illicit substances and the responsibilities that come with becoming an adult. The current generation of university students have been exposed to technology in way never before seen, which has changed the way simple acts such as socialising are experienced. The nature of SAD means that people are likely to turn to alternate forms of communication where they feel less anxiety, such as the internet or mobile devices (Gary, 2008). The increased ownership and use of mobile devices and internet services has provided the current generation with unparalleled access to new forms of communication (ABS, 2015). This trend has decreased the need for face to face conversation and, therefore, also decreased the opportunity for young adults to develop social skills. Taking this into consideration it could be that the current generation of tertiary students may be experiencing higher levels of SAD as they encounter social situations they do not have the skills to cope with and learn. Primary Objective: To demonstrate the efficacy of a mobile based Cognitive Behavioural Therapy mobile ‘app’ versus a control group, as treatment for Social Anxiety Disorder. Secondary Objective: To demonstrate the efficacy of a mobile based Acceptance and Commitment Therapy ‘app’ as treatment for Social Anxiety Disorder.
Interventions
Participants will be randomly allocated to either a control group or one of two experimental groups: the SAM or “What’s Up” mobile phone app group and instructed to use it according to a strict schedule provided to them.
What’s Up
App containing Acceptance and Commitment (ACT) mindfulness based therapies. Contains instruction metaphorical thinking, thinking patterns and management of worries. Also contains a set of ‘emergency’ techniques for anxiety/panic management which are breathing and musc
Participants will be randomly allocated to either a control group or one of two experimental groups: the SAM or “What’s Up” mobile phone app group and instructed to use it according to a strict schedule provided to them. What’s Up App containing Acceptance and Commitment (ACT) mindfulness based therapies. Contains instruction metaphorical thinking, thinking patterns and management of worries. Also contains a set of ‘emergency’ techniques for anxiety/panic management which are breathing and muscle relaxation techniques. Each section contains a brief description of the intended strategies, followed by explicit instruction for each one. Designed and uploaded to the Apple and Google Play stores by Jackson Tempra. There is no additional information available on Mr. Tempra, the app information weblink leads to a Facebook page with information concerning app updates, but no development information or evidence. (https://www.facebook.com/whatsupsapp/). Apps will be used via a touch screen mobile device such as a tablet or mobile smart phone owned by participants. SAM App containing Cognitive Behavioural Therapy (CBT) based therapies. Contains instruction on physical and mental relaxation, as well as an anxiety tracker function, records of situations stimuli that cause anxiousness - to be completed by users and finally a set of breathing and muscle relaxation techniques to be used in an ‘emergency’ anxiety situation. Each activity includes a predicted amount of time for completion and the ‘level’ of difficulty developers consider that activity to be. Designed and uploaded by the University of West England. There is a weblink provided in the app that leads to a website containing basic information such as download links, contact details and key features. (http://sam-app.org.uk). Apps will be used via a touch screen mobile device such as a tablet or mobile smart phone owned by participants. CONTROL GROUP Will not receive any app and will only be required to refrain from beginning to use a self-help app of their own accord or begin psychological treatment during this period. Treatment Period: 4 weeks. Regimen: SAM group - 2 hours of app use weekly, for a period of 4 weeks. Week 1 - Relaxation Physical: Calm breathing - 5 minute duration. Muscle relaxation (tense and relax exercise) - 10 minutes. Progressive muscle relaxation - 1-5 minutes. Ground Yourself 1 - touching your environment and objects in order to take control of anxiety) - 5-10 minutes. Ground Yourself 2 (associating body movement with relaxed memories) - 1-5 minutes. Week 2 - Relaxation Mental: The worry half-hour (set aside time to deal with worries and anxiety however you see fit) - 30 minutes. Picture peace (select picture from provided gallery and uncover it by rubbing across screen. Can be done multiple times) - 1-5 minutes. It’s only a thought (add worrying thoughts to app and then float them away with a button) - 1-5 minutes. A worry shared (talk to someone about anxiety) - 1-5 minutes. Simple meditation - 20 minutes. Stop that thought (add worry to app and then tap it to make it explode) - 1 minute. Week 3 - Combined Relaxation Physical and Mental strategies: Participants can pick any of the activities in any combination and perform them for the 2 hour period that week. Week 4 - Combined Relaxation Physical and Mental strategies: Participants can pick any of the activities in any combination and perform them for the 2 hour period that week. Activities are determined by what section of the app is allocated to participants each week. Further than that, participants will be able to choose which ever activity suits their needs and schedule the best as they vary on duration and level of practice required. What’s Up group - 2 hours of app use weekly, for a period of 4 weeks. Week 1 - Thinking Patterns: List of maladaptive thought patterns common to anxiety disorders allowing participants to identify which patterns are relevant to each participant and a positive alternative way of thinking. E.g. Catastrophising - imagining the worst that could happen, recognising that it’s not helpful and asking yourself what is most likely to happen. Week 2 - Metaphors: List of strategies focused on providing alternate ways of viewing negative thoughts. E.g. Passenger on the bus (imagine you are a bus driver and the noisy passengers are negative thoughts, you allow them to keep shouting but continue on anyway). Week 3 - Manage Worries: List of strategies for managing worries when they begin to interfere with life activities such as sleeping. E.g. Repeat your worry until you are bored silly, set aside worry time. Week 4 - Manage Worries: Same as week 3, participants will continue on with the activities they found helpful or try new ones as they see fit. Participants will be given an app use diary, but ultimately it will be left to the individual to monitor and record their own use. The diary is an excel spreadsheet that will be returned to the Senior Supervisor at the conclusion of the treatment phase. Control group will not be provided with any monitoring documents.
Sponsors
RMIT University, School of Health and Biomedical Sciences
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Written, informed consent obtained. Men and women over 18 years of age. Currently enrolled student at RMIT university. Score of 20+ on Brief Social Phobia Scale.
Exclusion criteria
Score of 4+ on the Simple Screening Instrument - Substance Abuse. Previous experience with CBT, ACT or mindfulness therapy. Currently undergoing CBT/ACT/Mindfulness therapy.
Outcome results
None listed