I bet there’s an app for that: Using mental health apps to manage anxiety and depression

The interventions for this research consist of five mental health apps: 1. Destressify 2. MoodMission 3. Smiling Mind 4. MindShift 5. SuperBetter All apps are freely available on the Apple App Store (for iOS devices) and Google Play (for Android devices). All participants will receive the same general instructions for using the app, no matter which app they have been assigned to: "We would like you to use this app for at least 10 mins per day, 5 days p.w. for at least 10 wks. (We will tell you when the “official” use period has finished, but you will be able to keep using the app after this time if you want to.) If you want to use it for longer than 10 mins per day and more than 5 days p.w., this is OK – it’s up to you. As long as you’re using it for at least 10 mins per day, 5 days p.w. After participants are randomised into an app group, they will be given specific information about the app, including download instructions. All apps have websites with further information and evidence for their effectiveness published in peer-reviewed journals as follows: 1. Destressify: Lee, R. A., & Jung, M. E. (2018). https://www.destressify.com/ Summary of instructions given to participants: Destressify was developed in the United States and is based on a technique called mindfulness, with a focus on reducing stress. When you first open Destressify, there is the option of watching a 12-minute video about “what is stress?”. It is not essential that you watch this. If you want to skip this video, tap on the “Get Started” button. You will need to create an account by providing an e-mail address, password, and other information. Follow the instructions to do this. If you’re concerned about your data, read the privacy policy at https://www.destressify.com/privacy/ . When you have finished creating your profile, you are given the option to either “View My Plan” or “View Practices”. The View My Plan option opens the core plan of mindfulness exercises that have already been selected for you. The View Practices option allows you to create your own plan. We recommend choosing the core plan and following their suggestions. After tapping on View My Plan, you can immediately begin your first mindfulness activity. In the Menu, tap on the button “Practices” to read information on the different types of activities available in the app. 2. MoodMission: Bakker, D., Kazantzis, N., Rickwood, D., & Rikkard, N. (2018). http://moodmission.com/ Summary of instructions given to participants: MoodMission was developed in Australia by a team of psychologists and mental health researchers at Monash University, and uses a technique called cognitive-behaviour therapy (CBT). You will need to create an account by providing an e-mail address and password. Follow the instructions when you open the app for the first time after downloading it, and take the time to answer the questionnaire – it helps the app choose appropriate activities for you. If you’re concerned about your data, read the privacy policy at http://moodmission.com/privacy. MoodMission works by asking you questions about how you are feeling, and suggests all types of activities in response to how you answer the questions. MoodMission does not make you do just one thing, but always provides different options. If you do not like any of the listed options, you have the opportunity to ask MoodMission to suggest others. At the bottom right of screen is the “Expeditions” button. Tap on this to find suggested programs for overcoming specific fears e.g. fear of public speaking, fear of flying etc. 3. Smiling Mind: Flett, J. A. M., Hayne, H., Riordan, B. C., Thompson, L. M., & Conner, T. S. (2018). https://www.smilingmind.com.au/ Summary of instructions given to participants: Smiling Mind was developed in Australia by mental health and meditation experts and is based on a technique called mindfulness, with a meditation focus. You will need to create an account by providing an e-mail address and password. Follow the instructions when you open the app for the first time after downloading it. If you’re concerned about your data, read the privacy policy at https://www.smilingmind.com.au/privacy-policy . After you have created an account, tap on the “All Programs” tab at the top right of screen. This will give you a list of all the programs available within the app. We recommend that you use the “Adult Programs” to start with because this consists of the greatest variety of activities. Once in “Adult Programs”, feel free to scroll down the page and start using any of the programs by tapping on it. (Our recommendation is to start at the top first, and then work your way down through the programs.) 4. MindShift: Paul, A. M., & Fleming, C. J. E. (2019). https://anxietycanada.com/resources/mindshift-cbt/ Summary of instructions given to participants: MindShift was developed in Canada by a not-for-profit mental health support organisation and uses a technique called cognitive-behaviour therapy (CBT). Although its focus is anxiety, the techniques can be applied to depression as well. You will need to create an account by providing an e-mail address, password, and other information. If you’re concerned about your data, read the privacy policy at: https://anxietycanada.com/mindshift-cbt-privacy-policy/ . After you have created an account, the app opens to its home screen. The Home screen allows you to choose how you are feeling today, and what type of anxiety you suffer from. Tapping on a type of anxiety takes you to information about that type of worry. When you scroll down the anxiety screen, the app allows you to select categories within that type of anxiety which lists some of the more common unhelpful thoughts associated with it. We recommend that you start by scrolling down the home page until you come to “Tools”. Tap on the button, “Healthy Thinking”, then tap on “Thought Journal”, and then tap on “Add New +”. This will get you started using one of the main functions of the app: coming up with more helpful thoughts when you are feeling anxious and/or depressed due to thinking negatively. 5. SuperBetter: Roepke, A. M., Jaffee, S. R., Riffle, O. M., McGonigal, J., Broome, R., & Maxwell, B. (2015). https://www.superbetter.com/ Summary of instructions given to participants: SuperBetter was developed in the United States by game designer Jane McGonigal and researchers at Stanford University and the University of Pennsylvania. It uses techniques from positive psychology and neuroscience (neuroplasticity). You will need to create an account by providing an e-mail address and password. Follow the instructions when you open the app for the first time after downloading it, and take the time to answer the questions – it helps the app choose appropriate activities for you. If you’re concerned about your data, read the privacy policy at https://www.superbetter.com/terms. A good place to start with SuperBetter is to tap on the “More” button at the bottom right of screen, then tap on “FAQ”, and read the entire FAQ section. It provides an excellent background to how SuperBetter works and will get you ready to start “playing” immediately. SuperBetter uses the idea of playing a video game and works by getting you to complete “quests”. Quests are activities designed to get you closer to achieving your specific goals. “Power-ups” are smaller activities designed to make you feel better and improve your mood quickly. After you have read the FAQ section, we recommend that you tap on the “SB To do” button at the bottom centre of screen, then tap the “Do 3 Quests” banner, then tap the “Hero, Start Here!” button. * Daily SUDS ratings provided by participants will be monitored by the lead researcher who is an experienced clinical psychologist. If low ratings indicate a risk of harm, the researcher will contact the participant. If a participant provides no rating for 7 days, the researcher will attempt to contact the participant. * As is normal in this type of research, the pre-intervention phase is designed to establish a baseline set of readings for the participant. The 3-week post-intervention phase is to allow readings of participants' distress levels following the official intervention period in order to determine if there are increases in distress or if intervention readings are maintained. This is also to allow the statistical procedure of time-series analysis. The final 6-month period does not require the participants to do anything.