SmartCAT, an app to help children handle anxiety, is capable of supporting brief cognitive behavioral therapy (BCBT) and could yield positive results over a short period of time, according to a study from the Department of Health Information at the University of Pittsburgh.
Generalized anxiety disorder, social phobia, and separation anxiety disorder are very prevalent in children and can contribute to social and academic problems and the development of depression, the study writes. Around 60 percent of kids who undergo cognitive behavioral therapy do not have an anxiety diagnosis by the end of the treatment, study author Jennifer Silk told MobiHealthNews.
SmartCAT supplements brief therapy, eight or fewer sessions, with a set of cues to remind young people of skills taught in the sessions, an online portal that allows therapists to monitor skill use, a secure message system for therapists to engage youth in real time and a rewards system.The app also houses a video library with clips to teach kids relaxation techniques and deep breathing exercises.
The pilot study is conducted with nine children, aged 9 to 14.
The preliminary pilot was evaluated in two phases. In the first, therapists tested the platform and offered usability feedback. These changes were made to SmartCAT before the second phase, which involved the nine children with anxiety issues. Three patients were given the 16 session cognitive behavioral therapy and the other six took the eight session BCBT. All the patients were given a smartphone after the first session.
Between sessions, patients were reminded to complete the skills coach routine within SmartCAT, which prompted the patients to walk through the steps of coping with anxiety. An alarm function was available so that the skills coach could be postponed if it was an inconvenient time to complete the assessment. The patient could also complete the questions more than once if he or she was feeling anxious, but therapists scheduled alerts for at least once a day between sessions. SmartCAT recorded the time it took for patients to complete the survey. At the next session, the therapist would discuss the data with the patients and patients could redeem a reward for the number of times they completed the skills coach.
After completion of the preliminary pilot, patients rated the app at 1.7 on a scale from 1 to 7, one being easy. The average time it took to complete the skills coach entries was approximately three minutes and the completion rate, measured by the number of skills coach entries completed throughout the program, was 82.8 percent.
Silk said her team will begin to add new features to the app soon.
Two new features include allowing patients to activate GPS so that they could show places where the child gets most anxious, like the bus stop, and adding games.
"We've developed our first game, Thought Buster," Silk said. "It has thoughts that people might think floating across the screen like though bubbles and the kids are instructed to pop the bubbles of thoughts that make them anxious. An example thought would be 'People are going to laugh at me' or 'Somebody's going to get hurt' or 'I'm not going to know how to do this.'"
The game will also have a mode to pop "coping" thought bubbles such as 'I've done this before,' which will help kids turn anxious thoughts into coping thoughts.
The point of the games and the daily skills coach is to allow for "ecological momentary intervention" -- or bringing therapy into daily life. Silk and the other lead author Bambang Parmanto have developed this program specifically for kids and see the potential for the app the be incorporated into other types of mental health therapies.
"There is an education component," Parmanto said. "There are teachable moments. That's the best -- when the patients really need it. Or in this case there is an episode of an anxious moment, that's when the assessment will be more accurate and the intervention will be more appropriate."
