Therapies are constantly advancing, spurred on not only by new enabling technology but also sadly by increasing need. Two weeks ago, a paper entitled “Clinical Efficacy and Psychological Mechanisms of App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Control Trial,” was published showing for the first time that digitally delivered mindfulness can be effective for treatment of anxiety.
Anxiety, already the most common mental illness, has increased during the COVID-19 pandemic. Traditional treatment for anxiety involves psychotherapy and medications. Most patients and physicians prefer to avoid medications due to known side-effects, delayed responses, and lack of efficacy. Psychotherapy is effective but labor intensive, potentially costly, and limited in access due to a finite number of therapists.
In the past, cognitive behavioral therapy (CBT) has been the most common effective intervention. This form of therapy requires one-on-one personal interaction. The growing shortage of therapists, combined with increasing need due to COVID and other stresses in modern society, motivated Dr. Judson Brewer of Brown University and his team to try to prove digital intervention is effective in allaying anxiety.
Before describing the experiment, a bit of background on mindfulness is shared in the article:
“Mindfulness can be defined as the awareness that arises when paying attention to the present moment. The attitudinal quality of not judging and allowing experience to unfold with curiosity targets maladaptive reinforcement learning by helping individuals to simply observe repetitive cycles of perseverative worry rather than to habitually react and reinforce them. Mindfulness training has been found to mechanistically break key links in the reinforcement pathway for other habitual behaviors such as smoking and emotional eating, with concomitant changes in related brain regions predicting clinical outcomes.”
While this mindfulness training is effective, increasing the scale of available interventions by developing a computer-based application required testing. Namely, could an “app” engage a patient and deliver mindfulness training?
Good news followed: Anxious people were identified by a screening questionnaire and subsequently divided randomly into two groups—receiving traditional face-to-face therapy or using the “app.” Both groups were assessed periodically with validated questionnaires employed in academic studies. Biases were removed, statistics substantiated, safety issues addressed, and then conclusions confirmed.
App-based therapy is effective in decreasing anxiety by employing mindfulness therapy. After two months of use by the test group, anxiety decreased 67%. App-based models for other conditions are the next opportunity to increase access for people with common mental health problems. Standard face-to-face interaction and medications will still be available when needed, but useful self-help will probably become first line therapy.