JMIR Publications

ABSTRACT

Background:

The use of mobile mental health apps to treat anxiety and depression is widespread and growing. Several reviews have found that most of these apps do not have published evidence for their effectiveness and the research on those that does exist has primarily been undertaken by individuals and institutions with an association to the app being tested. Another reason for the lack of research is that the execution of the traditional randomized controlled trial (RCT) is time-prohibitive in this profit-driven, fast-moving industry. As a result, there have been calls for different methodologies to be considered. One such methodology is the single-case design, of which no peer-reviewed published example with mental health apps for anxiety and/or depression could be located.

Objective:

The aim of this study is to examine the effectiveness of five apps (Destressify, MoodMission, Smiling Mind, MindShift, and SuperBetter) in reducing symptoms of anxiety and/or depression. These apps were selected because they are publicly available, free to download, and have published evidence of efficacy. This, therefore, allows the opportunity to replicate past findings using a different methodology in order to broaden the empirical base.

Methods:

A multiple baseline across-individuals design will be employed. Twenty-five participants will be recruited (five for each app) and will provide baseline data for at least three weeks. The sequential introduction of an intervention phase will commence once baseline readings have indicated stability in the measures of participants’ mental health and will proceed for ten weeks for each participant. Post-intervention measurements will continue for at least a further three weeks. Participants will be required to provide daily SUDS ratings via reply SMS text message and will complete other measures at five different time points throughout the research, including at six-months follow-up. Participants will also rate their app on several domains at the conclusion of the intervention phase.

Results:

Participant recruitment will commence in November 2019. The post-intervention phase will be completed by May 2020. Data analysis will commence after this. Write-up for publication is expected to be completed after the follow-up phase is finalized in November 2020.

Conclusions:

If the apps prove to be effective as hypothesized, this will be collateral evidence of their efficacy. Expected wider impacts could include: improved access to mental health services for people in rural areas, lower socioeconomic groups, and the child and adolescent age-range; and, the capacity to enhance face-to-face therapy through digital homework tasks that can be shared instantly with a therapist. It is also anticipated that in the future this methodology will be used for other mental health apps, including in larger RCTs, to bolster the independent evidence base for this mode of treatment. Clinical Trial: Australian and New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12619001302145p, http://www.ANZCTR.org.au/ACTRN12619001302145p.aspx