Accepted for/Published in: JMIR Formative Research
Date Submitted: May 2, 2022
Date Accepted: Sep 29, 2022
Brief app-based cognitive behavioural therapy for anxiety symptoms in psychiatric inpatients: a feasibility randomized control trial
ABSTRACT
Background:
Psychiatric inpatients have limited access to interventions or skills for managing anxiety symptoms. COVID-19-related restrictions further limited access to therapy groups on inpatient psychiatric units. App-based interventions may improve access, but evidence supporting the feasibility of their use, acceptability and effectiveness in psychiatric inpatient settings is limited.
Objective:
We conducted a randomized, controlled, mixed methods trial in an acute psychiatric inpatient setting to assess the feasibility and acceptability of Mindshift CBT, a free smartphone-based app designed to address anxiety symptoms.
Methods:
We recruited inpatients and randomized them to two conditions: treatment as usual (TAU) plus the Mindshift CBT app vs. TAU alone for 6 days, collecting quantitative data through pre and post surveys and qualitative data through individual semi-structured interviews conducted by our team of peer and clinical researchers.
Results:
Over a period of 4 weeks, 33 inpatients were referred to the study, 24 consented to participate, 20 were randomized, and 11 completed the study. Of the 9 randomized participants who did not complete the study, 2 withdrew and 7 were withdrawn because they were discharged or transferred prior to study completion (with a similar distribution among those randomized to the two conditions). Themes emerging from qualitative interviews included the acceptability and usability of the app for inpatient settings.
Conclusions:
Our results support the feasibility and acceptability of using Mindshift CBT on a psychiatric inpatient unit, with some caveats related to our design. Inpatients felt empowered by being included in a research study run collaboratively by peer and clinician researchers. Further study is needed to determine efficacy in comparison to existing standards of care. Clinical Trial: ClinicalTrials.gov, NCT04841603, www.clinicaltrials.gov
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