Previously submitted to: JMIR Mental Health (no longer under consideration since Jun 19, 2023)
Date Submitted: Jun 11, 2023
Open Peer Review Period: Jun 11, 2023 - Jun 26, 2023
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Effectiveness of smartphone app-based anxiety therapy in Williams Beuren syndrome: a single-case, multiple-baseline study
ABSTRACT
Background:
Williams syndrome (WS-OMIM 194050; Orpha 904) is a rare condition mostly associated with intellectual disability. People with Williams syndrome are eight times more likely to have anxiety disorders than the general population. Therapeutic solutions to treat the anxiety remain limited, particularly concerning non-pharmacological therapy. However, cognitive behavioural therapy (CBT) has been found efficacious in managing anxiety disorders and can be used for people with intellectual disability.
Objective:
This study assessed the efficiency of a CBT program based on a smartphone app for people with Williams syndrome and anxiety.
Methods:
We used a single-case experimental design with multiple baselines implying repeated measures of judgement criteria. Five adults with Williams syndrome and anxiety underwent nine CBT sessions. Participants performed daily self-assessments of anxiety by using a smartphone app that allowed for ecological and repeated evaluation of the anxiety. Anxiety and quality of life were externally assessed before and after the program. Participants were assessed during a 3-month follow-up.
Results:
We found a significant reduction in anxiety for all participants between the start and end of therapy as well as between the start of therapy and the 3-month post-therapy follow-up. Quality of life was improved but without reaching statistical significance. We also found an impact on other anxiety-related elements. Participants who were accompanied by a loved one at each session more regularly performed their daily self-assessments using the smartphone app than did others.
Conclusions:
This is the first study to highlight the benefits of a smartphone-based CBT protocol for anxiety in patients with Williams syndrome, using a protocol adapted to small sample sizes. It underscores the value of psychotherapeutic management with smartphone support, allowing for adapting tools for patients with intellectual disabilities. Clinical Trial: ClinicalTrials.gov ID: NCT03827525; https://clinicaltrials.gov/ct2/show/NCT03827525
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