Examining young adults daily perspectives on usage of anxiety apps: A user study

Abstract

The growing number of mental health smartphone applications has led to increased interest in how these tools might support users in different models of care. However, research on the use of these interventions in real-world settings has been scarce. It is important to understand how apps are used in a deployment setting, especially among populations where such tools might add value to current models of care. The objective of this study is to explore the daily use of commercially-available mobile apps for anxiety that integrate CBT, with a focus on understanding reasons for and barriers for app use and engagement. This study recruited 17 young adults (age M = 24.17 years) while on a waiting list to receive therapy in a Student Counselling Service. Participants were asked to select up to two of a list of three selected apps (Wysa, Woebot, and Sanvello) and instructed to use the apps for two weeks. Apps were selected because they used techniques from cognitive behavioral therapy, and offer diverse functionality for anxiety management. Qualitative and quantitative data were gathered through daily questionnaires to capture participants’ experiences with the mobile apps. In addition, eleven semi-structured interviews were conducted at the end of the study. We used descriptive statistics to analyze participants’ interaction with different app features and used a general inductive approach to analyze the collected qualitative data. The results highlight that users form opinions about the apps during the first days of app use. A number of barriers to sustained use are identified including cost-related issues, inadequate content to support long-term use, and a lack of customization options for different app functions. The app features used differ among participants with self-monitoring and treatment elements being the most used features. Author summary In recent years, there has been an increased need for mental health services among students on college campuses. Several mobile applications have been developed to support mental health and expand treatment delivery methods to increase the reach of mental health care. Anxiety disorders are among the most common mental health problems affecting young adults and cognitive behavioral therapy (CBT) is considered the most common psychotherapeutic treatment of anxiety disorders. Even though there are a plethora of mental health apps for anxiety available, evidence suggests that apps are not used for a long period of time. Here, we conducted a two-week study with young adults who have contacted a mental health service and are waiting for treatment to explore their daily perspectives on the usage of commercially-available mobile apps for anxiety that integrate CBT with a focus on understanding the reasons for, and barriers to, engagement during app use. We found that users of such apps form opinions during the first days of use, opinions that remain consistent. We also found that many app features are not used often and the same apps are used differently by different people. Overall, our study provides new insights into the barriers and factors affecting long-term use at different time points during app use.