A smartphone application for the treatment of generalized anxiety disorder

The current study aimed to evaluate the acceptability and effectiveness of a smartphone application in the treatment Generalized Anxiety Disorder (GAD). Cognitive-behavioral therapy (CBT) is commonly used to manage and minimize the aversive symptoms of GAD; however, studies have found only modest treatment gains when CBT is used alone (Brown et al., 2001). Further, GAD has been identified as the least successfully treated of the anxiety disorders (Newman et al., 2013). Previous studies have measured client acceptability of smartphone applications (Ainsworth et al., 2013; Pramana et al., 2013), but they have failed to measure the impact of the application on treatment outcomes (e.g., reductions in symptom severity). To fill this gap in the literature, the current study compared therapists using their treatment as usual (TAU; typically CBT) plus inclusion of the smartphone application (TAU+app) to two alternative treatment conditions: TAU plus the addition of a paper log for daily assessment of client data (TAU+paper), and treatment as usual alone (TAU). The current study tested the hypothesis that the integration of a cognitive-behavioral based smartphone application will produce greater reductions in anxiety by facilitating a better quality of communication between therapist and client, strengthening the quality of the therapeutic alliance, promoting skill acquisition, and providing more data regarding client progress. All participants completed dependent measures of anxiety, depression, global functioning and therapeutic alliance at each scheduled appointment during the 6 weeks of the study (the within subjects factor). While all three treatment conditions experienced decreases in anxiety from pretreatment to end treatment, there were no significant differences between conditions on measures of anxiety or therapeutic alliance. Further, although compliance rates were higher for the TAU+paper condition than the TAU+app condition, ratings of usefulness in therapy were higher for the TAU+app condition. Future directions regarding alterations to the smartphone application, efforts to increase compliance and interest, additional training for therapists, and overall implementation are discussed