engleski

mHealth: An overview of mobile applications for social anxiety treatment

Background: The development of mobile applications for prevention or treatment of mental health problems is growing (Boettcher et al., 2014). Social anxiety, defined as an excessive fear associated with social situations, is one of the commonly researched disorders in general digital health programs, i.e. eHealth (Boettcher et al., 2013). Usually, social anxiety is manifested as a fear of speaking in front of others, participating in social gatherings, meeting new people and expressing disagreement with others, all because of the fear of the negative evaluation (Leahy et al., 2012). Socially anxious people generally experience high levels of suffering and disfunction in academic, business and personal contexts. They are often reluctant to seek professional help, even though social anxiety is one of the most common psychiatric disorders (Alyami et al., 2017). Research shows that some of them turn to mobile applications (mHealth) to avoid the shame and stigma associated with seeking help (Alyami et al., 2017 ; Miloff et al., 2015). Social anxiety treatment in the form of mHealth can be useful and practical as it overcomes some of the problems of the healthcare system (Berrouiguet et al., 2016). However, potential problems of such applications are mostly connected to data protection, poor reliability of the assessment, inaccuracy of the information and the untested effectiveness of the therapeutic techniques included in the application (Whittaker, 2012). Objective: The aim of this research was to study in detail the existing mobile applications developed for the treatment of social anxiety and to find out the content and therapeutic techniques included in these applications. Method: Three databases with mobile applications were searched - Google Play, Apple store and Microsoft Windows. The keywords "social anxiety", "shyness", "social phobia", "social fear" and "social problems" were used to search for applications. For each database, the two authors independently assessed the existing applications. In the first round of evaluation, the authors checked whether the application was thematically focused on social anxiety and the improvement of social functioning. Only applications that contained information about the treatment of social anxiety in the title or description were downloaded and studied in detail, according to the following criteria: (1) Age groups (children and youth/adults/both) ; (2) Area of mental health problems that the application covers (exclusively for social anxiety/other difficulties as well) ; (3) Used or not used as a part of the therapy ; (4) Content in the application (psychoeducation, self-assessment, symptom monitoring, techniques for working on symptoms, correspondence with other users or the therapist). If the application contained techniques for working on symptoms, they were recorded. ; (5) Elements of gamification (e.g. monitoring progress, achieving new levels, receiving rewards, collecting points). If the application had gamification elements, they were recorded. ; (6) Media in the application (text, images, audio materials, video materials). Results: Out of 3207 identified mobile applications, 34 of them met the agreed criteria (12 were from Apple store database and 22 from the Google Play database). Most of the applications, 19 of them, were intended for all age groups. A total of 12 applications focused only on social anxiety, while the rest contained information on other mental disorders (e.g. stress, general anxiety, panic attacks, depression). All applications were designed for independent use and not as a part of therapeutic work. Almost all of the applications, 30 of them, included some of the techniques for working on anxiety symptoms. Half of the applications included psychoeducation on social anxiety, 12 of them monitoring symptoms, 11 self- assessment of the condition and only four the possibility of corresponding with other users or contacting a therapist. The most common techniques were relaxation, exposure and cognitive restructuring. Only one application included the behavioral experiment technique and coping cards. Most of the applications did not include some elements of gamification. Of the four apps that had elements of gamification, three apps included tracking progress, one winning medal and one collecting points, badges and achieving new levels. Most applications share information through text and audio materials. Conclusions: In conclusion, there are currently no mobile applications that focus exclusively on social anxiety and at the same time cover all the techniques that are otherwise used in the therapy for this disorder. A very small number of applications allow users to correspond with others, which is especially important for socially anxious people who will generally find it more difficult to make contacts or be willing to practice social interactions in person. It is necessary to develop a mobile application that would be focused on the treatment of social anxiety and contain quality interventions, with scientific verification of its effectiveness.

mHealth, mobile applications, social anxiety, cognitive-behavioral therapy

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