U of A developed phone app helps youth impacted by anxiety

The typical teenager you see with their head bent over a cell phone may not be on social media. Mandi Newton is helping adolescents impacted by anxiety by giving them what they want - a mobile app to practice skills learned while receiving cognitive based therapy treatment (CBT). Newton, a professor in the Division of General and Community Pediatrics, spent three years researching and refining the MindClimb app.

Therapists teach CBT to adolescents who then practice the tools when they are faced with feelings that they aren’t sure how to deal with. “If you are anxious, it means struggling to work at the things you are uneasy about. That can be truly uncomfortable and kids rarely enjoy doing it, especially teenagers,” says Newton. “We thought that having tools on their phone would make treatment a little more accessible and easier to do in-the-moment. I think that in-the-moment piece is key. If you have an anxiety disorder, anxious moments can sneak up on you. Then to have those tools right there can help you cope.”

The area of youth mental health is Newton’s passion. She frequently turns to innovation, technology, and clinical trial design as a solution. Newton developed BREATHE, Being Real, Easing Anxiety - Tools Helping Electronically, which is another CBT tool. The Canadian Institutes of Health Research provided a two-year grant for the MindClimb app. Newton, co-principal investigator Alexa Bagnell, a professor in the Department of Psychiatry at Dalhousie University, and an app developer collaborated to build the framework. Then they turned to youth to provide feedback.

“When you are anxious and you’re stressed, in that moment, you don’t need an app with 10 unique items on a menu. You require a pared-down version of a tool that can do what you need it to do, while your fingers are shaking, you’re nervous, not thinking clearly, and stressed,” says Newton. “Part of anxiety management is learning how to calm your body. Youth said that they wanted to be able to relax so they asked for access to music or sounds. We added videos and a microphone so a friend or they could record inspiring messages to themselves and they could play it back. That was an idea that stood out for me because I hadn’t thought of it before.”

Recruiting adolescents for the study took longer than expected, and the research took three years instead of two. Newton worked with clinical therapists to recruit adolescents. However, the MindClimb app research was tied to when the clinical therapy groups were scheduled. Clinicians also had to adapt to youth using their phone and bringing up the MindClimb app during therapy sessions. It was a behaviour change for clinical practice. “We were mindful and did not rush the research,” adds Newton.

Now that they have fully developed the MindClimb app, a not-for-profit organization is taking the steps to make it available across Canada. Newton is stepping aside for this part of the venture, and may become involved with future research to determine patient outcomes. But she has already seen the impact the MindClimb app is having on its users.

“We’re supporting a child in cognitive behavioural therapy. We’re meeting kids where they’re already at. Often when we do treatments, or offer interventions for kids, we ask them to learn new concepts. We challenge them to do uncomfortable tasks. They know they need to do it to feel better, but they don’t necessarily want to do it because it feels uncomfortable. With this app, we say that we understand the phone is an important piece of your life. We are working to make treatment more accessible to you and make it feel more like it’s a part of you. To me, it felt like a more user centred approach to treatment than we’ve done in the past,” she says.