A self-help anxiety app developed by UWE (The University of the West of England) is helping students to better manage their anxiety and provide 24/7 mobile support at any time or place.

The application called SAM provides a platform of therapeutic and immersive activities that students can access and use. Already in the top 100 health and fitness charts across 43 countries, this app is proving to be invaluable.

Developing an app, the process and impact

At the inception of the project, the project team at UWE conducted surveys on social anxiety within different learning situations at lectures, presentations, seminars and group work at both UWE and Plymouth University. From the research (see: Is social anxiety a hidden disability for university students?) it was evident that anxiety was a significant issue for undergraduate students.

Following on from the research the computer science and creative technologies department suggested that an app may be a versatile mobile solution.

Computing students at UWE were then invited as part of their course to design and develop a prototype app to aid anxiety management. Some of the research was funded by HEAT@uwe, an EPSRC-funded programme of activities to develop, facilitate and communicate interdisciplinary research between the Institute of Sustainability, Health and the Environment (ISHE) and Bristol Institute of Technology (BIT).

One of the important aspects for the development of the app was that many of the students involved in the design process had some social anxiety issues themselves, so many of the following considerations were aspects that the students would want in a self-help app:

• Monitoring and recording anxiety
• Detail the kind of physiological symptoms of anxiety experienced
• Worrying thoughts associated
• The types of avoidance behaviours as a result of anxiety

After the first initial trialling of the prototype the university further developed a full working version of the app and named it SAM.

In terms of the app, there are a number of different options for users, which are clearly displayed and invite the user to explore further, these are:

• Working with SAM – Information about what users can expect of SAM and guidance on getting the best out of SAM as a self-help tool
• Help for anxiety NOW – Clear and engaging instructions for managing moments of more acute anxiety
• How’s my anxiety now? – A visual display which enables users to record and monitor their anxiety over time – Users are invited to self-monitor on each of four dimensions of anxiety: feeling, thinking, physical sensations and avoidance tendencies
• Anxiety tracker – The ongoing record of the user’s anxiety on each of the four dimensions of anxiety, above
• Things that make me anxious – The user’s personal listing of anxious situations with ratings of the level of anxiety attached to each
• Self-help with SAM – An array of self-help options for managing cognitive and physiological aspects of anxiety, presented in a range of multi-media formats and offering different levels of challenge to the user
• My anxiety toolkit – An evolving and quick-reference collation of self-help tools, from the self-help options, which the user has assembled to meet their personal needs and preferences for managing anxiety
• Social cloud – A closed, anonymous social network of SAM users where they can share concerns, gain support, obtain further information and guidance about
• managing anxiety

Each section contains useful information, resources, examples and activities to help support students with their anxiety issues. For example, when selecting the Help for anxiety NOW section, this opens up three further activities to help the user cope with panic, covering:

• Calm breathing
• Picture peace
• Change the focus

By selecting the information icon, the student will see detailed instructions on how the activity works, as shown below:

The app can also record how a student or person is feeling at the present time, through the How’s my anxiety right now section. Within this area are four sliding bars that can be used to determine the levels of anxiety in different forms, covering:

• Feelings of anxiety and tension
• Worrying thoughts
• Unpleasant physical sensations
• Avoiding things I fear

These can then be saved each day to track the anxiety of the individual and accessed using the anxiety tracker, which shows a detailed chart, tracking the anxiety over the period of hours, days, weeks or months.

Self-help with SAM provides the students with detailed information about therapeutic and relaxation methodologies that can be considered with anxiety. This section additionally includes activities that can help promote and stimulate peaceful thoughts and provide a way to relax, such as with the picture peace activity, which is a simple, but effective way of helping to calm the mind through interacting with the screen to reveal the picture, as demonstrated below:

The activities and exercises can all be rated within the app as well as added to the My anxiety toolkit area, which saves specific exercises or activities so that the student can access their favourite ones quickly.

SAM has an area for recording anxiety and linking this to a task, which populates an entry into the outlook calendar on the tablet or smart device and an additional reminder can be added.

There are also interactive activities such as It’s only a thought which allows the student to enter their worrying thoughts and then these can be tapped to watch them float away as clouds.

Worrying thoughts can be exploded away using the Stop that thought activity, which allows the student to type their thoughts into a word bubble and then watch them explode into tiny letters that disappear from the screen.

There is also a social cloud area, which requires registration to sign up to and this allows sufferers of anxiety to communicate with each other and share their experiences for additional peer support.

“I think that SAM can be useful for people and of course it means that we can make available self-help for anxiety to many thousands more people than we can access in one-to-one therapy.” – Phil Topham, Counselling Psychologist and Visiting Research Fellow, UWE

SAM is regularly getting 4-5 star ratings and has featured on the NHS website as being one of the top apps for anxiety self-help.

Whilst the app should not be seen as a replacement for face-to-face therapy, it does provide a 24/7 mobile solution for students to use wherever they may be as long as they have an

internet connection with their smartphone or tablet device.

“I think that for some people it will mean that they will never need a face-to-face because they can sort out their problems with the help of SAM and for other people if they have a positive experience of using SAM it may make them more likely to consider face-to-face therapy when before they wouldn’t have even have thought of it.” – Phil Topham, Counselling Psychologist and Visiting Research Fellow, UWE

Reviews of the app

“I love it!!! – Up until now I’ve literally had no idea where to start with my anxiety. This app has saved me during two panic attacks already and during several situations in which I was beginning to get too stressed out and revved up. Thank you.”

“Life Changing- This app is truly the best app I’ve ever downloaded. Its techniques are very helpful and work very well. You could even save them in case you want to try them. What I like best about this app is the “Social Cloud”. The other users on the Social Cloud are very sympathetic and understanding. They got me through so much. Get this app. Now.”

Film

Find out more about this project and watch a film interview with Phil Topham, who talks about the app in detail and the challenges they faced.

Further links

UWE

SAM

Jisc RSC South West

AnxietyUK

HEAT@uwe

Acknowledgements and thanks to

Phil Topham
Praminda Caleb-Solly
Paul Matthews
UWE Project team
Plymouth University
Department of Computer Science and Creative Technologies
MyOxygen
Jisc
HEAT
Institute of Sustainability, Health and the Environment
Bristol Institute of Technology

Matt Ewens
Information Officer, Jisc RSC South West

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