The SmartCAT: An m-Health Platform for Ecological Momentary Intervention in Child Anxiety Treatment

Abstract

Introduction: Cognitive behavioral therapy (CBT) for child anxiety, although efficacious, typically requires 16-20 weekly sessions with a therapist. Brief CBT (BCBT; eight sessions) for child anxiety is promising but may have less favorable outcomes owing to reduced session time. Mobile health (m-health) has the potential to improve BCBT efficacy by delivering ecological momentary intervention to engage youth in learning and practicing CBT skills in their everyday lives (in vivo). Materials and Methods: We developed an m-health platform entitled SmartCAT (Smartphone-enhanced Child Anxiety Treatment). SmartCAT consists of (1) a smartphone application (app) that cues youth to use the CBT skills taught in sessions, (2) an online portal that allows therapists to monitor skill use, to send cues and treatment-related materials, to engage youth in real-time via secure messages, and to manage rewards, and (3) a communication protocol that allows real-time bidirectional exchange between the app and the portal. A pilot study with nine youth (9-14 years old) examined the platform's feasibility as an adjunct to BCBT. Results: SmartCAT was found to be capable of supporting BCBT for child anxiety and received positive feedback from both therapists and youth patients. Patients rated the app as highly usable (mean = 1.7 on a 1-7 scale, with 1 = ''easy''). Patients completed 5.36 skills coach entries per session (standard deviation = 1.95) and took an average of 3.14 min (standard deviation = 0.98 min) to complete the entries. Conclusions: A smartphone app is feasible within CBT for child anxiety. Users found SmartCAT both acceptable and easy to use. Integrating an m-health platform within BCBT for anxious children may facilitate involvement in treatment and dissemination of effective procedures.

Mental Health Mobile Apps for Preadolescents and Adolescents: A Systematic Review

“…Table 2 summarizes the 15 apps identified in this review: CopeSmart [26,39], Crisis Care [30], Daybuilder [27], Mayo Clinic Anxiety Coach [42,48], Mobiletype [34,35,44-46], Mobile Mood Diary [28,29], Pretty [47], REACH app [32], Recovery Record [40], Safety Plan app [38], SmartCAT [33], The ACT app [41], and TickiT [37] (two apps had no name [31,36]).…”

Web-Based Interventions for Youth Internalizing Problems: A Systematic Review

“…The mobiletype app did not differ significantly from an attention control on any of the mental health outcomes assessed. Recently, the SmartCAT app for the treatment of child and adolescent anxiety was developed by Pramana et al 54 However, the paper evaluating the program's efficacy was in press at the time of these analyses. Based on the available evidence, we are unable to make clear conclusions regarding the use of mobile apps for youth depression and anxiety.…”

Online Treatment and Virtual Therapists in Child and Adolescent Psychiatry

“…For example, SmartCAT is a child- and therapist-facing tool designed to facilitate use of psychotherapy skills outside of sessions and to provide therapists with information regarding skill use. 19 Children received a smartphone app consisting of notifications and rewards. Therapists receive a web portal to view information from the app.…”