Unwinding Anxiety is an app that aims to reduce stress and anxiety through a step-by-step mindfulness-based program. There are 30 daily modules that are about 10 minutes in length, which include self-paced video lessons and mindfulness exercises. Other features of the app include journaling to help identify anxiety triggers and track progress, weekly calls with experts, an online support community that covers different discussion topics and tips, and daily check-ins that ask about the user’s feelings and anxiety and then provides a brief mindfulness practice. There are also other tools to help users reduce their worry or stress in the moment, such as the worry tool, stress meter, and stress test. The app is free for the first 4 video modules, but then users must pay a subscription fee of $29.99/month, $139.99/6 months, or $209.99/year to receive full access to the modules and features.
Available for: iPhone (Requires iOS 12.1 or later). Android 5.0 and up
Developer: MindSciences, Inc.
Type of Treatment: Connect to a Peer, Mindfulness, Psychoeducation & Information, Symptom Tracking/Self-Monitoring
Targeted Conditions: Stress and Anxiety
Target Audience: Adults
Designed to be used in conjunction with a professional? No
Languages Available: English
Cost: Free with in-app purchases
Get it on: Apple App Store, Google Play, Web
In this pilot study, 34 participants who worked as physicians in a large US healthcare network and reported having anxiety participated in a nonrandomized app-based mindfulness intervention. All participants completed the Generalized Anxiety Disorder-7 (GAD-7) to measure their anxiety levels and Maslach Burnout Inventory to measure burnout. Participants took these questionnaires three times – at baseline, at a 1 month post-treatment, and at a 3 months follow-up. After participants completed the intervention, their GAD-7 scores were seen to decrease significantly at 1 month post-treatment (48% reduction, P<.001) and at 3 months follow-up (57% reduction, P<.001). Similarly, participants’ scores in cynicism also decreased significantly when it came to cynicism (50% reduction, P=.003 at 1 month post-treatment; 50% reduction, P=.009 at the 3 months follow-up) and emotional exhaustion at both time points (20% reduction, P<.001 at 1 month post-treatment; 20% reduction, P=.003 at the 3 months follow-up). The pilot study showed initial support that this intervention may be useful in decreasing anxiety levels for physicians.
Citation: Roy, A., Druker, S., Hoge, E.A., & Brewer, J.A. (2020). https://mhealth.jmir.org/2020/4/e15608/
A randomized controlled trial was conducted to test the efficacy and mechanism of the Unwinding Anxiety app, which was designed to target a potential mechanism of anxiety (reinforcement learning). Individuals were recruited for the study through Facebook advertisements. Sixty-five participants were randomized to receive either: 1) treatment as usual (n = 33), or 2) treatment as usual + Unwinding Anxiety app (n = 32). In the second group, participants were asked to complete 30 modules in the Unwinding Anxiety app over a 2-month period. Associated changes in outcomes were evaluated using self-report questionnaires 1 and 2 months after treatment initiation. Results showed that the Unwinding Anxiety app group demonstrated a significant reduction in anxiety (Generalized Anxiety Disorder-7; GAD-7) compared with the control group at 2 months (67% vs 14%; median change in GAD-7: –8.5 [IQR 6.5] vs –1.0 [IQR 5.0]; P<.001; 95% CI 6-10). Additionally, increases in mindfulness at 1 month (nonreactivity subscale) mediated reductions in worry at 2 months (Penn State Worry Questionnaire (p=.02) and decreases in worry at 1 month mediated reductions in anxiety at 2 months (p=.03). These results support the clinical efficacy of the Unwinding Anxiety app for individuals with anxiety (Roy et al., 2021).
A nonrandomized pilot study by Roy, Druker, Hoge, & Brewer (2020) assessed whether the Unwinding Anxiety app could reduce anxiety in physicians and to explore if anxiety and burnout were correlated (i.e., if the app led to a reduction in both anxiety and burnout). Participants included 34 physicians who worked in a large US health care network and reported having anxiety. The main outcome measure was anxiety (measured by the Generalized Anxiety Disorder-7 (GAD-7), and the secondary outcome measures assessed burnout (cynicism and emotional exhaustion items from the Maslach Burnout Inventory). Results showed that GAD-7 scores decreased significantly at posttreatment by 48% (p < .001). There was also a significant correlation between anxiety and burnout, as well as a significant decrease in cynicism at posttreatment and emotional exhaustion at both time points. (Roy, Druker, Hoge, & Brewer (2020); https://mhealth.jmir.org/2020/4/e15608/PDF).
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