App Review: SAM
The Self-Help Anxiety Management app is a good example of an app that has been designed for and by the people who are going to use it. Using the concept of self-help Phil Topham, Praminda Caleb-Solly and Paul Matthews of the University of the West of England spent 5 long years and £100,000 working with students and staff to develop an app that delivers anxiety management techniques and information from your smartphone. With over a quarter of a million users by the end of 2014 it is fair to say that this app is not only useful but extremely well-used too.
This is certainly an app that has been developed to be picked up and used immediately, the design as a whole being very intuitive. The interface is uncomplicated and efficient, benefitting from personalisable features. For instance My Anxiety Toolkit allows you to save certain ‘self-help tools’ that you find effective so they are easily accessible when you return to the app. The tools themselves are quite engaging and interesting – one lets you listen back to your voice whilst another invites you to ‘clean the screen’ to reveal a picture. These elements of Attention Bias Modification twinned with gamification (i.e. ‘fun’) have demonstrated mixed results in recent studies using smartphone apps (Dennis & O’Toole, 2014; Enock, Hofmann, & McNally, 2014) but the role of mobile distraction within self-help for anxiety will, I’m sure, be an interesting area of research in the future.
Security and Safety 3/5
The security and safety of any app can be difficult to ascertain. The backend of the app would appear to be secure considering it was developed by both an app development company and computer scientists. At the frontend whilst it doesn’t have the option to secure it with a passcode, the innocuous name ‘SAM’ would be unlikely to invoke comment at its appearance on your phone. It is also clear how to report an issue. The Social Cloud aspect would, I feel, cause concern. It is essentially an unmoderated forum – people are able to chat anonymously with each other and the only oversight comes from within this user-community. It is true that online forums have often functioned as a result of both this anonymity and beneficence of self-moderation (Ryan, 2010). However, these aspects are also often considered attributable to some of the more negative behaviours online (Joinson, 2002). The likelihood of harm resulting from an online forum is very low (Eysenbach, Powell, Englesakis, Rizo, & Stern, 2004) but there is a need for this risk to be considered and I feel it would benefit from it being more explicit. The discussion around online forums in areas of mental health is certainly one wrought with ethical and clinical dilemmas, ones that need to be addressed in more depth than can be provided here.
Phil is a counselling psychologist and much of SAM reflects this. It is well-researched and sits within a number of self-help and behaviour change frameworks such as psychoeducation and transtheoretical model of change (Abraham & Michie, 2008). The qualitative response (assessed through online reviews, blogs and vlogs) appears to be overwhelmingly positive and many individuals find this a useful and appropriate app. Overall the app presents itself well but I am not convinced as to the therapeutic benefit of the Social Cloud. Whilst peer-to-peer online support is often cited as advantageous for many reasons (Lal & Adair, 2014; Proudfoot et al., 2012) research suggests that it may not provide any significant additional benefit to an intervention (Freeman, Barker, & Pistrang, 2008). For this reason, and paired with the additional ethical concerns that an unmoderated forum may present, I feel the SAM app must lose a point.
This app really is a wonderful app and very enjoyable to use. Feedback from others who have used it is always positive. I feel it would be useful as an adjunct to therapy as well as for those who prefer to self-manage their anxiety.
I had the opportunity to speak with Phil via Skype and he filled me on some more details about the app and its development.