Improve Mental Health and Well-Being with Smartphone APP Mindfulness Training
By John M. de Castro, Ph.D.
“The seemingly simple act of mindfulness may help reduce the impact of stress, anxiety, depression, and chronic pain. Mindfulness is the act of paying attention to moments of experience with an accepting and friendly attitude so as to observe with all the senses what is happening in each moment. The practice of mindfulness is an effective means of enhancing and maintaining optimal mental health and overall well-being.” – APA
Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Mindfulness training programs over the internet and with smartphone apps have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These online and smartphone app trainings have been shown to be effective. But the question arises as to the relative effectiveness of various online and mobile trainings in inducing mindfulness and improving psychological health.
In today’s Research News article “Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231823/ ), Mak and colleagues compared the efficacy of 3 smartphone aps that trained for either mindfulness, self-compassion, or cognitive behavioral psychoeducation, to improve mental health and well-being in adults.
They recruited adults online and randomly assigned each to one of the three trainings. The participants downloaded the apps for their smartphones. The trainings were delivered in 28 daily sessions. The mindfulness exercises, included body scan, mindful breathing, mindful eating, and mindful walking. Self-Compassion training consisted compassionate body scan, affectionate breathing, loving-kindness meditation for beginners, compassionate walking, soften-allow-soothe, self-compassion break, and self-compassion journaling. Cognitive behavioral psychoeducation included relaxation skills, coping strategies for stress, problem-solving skills, emotional management skills, and cognitive strategies for negative thoughts.
The participants completed online measures of mental well-being, psychological distress, mindfulness, self-compassion, discomfort with emotions, ambiguity tolerance, program satisfaction, and utilization before and after training and 3 months later. There were, unfortunately relatively low participation rates with 28% of the recruited participants who downloaded the apps never activated them. Of those that did only 24% completed their program and only 17% completed the follow-up measures. Most of the attrition occurred in the first week.
They found that all three trainings produced significant enhancements of mental well-being and mindfulness and significant reductions in psychological distress that persisted at the 3-month follow-up. Self-compassion, and cognitive behavioral psychoeducation trainings, but not mindfulness, resulted in higher self-compassion at the end of training but this was no longer significant at follow-up.
This study did not have a control condition for comparison, so the conclusions have to be tempered with the understanding that contaminants such as placebo effects, and time and practice-based contaminants might be responsible for the results. In addition, the high attrition rates may be responsible for the results as those who were not helped by the apps terminated participation leaving only those who were improving left in the sample.
On the other hand, other controlled studies have demonstrated the efficacy of mindfulness and self-compassion trainings and cognitive behavioral psychoeducation in improving psychological health and well-being. So, the results from the present study are likely due to the trainings and not contaminants. Hence, these findings are suggestive that the three smartphone apps are able to improve the mental health and well-being of otherwise normal adults. This is important as being able to deliver these trainings over smartphones allows for the distribution of these mental health improving programs economically to widespread audiences.
So, improve mental health and well-being with smartphone app mindfulness training.
“Fine-tuning which type of mindfulness or meditation someone uses as a prescriptive to treat a specific need will most likely be the next big advance in the public health revolution of mindfulness and meditation. Stay tuned!” – Christopher Bergland
CMCS – Center for Mindfulness and Contemplative Studies
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Mak, W. W., Tong, A. C., Yip, S. Y., Lui, W. W., Chio, F. H., Chan, A. T., & Wong, C. C. (2018). Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial. JMIR mental health, 5(4), e60. doi:10.2196/mental.8597
Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health.
The aim of this study was to examine the efficacy of 3 mobile app–based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation.
This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators.
Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users’ satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant.
Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs.