“Intellect”, a Mobile Health Application based on cognitive-behavioral therapy principles, improves Anxiety and Worry: A Randomized Controlled Trial with an Active Control and a 2-Week Follow-Up

Abstract

Digital self-guided mobile health (mHealth) applications are cost-effective, accessible, and well-suited to improve mental health at scale. This randomized controlled trial (RCT) evaluated the effectiveness of a recently developed mHealth programme based on cognitive-behavioral therapy (CBT) principles in improving worry. We also examined psychological mindedness (PM) as a mediator by which app engagement is thought to improve outcomes. The intervention group completed a 2-week “Anxiety and Worry” programme with daily CBTinformed activities, while the active waitlist-control completed a matched 2-week mHealth programme on procrastination. Participants filled out the Generalized Anxiety Disorder (GAD7), Patient Health Questionnaire (PHQ-9), and Psychological Mindedness Scale (PMS) at baseline, post-intervention and 2-week follow-up. App engagement was measured at postintervention only. Both groups showed significant improvements on anxiety and depression scores from baseline to post-intervention, but no group differences were observed. From postintervention to follow-up, only the intervention group showed further improvements for anxiety levels. Higher engagement with the mHealth app reported lower anxiety at post-intervention, and this relationship was fully mediated by psychological mindedness. This study provides evidence that (a) engaging in a CBT mHealth App can effectively reduce anxiety and worry, and (b) Psychological mindedness is a potential pathway by which engaging with a mHealthapp improves worry. While overall effect sizes were small, at the population level, these can make significant contributions to public mental health.