App-based psychotherapeutic exercises provide immediate, accessible anxiety relief, helping overcome common mental health barriers such as limited access to therapists, costs, stigma, and logistical challenges.
These digital interventions offer flexible, scalable solutions, empowering individuals to manage anxiety independently and effectively.
Sandkühler, J. F., Kahl, F., Sadurska, M. Z., Brietbart, P., Greenberg, S., & Brauner, J. (2025). The Immediate Impact of App-Based Psychotherapeutic Exercises on Anxiety: An RCT. Depression and Anxiety, 2025(1), 5586831. https://doi.org/10.1155/da/5586831
Key Points
- Focus: The study explores the immediate impact of app-based psychotherapeutic exercises on anxiety reduction.
- Aims: To compare the immediate anxiety-relieving effectiveness of 12 psychotherapeutic exercises using an app versus control conditions.
- Findings: All 12 psychotherapeutic exercises significantly reduced anxiety immediately, with mindfulness and relaxation techniques showing larger effects than cognitive restructuring.
- Implications: Immediate anxiety relief through accessible app-based exercises could significantly enhance engagement, self-efficacy, and crisis management in anxiety treatment.
Rationale
Anxiety is prevalent, with significant individual and societal costs. Accessibility barriers prevent many from receiving in-person therapy.
Digital interventions offer scalable, immediate anxiety relief but lack comparative studies examining multiple exercises simultaneously.
Understanding immediate intervention effects can encourage continuous engagement, which is critical for long-term effectiveness.
Currently, mindfulness, cognitive restructuring, and relaxation methods have separately demonstrated efficacy but lack direct, immediate comparative analysis.
Next research steps should assess long-term efficacy and engagement impacts.
Method
A parallel, double-blind randomized controlled trial comparing 12 psychotherapeutic app-based exercises to two controls (reading informational text, measurement-only).
Procedure
- Participants randomly allocated to exercises or controls.
- Anxiety assessed before and immediately after interventions via a validated anxiety slider scale.
- Interventions lasted approximately 7-10 minutes.
Sample
- 1,092 participants aged 21-92 (average age 39), 66% female, primarily White (77%), recruited online in the U.S.
Measures
- Custom Anxiety Scale: Three-slider questions assessing anxiety, validated against the State subscale of the State–Trait Anxiety Inventory (STAI).
Statistical Measures
- Mixed ANOVAs, independent t-tests, Cohen’s d for effect sizes, robust ANOVA methods (trimming, bootstrapping).
Results
- All exercises significantly outperformed controls in reducing anxiety.
- Effect sizes (Cohen’s d): Cognitive restructuring (0.5-0.9), diaphragmatic breathing (0.6), gratitude (0.8), expressive writing (1.1), progressive relaxation (1.3), guided imagery (1.3), mindfulness (0.9-1.5).
- Mindful breathing had the largest effect size (1.5).
- Differences among exercises substantial; mindfulness consistently showed larger effects than cognitive restructuring.
Insight
The study uniquely compares multiple interventions directly, confirming substantial immediate anxiety relief, particularly through mindfulness-based methods.
This research expands knowledge by emphasizing the potential of app-based methods in providing immediate, clinically relevant anxiety reduction.
Future research could explore long-term outcomes and integration with ongoing mental health care.
Implications
Practitioners and policymakers could leverage these findings by incorporating validated app-based exercises into standard care, particularly for crisis management and early intervention.
Recommended implementation includes training professionals on app integration, promoting self-management, and addressing potential technology access barriers.
Strengths
This study had several methodological strengths, including:
- Rigorous experimental design (RCT).
- Large, diverse online sample improving generalizability.
- Comprehensive validation of anxiety measures.
- Robust statistical analysis.
Limitations
This study also had several limitations, including:
- Focus on immediate effects; lacks longitudinal assessment.
- Potential selection bias (online recruitment, U.S. population).
- Lower control group treatment expectations.
Socratic Questions
- How might participant expectations have influenced the immediate effects observed?
- What additional controls could further validate the results?
- How can practitioners integrate these findings into diverse clinical settings?
- Could similar immediate effects be achieved in non-digital, traditional therapy contexts?
- What might be the implications if long-term follow-up revealed diminished effects over time?
