Towards a self-applied, mobile-based geolocated exposure therapy software for anxiety disorders: SyMptOMS-ET app.

Objective: While exposure therapy (ET) has the potential to help people tolerate intense situation-specific emotions and change avoidance behaviours, no smartphone solution exists to guide the process of in-vivo ET. A geolocation-based smartphone software component was designed and developed to instrumentalize patient guidance in in-vivo ET and its psychological validity was assessed by a group of independent psychology experts.

Methods: A team of computer scientists and psychologists developed the ET Component for in-vivo ET using geolocation-based technology, following the process-centred design methodology. The ET Component was integrated into the SyMptOMS-ET Android application, which was developed following the co-design methodology. Next, nine independent psychology experts tested and evaluated the ET Component and the SyMptOMS-ET app in the field, following the think-aloud methodology. Participants also completed the Mobile Application Rating Scale (MARS) instrument to quantitatively evaluate the solutions.

Results: We present the SyMptOMS-ET app's main features and the ET Component exposure workflow. Next, we discuss the feedback obtained and the results of the MARS instrument. Participants who tested the app were satisfied with the ET Component during exposure scenarios (score of 4.32 out of 5 [ 0.28] on MARS quality aspects), agreed on the soundness of the theoretical foundations of the solutions developed (score of 4.57 [ 0.48] on MARS treatment support aspects), and provided minor think-a-loud comments to improve them.

Conclusions: The results of the expert evaluation demonstrate the psychological validity of the ET Component and the SyMptOMS-ET app. However, further studies are needed to discern the acceptability and efficacy of the mHealth tool in the target population.