In this use case, we developed a first-of-its-kind, fully instrumented sensor-based smartphone-guided in vivo exposure therapy using a just-in-time intervention for anxiety disorder. Exposure therapy is a core component of the well-recognized Cognitive Behavior Therapy (CBT), which has been proven to be effective for a range of disorders. The core underlying idea is to arm the patient with specific coping mechanisms (e.g., recognizing negative thought processes, breathing exercises), and then gradually expose them to the feared situation (e.g., large open spaces, crowded areas).

To this end, we developed an application suite, consisting of a mobile and smartwatch application on the one hand, and a configuration and monitoring application on the other hand. The mobile and smartwatch applications are capable of systematically and timely collecting quantitative (i.e., sensor data, such as GPS coordinates or hearth rate) and qualitative data (i.e., through short questionnaires about the patient's mental state), based on which the patient is guided through (a series of) exposures. The app encourages the patient to do exposures when detected a feared situation, and then provides step-by-step instructions and multimedia therapeutic content delivery, based on his/her behavior and mental state (e.g., determine how long to stay, remind coping mechanisms, propose exercises, allow an escape). In the app, patients can also see their progress and revise psycho-educational material at any time. Through the configuration and monitoring web application, therapists can configure exposures for their patients (e.g., locations for exposure, contextual modifiers such as weather conditions or timeframes), can view spatial and temporal overviews of their progress: how many exposures have been done, what is the patient's behavior in each exposure, what is his/her overall progress, etc.

Currently, the Exposure Therapy application suite is being used in a large-scale Randomized Controller Trial, where 144 patients are treated in two experiment arms: half of them using traditional CBT therapy and half of them using the novel SyMPToMS Exposure therapy-based treatment. If you suffer from anxiety and you are interested in joining our medical trial, feel free to contact us at tratansiedad@uji.es.