There is no sound!
Don't panic. All that has happened is that you muted your iOS device with the side switch. This can be very confusing as the device will still play sound from music and video apps, but will not play sound from games. Even serious games like ours get muted. Before you downgrade us from 5 stars to 1 take a look at this nicely written blogpost that shows you how to get the sound back.
No way Phobia Free works, Itsy is too cute and cuddly!
It's not really a question but we get your point. Itsy is not meant to scare anyone. It is a device we use to get people who have a spider phobia to be comfortable with the app. We have a total of 6 different spiders in the app apart from Itsy. These other spiders go from cartoony, but with realistic spider-like movements to a simulated tarantula that looks and behaves like the real thing. If you don't believe us visit the Phobia Free section and click on the links to see all the other spider models we use, but don't tells us we did not warn you. If you have a phobia you may want to have someone else look at those for you first.
How much will the apps cost?
Please check the prices in the individual app stores as we run promotions from time to time. Our prices will always be much lower than a single therapy session. We aim for our prices to be affordable and comparable to those of high-quality evidence-based self-help books.
Where can people get the apps?
What platforms are they available on?
Be Stress Free is available on Web, Android and iOS. Phobia Free is only available on iOS at the moment. We will consider other platforms depending on demand.
Are the apps backed by any organisation?
Phobia Free has been reviewed and approved by the NHS. We have the support of Anxiety UK, the leading charity for anxiety disorders in Britain. Our academic partner is University of Roehampton and we have completed research this year on Be Stress Free. The researchers were independent to us. We are supported by Wayra, the technology accelerator from Telefonica O2 and by UnLtd, an initiative from the Cabinet Office to promote social enterprise. We have a grant from Nominet Trust and Founders Forum for Good to develop Agoraphobia Free and from Creative England to develop an app targeting social phobia.
Who has used the apps?
Around 27,000 people and counting. We also have been getting very positive reviews from our users in the app store. We have a survey of 397 people who we simply approached to tell us about the app using a survey. We asked them to download the app and then tell us about what they thought of it. Here is what they told us.
Phobia Free has had around 6,000 users to date which is growing every day. Russell is the only one that we have been able to directly monitor although many people have told us the app has helped them. We don't like testimonials so we don't publicise that information. We only use the advice we get to improve the app, not to promote it. We will release the results of formal studies when we produce them.
How do we know they work?
Before you go any further you should read our post on this very subject. We have designed them based on proven techniques both for relaxation and for the treatment of phobias. The novel elements (games and augmented reality) do have evidence to back their efficacy but, to our knowledge, have never been used quite this way. Here's an overview of the science behind them.
Stress free trains you to do 4 different relaxation techniques and allows you to practice them over time (which is what really makes them effective). The four techniques are: calm breathing, differential deep muscle relaxation, self-hypnosis and meditation
Deep slow breathing is an essential technique incorporated in many relaxation exercises. It has been extensively examined in the literature in different setting. A good review of the evidence behind it and its uses can be found in General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy, Chapter 14 by Hazlett-Stevens and Craske. You can read a preview of the chapter here.
Differential Deep Muscle Relaxation
Since its description by Jacobson in 1938 this technique has a record of proven efficacy. There is a 2007 review of the literature that summarises all the available evidence up to that date which you can find here.
This technique is not effective in everyone and it requires some practice but it can be very helpful in some people. It has proven efficacy in anxiety related to many situations. It has been particularly studied in people going through different medical treatments like dialysis, chemotherapy, surgery and dentistry. There is a 2010 review that goes through all that evidence.
This is probably the technique that has received the most attention recently. It requires practice to master but everyone can use it if they devote the time to learn it and practice it. There is a complete review and meta-analysis of all the evidence of meditation in the management of anxiety published in the British Journal of Psychology in 2012.
We know that the basic technique we use in Phobia Free is proven; that is systematic desensitisation. You can see here the original paper by Joseph Wolpe on it. This is a technique he established in 1961 and has stood the test of time. We have adapted it into a game and made it fun (well, Richard and the team made it fun), but we believe the basic ingredients are all there. We have some indication that we are right as Russ has spider phobia and the app seems to make him nervous enough to work as a substitute to facing real spiders; this is the key to systematic desensitisation. We also know from research into modified games, virtual reality and augmented reality that these things do the trick when used in therapy instead of putting people in front of the things that they fear (see this chapter by Christiane Eichenberg and Carolin Wolters for a comprehensive look at all the research in this field). The difference is that we do not have a real life therapist to use alongside the games and augmented reality, we have Dr Freeman and Itsy.
We also know that the better quality self-help books help and we have the same basic material in what we believe to be a far more easy to use format. We are clear that this is probably not going to be as effective as face-to-face therapy. We also know a lot of people don't need face-to-face therapy, or can't access it, or rather not go see someone and would much prefer to do it themselves.
Here's a collection of scientific peer-reviewed papers on the use of serious games, virtual and augmented relity in the treatment of spider phobias.
(1) Bouchard S, Côté S, St-Jaques J, Robillard G, Renaud P (2006) Effectiveness of virtual reality exposure in the treatment of arachnophobia using 3D games. Technology and Health Care 14: 19-17
(2) Carlin AS, Hoffmann HG, Weghorst S (1998) Virtual reality and tactile augmentation in the treatment of spider phobia: a case study. Behaviour Research and Therapie 35: 153-158.
(3) Hoffmann HG, García-Palacios A, Carlin A, Furness III TA (2003). Interfaces that heal: Coupling real and virtual objects to treat spider phobia. International Journal of humancomputer interaction, 16(2): 283-300
(4) Michaliszyn D, Marchand A, Bouchard S, Martel M-O, Poirier-Bisson, J (2010) A randomized controlled clinical trial of in virtuo and in vivo exposure for spider phobia. Cyberpsychology, Behavior and Social Networking 13(6): 689-695
(5) Rinck M, Kwakkenbos L, Dotsch R, Wigboldus DHJ, Becker ES (2010) Attentional and behavioural responses of spider fearfuls to virtual spiders. Cognition & Emotion 24(7): 1199–1206.
How do people know you are real doctors if you don't wear white coats?
Doctors in Britain do not wear white coats. Also, be aware that white coats are really cheap and anyone can buy one, put it on, and try to convince you they are a real doctor. For Russell's and Andres's credentials you can check the General Medical Council website Just click on 'check a doctor's registration' enter their GMC numbers and you can see their registration details including their status as specialists in psychiatry. Russell's number is 4622936 and Andres's number is 4459110, If you check you will learn that both have 4 names each.
Other medical websites feature a lot of pictures of doctors treating patients, how come we have none of that?
Andres and Russ both still have a day job as psychiatrists and they see patients every day. It is not ethical for them to get real patients to promote their ventures. Their patients would love to help them, but they do not feel it is right to ask. Also the GMC would rightly take a very dim view of that.
Using actors to pose as patients is another possibility, but Russ and Andres both felt awkward pretending. They felt it would be somehow misleading so they decided against it; hence no pictures of patients. We do have videos of the artists and programmers in the team using the app and there is a secret video of Andres doing a desensitisation session with Russell which we will air at some point.
You will also notice we do not use testimonials as many do. We will publish results of surveys and results of trials in collaboration with external agencies. We will disclose conflicts of interest as they arise. Testimonials are anecdotal by their very nature and not that useful when judging the quality of something.