Apps for social anxiety

At a glance

Compared with waiting

In 10 trials combined, apps beat the comparison by a moderate amount. Across all app trials in that review, most compared apps with waiting or other inactive controls.

What it takes

Often free or a monthly subscription. A few minutes a day.

What it is

Apps for social anxiety usually do one or more of these:

• teach CBT ideas in short lessons
• help you plan and log exposure steps
• offer breathing or mindfulness exercises
• track your mood or anxiety
• train attention with games

They are cheap and private, and you can start at 2 a.m. without talking to anyone. That makes them appealing when getting help feels impossible.

What the evidence shows

• Most apps are untested. Many apps say they help with social anxiety. Very few have a published trial for it.
• Combined trials show a moderate effect, with a catch. A large review of app trials combined 10 trials for social anxiety. Apps beat the comparison by a moderate amount. But the results varied a lot, and most trials had a high risk of bias. Bias here means design problems that can make a treatment look better than it is. The only low-risk larger trial found no clear difference.
• Weak comparisons inflate results. Most app trials in that review compared the app with waiting, with assessment only, or with information to read. When an app beats nothing, that does not show it beats a free book.
• Single-app trials are thin. One app, Alena, beat waiting in two online trials run by its developers, with 102 and 248 people. The difference was small. People joined online based on a questionnaire score, not a diagnosis. A US trial of 82 people tested a one-week app of imagined exposure.
• Attention-training games did not work at home. Some apps train you to look away from angry faces. In the lab this showed some promise. Delivered over the internet, it did not help, and a Swedish home trial found an “infinitesimal” difference.
• Internet CBT is different. Full online programmes with a therapist have much stronger evidence than apps. See internet CBT.

What the trials have not answered

• Whether any app works as well as a free CBT book or guided internet CBT.
• Whether people keep using apps, and keep their gains, beyond a few weeks. Few trials report this.
• Whether results hold in people diagnosed with social anxiety disorder, not just people who scored high on an online questionnaire.

How to choose an app

If you want to try one, ask:

1. Has this app been tested in a trial for social anxiety? Look for a published study, not just “based on science”.
2. Who ran the trial? Trials run by the app’s maker are a start, not proof.
3. Does it get you doing things? Apps that help you plan real exposure and drop safety behaviours fit what works. Apps that only calm you down treat the feeling, not the avoidance.
4. Is it honest? Be wary of apps promising a cure. On Reddit, some recovery stories turn out to be disguised adverts for an app or course.
5. What happens to your data? Check the privacy policy before you write anything personal.

An app can be a useful companion to a self-help book or therapy, for logging exposure steps or practising between sessions. On its own, a CBT self-help book or guided internet CBT has better evidence.