The SMILE app, a smartphone application delivering CBT-based interventions using mobile sensing technology, significantly decreased anxiety symptoms in youth aged 12-21 with severe anxiety at 4 weeks and also reduced depression symptoms, suggesting efficacy and potential scalability as a solution for youth with severe anxiety.
Anxiety symptoms significantly decreased in the SMILE app treatment group compared to the control group at 4 weeks post-intervention.
Anxiety symptom reductions in the treatment group were marginal but not statistically significant at 12-week follow-up.
Depression symptoms showed significant reductions in the treatment group compared to the control group.
No significant changes were observed for insomnia in the treatment group compared to the control group.
The SMILE app uses mobile sensing technology to deliver personalized, CBT-based interventions tailored to individual behavioral patterns in youth with severe anxiety.
This research suggests that a smartphone app called SMILE, which uses phone-based sensors to monitor behavior and deliver personalized anxiety management exercises based on cognitive behavioral therapy (CBT), can meaningfully reduce anxiety symptoms in young people aged 12-21 who experience severe anxiety. In a randomized controlled trial with 107 participants, those who used the SMILE app alongside a mobile sensing app showed significantly greater reductions in anxiety after 4 weeks compared to those who only used the sensing app without the CBT content. The app also helped reduce depression symptoms. However, the anxiety benefit was only marginally present at the 12-week follow-up and did not reach statistical significance, and there was no significant effect on sleep problems (insomnia). The key innovation in this app is its use of mobile sensing — the phone passively collects data about a user's behavior patterns — and then uses that information to deliver interventions tailored to the individual, rather than offering one-size-fits-all content. This research suggests that personalizing digital mental health tools using real-time behavioral data may make them more effective than standard app-based approaches. This matters because anxiety disorders are common among young people but access to professional treatment is often limited due to cost, availability, or stigma. A scalable smartphone-based tool could help bridge this gap by providing evidence-based support to youth who might not otherwise receive it. The findings support further development and study of personalized digital mental health interventions for anxious youth.
Hagalwadi J, Sutherland D, Dolek S, Marin-Dragu S, Bagnell A, Wozney L, et al.. (2026). An app responding to behavior of people to promote mental wellbeing in anxious youth.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2026.121503