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Over the last ten years, there has been a phenomenal rise in the number of smartphone apps sharing meditation and mindfulness-based practices. This increase in popularity clearly demonstrates a demand for techniques to deal with the challenges of modern life. It cannot be denied that it is fabulous to see so many people being introduced to practices that have the potential to improve health and wellbeing. But how can we use mindfulness-based apps mindfully, ensuring that the content we are accessing is respectful of the lineage of mindfulness, effectively designed and delivered and that the apps hold equal consideration and respect to benefit their users and their shareholders?
How is the mindfulness-based apps industry growing?
More than 2,500 meditation and mindfulness-based apps have launched since 2015 (1).82% of European apps for mindfulness are provided free of charge (2) with the majority aimed at improving wellbeing and reducing stress levels, improving physical health or reducing anxiety and depressive symptoms. The global mindfulness-based meditation apps market accounted for 153.6$ million in 2019 and is estimated to be 341.9 million by 2029(1). The continued growth of the mindfulness-based app industry now sees app developers seeking to provide additional content and features to engage users. This pattern of development has supported a boom in workplace wellbeing with many employees now offering access to mindfulness techniques to employees through the use of these apps. Two apps, Calm and Headspace are estimated to claim nearly 70% of the overall market share with Calm becoming Apple's number 1 app of the year in 2019 (1). Both Calm and Headspace are expanding their reach by partnering with corporate entities to dominate the workplace mindfulness space.
What are the benefits of using mindfulness-based apps?
The use of mindfulness-based apps to reduce stress, anxiety and improve health and wellbeing is increasingly being robustly evaluated. A review conducted in 2018 identified only 4 evaluations of apps that targeted perceived stress levels (3). When results of these studies were combined with other electronic interventions there appeared to be a trend in stress reduction (3). A more recent review included 27 randomised studies all including smartphone apps. Results showed that the use of smartphone apps with elements of acceptance and mindfulness resulted in significantly higher levels of acceptance and mindfulness (4). The use of these apps also showed a reduction in psychological distress and increases in self-compassion (4). Another review published at a similar time included 34 studies showing a trend of reducing stress, anxiety, depression and psychological well-being by using mindfulness-based apps(5).
For the management of specific health conditions, fewer studies on the use of smartphone apps are available but the use of electronic eHealth interventions is encouraging. Of 17 studies identified in 2018 delivered largely through web-based platforms mindfulness- and relaxation-based interventions showed a potential for positive effects for people with a variety of conditions (irritable bowel syndrome, chronic fatigue syndrome, cancer, chronic pain, surgery and hypertension) (5).
As with any research, it is important to consider the exact intervention delivered and the population. When eHealth interventions, including smartphone apps in employees, was evaluated the mindfulness-based interventions showed greater effects than interventions including cognitive behaviour therapy or stress management (6). The authors conclude that "employers and other organizations should be aware that not all interventions are equal, many lack evidence and achieving the best outcomes depends upon providing the right type of intervention to the correct population" (6).
Apps clearly allow users to access content flexibly at their own time and choice of location. The use of technology to provide reminders, notifications and timers can also be helpful to develop or maintain a mindfulness-based practice.
Are there any harms of using mindfulness-based apps?
There are currently no standards for the development of a mindfulness-cased app leading to a large variation in the quality of apps on the market. The majority of apps have been shown to have minimal data protection and privacy features (23% with a privacy policy) or any consent requirements (7). Very few apps work with researchers or health-care professionals to develop their content and so the content may not support the intended aims of the app. A small minority of apps are able to demonstrate any evaluation of their effectiveness or share this with their users.
Can mindfulness-based apps teach us true mindfulness?
The Buddhist interpretation of mindfulness is paying attention but also identifying unskillful and skilful thoughts, feelings and actions. This expression of mindfulness encourages non-attachment to material things and to strive for greater awareness and spiritual enlightenment. An often shared argument against mindfulness apps is that they may be touching lightly on these principles, or overlooking the root causes and conditions in society resulting in suffering by focusing solely on techniques to aid the individual to deal with the stresses and strains of life.
How can you use mindfulness-based apps mindfully?
There is emerging evidence that using mindfulness-based apps can improve health and wellbeing when used consciously and at the same time allow you to generate a greater understanding of mindfulness in general. Despite the potential disadvantageous of a burgeoning market that is not quality assessed the benefits do appear to outweigh the harms. As with any practice linked to conscious living being aware of the benefits and disadvantages is a key component of decision-making. Here are 8 ways that you can use mindfulness-based apps mindfully:
Be conscious of your use of your smartphone to access the app. Having an app to access mindfulness-based practices on your smartphone is super convenient. It allows you to practice at any moment in the day and in any location. In a digital age when we are surrounded by technology and enticed into using it, its vital to be mindful of our use of it, even for self-care practices. Try to use your smartphone solely for the purpose of the practice, without getting drawn into a rabbit hole of content before or after. Consider turning off your notifications during practice time to ensure that you are fully present in the mindfulness-based app.
Be aware of the quality of the app that you are downloading. Databases such as the Mobile Health App Database MHAD http://mhad.science/ can be useful in identifying those who are developed based on a scientific approach. The One Mind Psyber Guide is also a great resource to find an app that suits a particular mental health issue https://onemindpsyberguide.org/ and provides an assessment of the credibility, user experience and transparency and detailed reviews conducted by professionals.
Be clear of the reason you are using the app. It is important to make a distinction between using mindfulness-based practices to improve health and wellbeing and the use of these practices for particular medical conditions. There is a wealth of evidence for the use of mindfulness-based therapies for physical and mental health conditions but take care in choosing the correct one for you. If you want to use the mindfulness-based app as a complementary therapy take a few moments to chat with your physician for advice on what might be the best option for you and how this can support your treatment.
Be cautious of health claims used to market apps. Consider the research and how the apps have been developed. Are the techniques used supported by research? There is a call for more stringent regulation of health-related apps as many apps do not meet the latest scientific evidence for treating conditions. The challenge is that the growth of apps is often faster than science can keep up with. Some simple checks can help: Look for information on how the app was created and who helped the development process. Look at the teachers providing content on the app and if they share their credentials for teaching. Look for any evidence that the app has been tested or evaluated with a group of people and what the results were. The more we ask these questions the more apps will need to be transparent.
Be wary of workplace wellness gifts If your employer has gifted the use of a mindfulness-based app to you it generally indicates they are thinking about your wellbeing. However, it may take more than the app to create a mindful workplace. By gifting access to mindfulness-based apps workplaces can be resolving responsibility to make other changes. Mindfulness does not substitute flexible hours, changing workloads and pressure or avenues for employees to discuss their own mental health and access the support they need. Although well-intended the aim can be to improve productivity, reduce illness rates and health-care costs to the organization. If the wellbeing of your workplace could be improved then continue to ask for changes that matter as well as adopting more mindful approaches to your own self-care.
Be picky about your choice of app. Choose an app that respects your time and the way you want to use it. If you find that an app is sending way too many notifications and updates or offers then maybe this app is not the right one for you. The relationship with an app should be like the relationship you have with a yoga mat. A relationship of mutual respect for using the product and what it can provide for you. Try the free version before you make a purchase and don't be afraid to press the disinstall button if you need to - there are plenty of other apps to look at!
Be mindful in your daily life - Think about taking your mindfulness-based practice off your smartphone. How can you address some of the issues in your life by being more mindful? Start small with your interactions with loved ones, colleagues and friends. Then consider how you could contribute to addressing broader societal issues that contribute to misery and suffering. Try to see the incorporation of mindfulness into your life as an opportunity to share your approach with the world. Be inquisitive about what mindfulness means and how it can benefit you and the world around you. You may enjoy exploring apps developed from Buddhist communities to expand your understanding of the meaning of mindfulness. Plum Village app offered by Thich Nhat Hanh and his monastic community is an example.
Be conscious of how you spend your money. It is important that we value the time, resource and energy that is required to train, develop and deliver the material that is included in smartphone apps. However, we can be conscious of where our money goes and how the app developers are investing it. If you are passionate about a social cause then look for an app that supports something similar or at least does not invest in a project that is directly opposing this issue. For instance, Smiling Mind is a not-for-profit app originally designed to share skills with young people to help them thrive.
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References
1. Global Mindfulness Meditation Apps Market, By Operating System (IOS, Android, and Others), By Service Type (Paid and Free), and By Region (North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa) - Trends, Analysis and Forecast till 2030” https://www.globenewswire.com/news-release/2020/06/10/2046383/0/en/Global-Mindfulness-Meditation-Apps-Market-is-Estimated-to-be-341-9-Million-by-2029-and-is-Anticipated-to-Grow-with-a-CAGR-of-8-3-PMI.html
2. Stay present with your phone: A systematic review and standardized rating of mindfulness apps in European App Stores. https://pubmed.ncbi.nlm.nih.gov/33215348/
3. A systematic review of Electronic Mindfulness-Based Therapeutic Interventions for Weight, Weight-related behaviours and Psychological stress https://pubmed.ncbi.nlm.nih.gov/28885896/
4. Can acceptance, mindfulness, and self-compassion be learned from Smartphone Apps? A systematic and meta-analytic review of randomized controlled trials. https://pubmed.ncbi.nlm.nih.gov/32586436/
5. The Efficacy of mindfulness meditation apps in enhancing users' well-being and mental health-related outcomes: a meta-analysis of randomized controlled trials. https://pubmed.ncbi.nlm.nih.gov/33049431/
6. Effectiveness of Mindfulness- and Relaxation-based eHealth interventions for patients with medical conditions: A systematic review and synthesis. https://pubmed.ncbi.nlm.nih.gov/28752414/
7. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/29267334/
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