Smartphone-based application for cognitive behavioral therapy of panic disorder: A feasibility study with volunteers reporting past panic attacks

Abstract

Background Panic disorder affects up to 5% of people. It is often treated with cognitive behavioral therapy (CBT) and antidepressants. However, access to CBT remains limited because of psychiatrist and psychologist shortages and long wait times. Digital health solutions have emerged to address this gap. Still, many applications lack personalization and professional oversight. Against this background, this study evaluated the feasibility of a smartphone-based application delivering structured CBT sessions for panic symptoms among Turkish-speaking adults with a history of panic attacks. Methods Twenty healthy volunteers participated. Each had at least one lifetime panic attack and no current psychiatric disorder. They completed five CBT-based sessions using the application. The sessions included psychoeducation, panic diaries, cognitive restructuring, and interoceptive exposure. Motivational interviewing strategies supported the sessions. To assess feasibility, we examined acceptability, demand, and practicality. Key outcomes were session completion rates, time on task, requests for assistance, perceived comprehension, willingness to continue, and likelihood of recommending the app. Results All 20 participants finished the five sessions. Session completion times differed by education level (F(2,17)=5.561, p=0.02). High school graduates required more time than university or postgraduate participants. Assistance requests were rare, occurring less than 0.5 times per session. Requests increased with age (ρ=0.46, p=0.04). Perceived understanding peaked at Session 3 (75%). Willingness to continue declined modestly at that session. Ultimately, 95% would “definitely recommend” the application. All respondents stated they would use it if they experienced panic attacks. Conclusions The structured CBT-based mobile application was found to be feasible, acceptable, and practical. It achieved high completion and recommendation rates. Our findings suggest it is essential to tailor psychoeducational content to each person’s educational level. Older users may need additional support. This application may be among the first structured CBT mobile interventions for panic disorder developed in Türkiye. It could serve as a pioneering digital mental health tool internationally.