Going with the Flowy

For people who experience anxiety and panic attacks, breathing retraining methods have been shown to be an effective strategy to alleviate distressing physiological symptoms. While traditional clinical therapy provides patients with a wide variety of highly effective evidence-based treatments, such as Cognitive Behavioural Therapy (CBT), breathing retraining, and exposure therapy, it can sometimes be challenging to put these new skills into action at the time of requirement. For PlayLab London, these ideas led to the creation of a game that could act as a complementary tool to therapy, providing breathing retraining and support at the time of heightened anxiety. The product – a game called Flowy.

Flowy is a smartphone game designed to combat anxiety disorders and panic attacks. Through a combination of breathing training, narrative, and game mechanics, Flowy is designed to teach deep breathing techniques. The game has been designed as a complementary tool to assist people during the moment they are experiencing feelings of anxiety and panic. The game designers, PlayLab London state “Flowy helps people perform breathing retraining exercises wherever they go, a well evidenced technique, commonly given by clinicians to people experiencing regular panic attacks or a lot of anxiety.

Earlier this year, a randomised controlled pilot trial of 63 participants, was conducted (Pham, Khatib, Stansfeld, Fox, & Green, 2016). The study was a web-based, two-group trial, focussed on evaluating the clinical efficacy of the game, and providing evidence for the feasibility of this approach. One group of participants used Flowy for 4 weeks, while the other group formed the wait list control group (they received the game afterwards too).

For those in the intervention group, 100% of participants said that Flowy was an acceptable anxiety management tool. Flowy engaged participants, and following the four weeks of use, resulted in significant reductions in anxiety, panic, and self-reported hyperventilation scores, and a significant increase in quality of life. Furthermore, participants found that the game was fun and useful, and would continue to use Flowy, and recommend it to their family and friends.

While we should take care interpreting these results, particularly in relation to the limitations of the study, this RCT shows great feasibility for this approach, in particular with patient engagement. Flowy is not a replacement for professional mental health care, but this evidence suggests that it may be a valuable complementary tool.

The developers reported “75% of people who use Flowy, while they are anxious or very anxious, are no longer anxious when they finish”, and one user of the game said that it feels like “a secret weapon”. So if you fancy picking up the secret weapon of deep breathing, check out Flowy. The beta is available for free on the Google Play store here.

Pham, Q., Khatib, Y., Stansfeld, S., Fox, S., & Green, T. (2016). Feasibility and efficacy of an mhealth game for managing anxiety: Flowy randomized controlled pilot trial and design evaluation. Games for Health Journal, 5(1), 50-67.

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