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ReachOut Breathe is an app for managing anxiety via controlled breathing exercises. Learn more about the app, and get information on when it is appropriate to use it, find out what young people thought of it, and read professional advice and young people’s tips for using it in practice.

 

This tool will assist with:

  • regulated breathing exercises
  • managing panic attacks
  • reducing anxiety
  • improving mindful self-awareness skills.
ReachOut breathe

About Breathe

The ReachOut Breathe app helps reduce symptoms of stress and anxiety by slowing down the heart rate with focused breathing exercises. Using the app on their iPhone or Apple Watch, the user is guided to undertake a controlled breathing exercise, and is able to get biofeedback on the impact of the exercise by measuring their heart rate before and after.

There is a wealth of publications based on this technique and it is the standard non-pharmacological anxiety reduction technique taught in medical school. It is consistent with both mindfulness-based cognitive behaviour therapy (MCBT) and acceptance commitment therapy (ACT), with significant evidence of efficacy behind both approaches. The measurement of heart rate through the use of phones and wearable devices has been shown to be effective and helpful in self-monitoring.

Other notable features:

  • Heart rate is measured using the flash and camera on the back of an iPhone.
  • Users can add reminders to practice the breathing exercises during their day.

Where to access this tool

ReachOut Breathe is free to download, and is available on Apple (iOS) devices and the Apple Watch.

When to use Breathe

The Breathe app can be used for anyone experiencing some form of anxiety or stress. For those suffering panic attacks, it is a good way of practicing breathing retraining (learning to slow the breath and heart rate). It can be particularly helpful for young people you are trying to encourage towards non-pharmacological or self-help forms of anxiety management.

This app would also be appropriate and helpful for young people wishing to practice and develop mindfulness, with guidance on how to use it for that purpose. Young people report finding it helpful for calming themselves before or during stressful situations, as a technique for focus or distraction, and for relaxation.

What young people thought of Breathe

Likes

  • We could measure our heart rate within the app in a relatively easy and unique manner.
  • I liked that the app gave additional information on why controlled breathing was important.
  • The graphics and the simple design is the best. Love the use of the circle, the filling and unfilling of the circle really helps you concentrate on the air filling your lungs.
  • The minimalist design is gorgeous and keeps the focus on the activity at hand. Also amplifies usefulness as the graphics are calming in their own right.
  • Easy to access the breathing/heart rate screens as soon as the app is opened rather than having to navigate through a lot of screens. No sign in/sign up was very desirable too. :)
  • It’s easy to use and functional. It makes sense, which takes anxiety out of using it.

Dislikes

  • More thorough tracking of readings and use could be useful.
  • The only issue was that the heart rate monitor is difficult to use with iPhone cases and I had to take mine off for my fingerprint to register.
  • The heart rate monitor could not detect my pulse and it took a few trial and errors to finally get there. The same happened with the breathing feature.

Professionals’ advice on using Breathe in practice

Use the app with the patient to show them its usefulness. Be familiar with it yourself so as to normalise it for them too. - Jeremy

This app has the advantage of being able to offer mindfulness practice, breathing retraining and biofeedback and would be useful for young people with a variety of mental health concerns. - Anna

How to introduce Breathe

  • Discuss the technique of using breathing exercises as a way of managing anxiety, responding to panic attacks and bringing focus in times of stress.
  • Introduce the app as an easy and accessible way of doing breathing exercises and seeing the impact through changes in your heart rate.
  • Show them the app on your phone or device and walk through how to measure their heart rate, and how to undertake a breathing exercise. Encourage them to give it a go themselves to see how it works.
  • Ask them to practice the technique between your sessions, in particular during times of stress.

Tips on using Breathe’s key functions

  • The app’s key functions (heart rate measurement and breathing exercise) are easily accessed by tapping on the corresponding circles, available on the home screen.
  • It will take a short period for the phone to register your heart rate, during which a yellow light will appear on the screen near the flash. When the phone has registered your heart rate it will show a circle slowly filling as it records the heart rate over 15 seconds (for accuracy).
  • The app will guide you through the breathing exercise – holding your thumb on the screen and breathing in until the circle is filled, holding your breath until a line around the circle is completed; and then removing your thumb and breathing out while the circle empties.
  • When you are ready to stop, press the pause button in the top left hand corner of the screen and press finish. An option to measure your heart rate again will be provided.
  • Breathing intervals (breathe in, hold, and breathe out time) can be adjusted in the settings section of the menu.
  • The reminder function is also located in the settings section of the menu.
  • Information on controlled breathing, its benefits and when to use it is available in the help section of the menu.

How to follow up with a young person

  • At your next session, ask them if they have tried the breathing exercises. Ask them for feedback on how much they helped.
  • Discuss situations in which the exercise might be helpful.

Advice from young people

Make sure they read the instructions on how to use both features and encourage them to be patient while it works.

Know your information about the benefits of controlled breathing and how this app can help young people.

Encourage young people to give it a go in different settings - when you’re under high stress, but also when you just want to take some time for yourself.

Be sure to express that it is also for general use; you don't have to be mid panic attack to find it improves your emotional or physical state.

Recommend it, give reasons why you think your client would benefit, but don’t force them to use it. Young people might find "breathing activities" a bit uncool and feel a bit silly being asked to preform them.

Use it, use it, use it, use it!

Acknowledgements

This tool was reviewed by Adrienne (20), Anna (20), Indah (21), Isabella (19) and Meagan (19), young people from the ReachOut.com community. Professional advice was provided by Anna Sidis (Psychologist) and Jeremy Law (Psychiatry Registrar).

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