Young people’s smartphone use has been receiving considerable backlash in the media and in proposed legislation, exemplified in the considerable interest in Netflix’s Adolescence series that has reignited calls for smartphone restrictions. However, newly-released research on Clear Fear, a self-guided cognitive behavioural therapy (CBT) mobile app designed to help children and young people manage anxiety, demonstrates the real-world value that smartphones can and do have in providing effective and accessible mental health support to young people, on-demand and at scale. Such innovations are under threat by blanket bans and a black-and-white view of young people’s technology use that paints all elements of smartphones with the same brush—a statement that has been similarly made in a recent Lancet paper.

Having recorded over one million downloads worldwide, the Clear Fear app uses evidence-based CBT techniques in a youth-friendly format, providing young people with accessible and practical tools to effectively manage their symptoms of anxiety. And now a peer-reviewed study, newly published in the Journal of Medical Internet Research (JMIR) Formative Research, provides promising evidence of the usability, acceptability, safety, and effectiveness of the app for young people with anxiety, particularly those who are unable to access immediate treatment.

After just eight weeks of use, the NHS-approved, evidence-based mobile app was found to produce statistically significant reductions in the cohort’s levels of anxiety, depression, and emotional and behavioural difficulties. This innovation therefore has the potential to provide accessible, immediate, cost-effective, and evidence-based support for young people’s mental health, complementing existing stretched traditional support services and alleviating pressure on them.

The researchers also found that, of the 37 young people aged between 16 and 25 years with symptoms of anxiety who took part, 92 per cent said that the Clear Fear app helped to reduce their feelings of anxiety, as well as 87 per cent saying it helped reassure them when feeling anxious.

“I liked the way the app asked what you were afraid of and then what you could do to battle it. I liked the way the questions made you face your fears and really think about it and not hide them.”  [anonymous study participant]

Alongside reducing feelings of anxiety, 84 per cent of those who used the app found it easy to use, and over 70 per cent used it frequently over the nine total weeks of the study.

“I liked using the immediate help feature and doing the breathing activities and panic attack feature because it helped to calm me down while having a panic attack. I also liked the safety net feature to remind myself what help I could get.”  [anonymous study participant]

These results complement existing in-app data from Clear Fear, which indicates that its activities are helpful in 93 per cent of instances. 

More about the Clear Fear app

Clear Fear is an interactive mobile app developed for children and young people to be able to access the kind of support for anxiety that is often provided in therapy sessions (Cognitive Behavioural Therapy), in a youth-friendly format, providing young people with accessible and practical tools to effectively manage their symptoms of anxiety. It was developed by experienced Consultant Clinical Psychologist Dr Nihara Krause MBE, in collaboration with young people themselves, and has even been recommended by Tom Holland.

As an app, it also means that this support can be available ‘in the moment’ and at any time of day or night, whenever a young person needs it. 

The Clear Fear app empowers young people to effect their own positive change, by utilising evidence-based CBT techniques to:

• face their fears;
• learn to reduce physical responses to anxiety, such as tense muscles and poor sleep;
• change their thoughts and behaviours;
• release emotions;
• learn about anxiety; and 
• monitor how they are doing and what works best for them.

Having been developed and maintained by a youth mental health charity, stem4, the app is also entirely not-for-profit: free to use for young people all across the UK, no in-app purchases, no advertisements and no selling of user data. No catch—just a tool designed to be as genuinely helpful as possible.

Why do we need apps to deliver mental health support?

It is widely-known that rates of children and young people’s mental health issues are consistently increasing in the United Kingdom, and anxiety is the most commonly experienced issue. Just under 1 million children were referred to the National Health Service’s Child and Adolescent Mental Health Services (NHS CAMHS) in the United Kingdom in 2022/23 [1], and in the following year, 200,000 were referred for anxiety in particular at a rate of over 500 anxiety referrals per day [2]. 

Traditional support services such as counselling provided by the NHS, while immensely valuable, are unfortunately unable to meet this exceptional and increasing demand, leaving hundreds of thousands of young people a year in the UK without the support that they need and deserve. As an exceptionally in-demand and overstretched service, just 30–40 per cent of children and young people who need mental health support from the NHS actually receive it [1, 3]. And this doesn’t include those who do not meet NHS criteria for treatment, but who would benefit from intervention both to improve their quality of life and to prevent development of a clinical issue requiring NHS treatment in future. 

Furthermore, the rising tide of youth mental health issues, alongside lasting impacts from the pandemic, mean that effects are being increasingly seen within schools in the form of increased absences, poorer behaviour, and teachers needing to provide increasing emotional support to students [4].

Amanda Collyer, Student Support and Wellbeing Ambassador, Howard of Effingham School, said: 

“There is a massive need for schools to support students struggling with anxiety every day, but our teachers often struggle with time, resources and even the expertise to provide the help every student needs. Having a clinically validated resource like Clear Fear, which students can access instantly, will make a real difference. We’re excited to start using it in our school to provide immediate, evidence-based support when it’s needed most.”

Easily-accessible technologies that provide safe and effective mental health support to children and young people at scale are therefore essential to be able to meet this growing demand, and are also able to save on costs. Anxiety treatment via CAMHS costs the NHS an estimated £2,338 per child [5]. Meanwhile, untreated anxiety in schools is a costly and growing problem across the UK, contributing to repeated school absences, which incur estimated costs of over £1 billion per year between education, healthcare and justice systems [3].

Support that is instantly-accessible, interactive and personalisable, available 24/7 and portable, that leverages young people’s existing technology, and that requires no waitlist or minimum criteria to access arguably cannot be delivered in any way other than as a smartphone app. Clear Fear achieves exactly this. 

Why do we need this research?

While apps are uniquely able to deliver effective mental health support into the hands of young people in the ways described above, it is also imperative to ensure that they are safe to use and work as they should, which is why this new study is a crucial step in evidencing the safety and effectiveness of the Clear Fear app.

Dr Nihara Krause MBE, founder and Chief Executive of stem4, the UK’s leading digital charity supporting children and young people’s mental health, commented:

“8 per cent of the 11.9 million children in England were referred to CAMHS in 2022/23, and most were unable to access talking therapies to treat symptoms of anxiety. This study shows that the Clear Fear app provides an effective, accessible, and scalable solution for managing anxiety, which young people are willing to engage with. 

“By integrating evidence-based Cognitive Behavioural Therapy (CBT) techniques into a user-friendly digital format, Clear Fear empowers young people to take control of their mental health while reducing reliance on overstretched healthcare and educational systems. 

“If we were to place Clear Fear into the hands of 100,000 more young people in the UK, which we are aiming to achieve via partnerships with schools, it could help the escalation of difficulties, provide young people and schools with tools to manage anxiety symptoms, and potentially free up waiting list spaces within CAMHS.”

The Clear Fear App for Schools

stem4 is working in partnership to embed Clear Fear within individual schools across the UK, scaling up access and reducing the strain on education and health resources. Get in touch at enquiries@stem4.org.uk to find out more or to register your interest in becoming a participating school.

– Ends –

A pilot study ‘Evaluation of the Clear Fear Smartphone App for Young People Experiencing Anxiety: Uncontrolled Pre– and Post–Follow-Up Study’ (Samele C, Urquia N, Edwards R, Donnell K, Krause N) was published in JMIR Form Res (DOI: 10.2196/55603).

For further information, please contact enquiries@stem4.org.uk 

References

1. Children’s Commissioner. (2024). Press Notice: Over a quarter of a million children still waiting for mental health support, Children’s Commissioner warns. https://www.childrenscommissioner.gov.uk/blog/over-a-quarter-of-a-million-children-still-waiting-for-mental-health-support/ 
2. Children’s Commissioner. (2024). Children’s Commissioner responds to new figures on children referred to mental health support for anxiety. https://www.childrenscommissioner.gov.uk/blog/childrens-commissioner-responds-to-new-figures-on-children-referred-to-mental-health-support-for-anxiety/ 
3. Children & Young People’s Mental Health Coalition. (2025). Future Minds: Why investing in children’s mental health will unlock economic growth. https://cypmhc.org.uk/wp-content/uploads/2025/02/Future-Minds-Report-2025-WEB.pdf 
4. The Guardian. (2025). How Covid changed children in Britain: Uncertainty, disruption, increased screen use and crippling anxiety are some of the legacies of pandemic school closures. https://www.theguardian.com/uk-news/2025/mar/18/how-covid-changed-children-britain 
5. British Association of Social Workers. (2017). Briefing: Children’s Mental Healthcare in England. https://basw.co.uk/policy-and-practice/resources/briefing-childrens-mental-healthcare-england 

About the Clear Fear App

The Clear Fear app aims to support young people in managing symptoms of anxiety early in their stage of development. It does this by:

1. Providing cognitive behavioural strategies to suit anxiety disorders.
2. Encouraging self-monitoring and self-management while building resilience.
3. Teaching alternative, adaptive ways to deal with anxiety.

The app provides a first step for young people looking for immediate techniques to help manage anxious thoughts and behaviours for longer-term change. It is also designed to be easily accessible for those who do not meet the criteria for mental health services or are currently on a waiting list to receive appropriate treatment for an anxiety disorder. The app does not replace specialist treatment but can be used in addition to it.

For more information on the Clear Fear app, visit the website here.

About stem4’s Library of Evidence-Based Apps

Clear Fear is one of five evidence-based apps developed by UK charity stem4 to address a range of mental health challenges in young people. Together with Calm Harm, Move Mood, Worth Warrior, and Combined Minds, stem4 is leading the way in providing comprehensive, evidence-based digital mental health support for young people.

For more information, visit stem4’s website.

Special Thanks
stem4 is grateful for the support of:

• Comic Relief and the Paul Hamlyn Foundation for funding the development of Clear Fear.
• The Nominet Reset Mental Health programme for supporting the app’s evaluation.
• Informed Thinking for their support in the study.
• The young people whose feedback and participation drive our mission to innovate and improve mental health care.