PACT Panel Review

PACT is a website-based app which provides daily psychological wellbeing support for people with Parkinson’s.

The app consists of short activities based on a type of therapy called Acceptance and Commitment Therapy (ACT for short). This can help you deal with difficult thoughts and feelings, and encourages you to do more activities that are important to you and in line with things you value. 

Dr Angeliki Bogosian is a researcher at City St George’s, University of London, and a key figure in the development and research of the PACT app. Dr Bogosian told the Tech Guide: “The idea of PACT came during the pandemic when digital apps and digital health support had to replace face-to-face delivery quickly. 

“We came up with the idea of PACT, and when we ran the idea by a group of people with Parkinson’s, we got overwhelmingly positive feedback. People reported that such an app would be helpful not only during the pandemic but could also help people with Parkinson’s with mobility issues or those who live in remote areas and have difficulties accessing psychological support.“

The app was developed by researchers from various universities, alongside 7 people who have Parkinson’s and 3 family members and carers.

With support from the Parkinson’s UK Research team, Dr Bogosian recruited 57 people with Parkinson’s to test how effective the app was in a research study.

Dr Bogosian said: “After using the app for 4 weeks, people with Parkinson’s showed less symptoms of depression. People found it really useful in terms of identifying a sense of meaning and developing a more positive mindset. They also liked the flexibility and ease of using the app.”

Please note: PACT is designed to promote psychological wellbeing and provide general wellness support. It is not a medical device and is not intended to diagnose, treat, cure, or prevent any mental health conditions or illnesses. Please contact a mental health professional if you feel that you need more support than this website can provide.

PACT is designed for mobile devices but you use it through your web browser, rather than installing it on your device from your app store. This also means you can use it on a normal computer or a tablet too. 

To start using the app, you sign up with an email address and a password. Set up was described as “fairly easy” by most of our review panel.

A reviewer whose low mood leaves her feeling self-conscious told us: “Everything was very clear. I set it up easily.”

Another reviewer agreed, adding that the website was ”Parkinson’s friendly”. They said: “The layout is well thought out with clear buttons and clear instructions.”

The modules

The app is structured into a 4-week course, consisting of 4 modules. Within each module, there are 7 sessions to complete. The aim is to do at least one session per day for 4 weeks. 

For the first 2 modules, the course follows a guided structure, with sessions presented in a pre-set order. As you complete each session, the next one unlocks, and in this way you can work through all 7 sessions, one at a time. 

The sessions cover topics like motivation, changing behaviours, mindfulness and goal setting. Most of the sessions are in video format, consisting of bite-sized animations that last 3-10 minutes.

In each session, you will be prompted to add a reflection by typing your response or audio format by clicking the button titled ‘start recording’ and speaking your response. These reflections typically ask you to think about what you have just seen, heard or read, and to imagine how it applies to your own life. 

1 reviewer particularly liked the voice recording note-taking option. “There is an option to voice record notes rather than just type which I liked. Navigating this app is very intuitive and there isn’t too much scrolling. It really was very easy to use.”

After completing all sessions in a module, you will be asked to reflect on how you currently feel and to review your progress. The website prompts you to complete 6 ‘My progress’ questions. It uses the responses to these questions to recommend sessions to you in Week 3 and 4. 

In weeks 3 and 4, you have the option of choosing a recommended session or picking your own. If you would like some guidance and are not sure which session to do next, you can choose the recommended session. The recommendations have been made based on your responses to the ‘My progress’ questions in the first 2 weeks.

A reviewer who has anxiety said: “The narrators in the session videos have a very calming voice… The animated videos use analogies to make the complex theories easier to understand. This helped to make the lessons ‘click’ for me.”

Most of the review panel liked the doodle-style videos, but 2 reviewers had some issues with them.

A reviewer who has anxiety that impacts their sleep felt the animations were not right for the Parkinson’s demographic. 

“I’m not sure who the audience is intended to be. Most of the graphics depicted young people and the idea of getting married and family life featured heavily in graphics which alienates single people and also doesn’t really fit with the Parkinson’s demographic.” 

Another reviewer agreed. They said: “I think the graphics and animations could be more engaging and it needs to become more Parkinson’s specific.”

Integrating into daily life

To complete the course within 4 weeks, you’re recommended to do 1 session each day. However, this is not compulsory. You can do as little or as much as you would like depending on how you’re feeling and your personal schedule.

A reviewer who was diagnosed with Parkinson’s in their 40s and is now 60 years old, said: “You can pick when you do the sessions and there is no huge time requirement for each session. You do need to practice the techniques on top of listening to the sessions but it’s easy to fit into everyday life.”

You can set up email notifications to remind you to complete a session. You can choose from a daily, twice daily or weekly reminder.

“I was able to set aside time each day for the course. The reminder notifications were useful and nicely worded,” said a 62-year-old reviewer. 

Impact on mental health and wellbeing 

PACT has been designed to promote psychological wellbeing and provide general wellness support. It is not a medical device and is not intended to diagnose, treat, cure, or prevent any mental health conditions or illnesses.

3 reviewers found the app helpful in giving them the tools to manage their low mood and anxiety and 2 found it “basic” and “too simplistic”.

A reviewer who says their low mood has impacted their hobbies like sewing and knitting told the Tech Guide: “It worked well for me. It has given me tools to manage anxiety and low mood. I feel I can come out of a low mood by focusing on the things I’ve learned.”

They said they were “very likely” to recommend PACT to others with Parkinson’s, adding “it was really helpful and it’s now something I can come back to.”

This was not the case for another reviewer, who told us their anxiety impacts their relationship with others. They said: “The product is not particularly Parkinson’s specific, many of the exercises were simplistic and some of the processes already known to me. Personally, it did not result in any significant changes to my life.”

However, they added: “I think the principle behind it is good and I’ve no doubt there will be many people who will get something from it.” 

Another reviewer also felt it was “generic”. They said: “I use a psychotherapist on a regular basis and from this I obtain real benefit and learning.

“Personally, I found it quite generic, but certain elements can be of use as part of a regular review of how you are feeling. This app is useful at a very basic level - but it is certainly not going to solve anything for you.”

A reviewer whose anxiety often leaves them overthinking liked the sessions and felt they would continue trying out the techniques. However, they did have one particular gripe.

“Some of the sessions were really useful and I have practiced certain techniques but too many of them started by telling me to just relax, if only I could! Parkinson’s can make relaxing virtually impossible on a bad day. Other sessions told me to sit up straight or concentrate on being still or think about the sensations in my body - none of which are easy or relaxing for me so that became increasingly annoying.”

Summarising their experience, they added: “On the positive side there are some strategies and techniques that I‘m going to continue to try, but on the negative side I never want to be told to ’just relax’ again!”

PACT is free for anyone to use. It currently consists of just 4 modules, that can be rewatched as often as you’d like, but Dr Bogosian does have plans to add more content in the future.

A reviewer who felt the platform was “generic” would still recommend it to others. They said: “I have found yoga and therapy to be the most useful for me - but that comes at a cost - this is free and easy to use - so worth a look and you just may find something for you in it.

“As it’s free there is no harm in having it as part of your Parkinson‘s ’armoury’. I wouldn’t pay for it though.”

A 75-year-old reviewer said: “This has been developed specifically for people with Parkinson’s, which I think is important and makes it more appealing than a generic mental health app. It does have some useful strategies so I’m very pleased that it’s completely free.”

This sentiment was shared by a reviewer who pointed out the difficulties of accessing free mental health support. “There seems to be two main options when it comes to getting help. You can get it free on the NHS but there can be extremely long waiting lists, or you can pay for a private professional. I can’t afford to do it privately and I know this is the case for a lot of other people. 

“It’s worth trying PACT because it’s helpful, you can do it from home and it’s free.”