Mindable FAQ - How can we help?

The digital health application “Mindable: Panic Disorder and Agoraphobia” is aimed at people aged 18 and over who suffer from the symptoms of agoraphobia and/or panic disorder. The treatment program is based, according to S3 guidelines for the treatment of anxiety disorders, on methods of cognitive behavioral therapy with an emphasis on confrontation techniques.

Mindable aims to support users in addressing their anxiety proactively. Therefore, the treatment modules consist of psychoeducation, habituation of body symptoms through targeted symptom provocation, and in-vivo confrontation exercises.

In addition, Mindable enables the systematic recording of symptoms, anxiety trajectories and behavior. Treatment progress can thus be optimally documented and, if necessary, shared with treating physicians and psychotherapists.

Mindable is aimed at patients 18 years of age and older with a confirmed diagnosis of a

Agoraphobia (ICD-10 F40.0) and/or panic disorder (ICD-10 F41.0).

We recommend Mindable in particular:

• to bridge the waiting time for a therapy place
• in case of regional lack of supply offers
• as a low-threshold offer for patients who do not wish to undergo therapy for the time being for fear of stigmatization

Prescription of Mindable is not indicated in patients with the following mental disorders:

• Schizophrenia and delusions (F20-24, F28, F29)
• Bipolar affective disorder (F31)
• Major depressive episode with psychotic symptoms (F32.3)
• Recurrent depressive disorder, present severe episode with psychotic symptoms (F33.3)
• Acute intoxication (F10.0 – F17.0)
• Suicidality and suicide attempt (R45.8; Z91.8).

Individual exercises are only conditionally recommended for the following physical limitations and illnesses:

• Pregnancy
• cardiovascular diseases (e.g. high blood pressure at rest, cardiovascular disorders)
• pneumological diseases
• photosensitive epilepsy
• Substance dependence

The corresponding exercises are marked with warnings. Advise your patients not to perform these marked exercises.

The term “DiGA” stands for “digital health application” (digitale Gesundheitsanwendung). These are CE-marked Class I or IIa medical devices whose main function is based on digital technologies. This main function is to assist in the detection, monitoring, mitigation or treatment of disease or detection, mitigation, treatment or compensation of injury or disability through digital technologies. A DiGA are thus a “digital assistant” in the hands of the patient.

Mindable is also a DiGA and therefore listed in the official DiGA directory of the BfArM. Psychotherapists and doctors can prescribe Mindable by prescription. The costs are covered by the statutory health insurance.

A so-called health or wellness app can be any available digital application on the international market. Manufacturers can offer these freely and are not subject to any review or monitoring.

A digital health application (DiGA), on the other hand, is a selected app or web-based application that may only be offered on the German market after a strict government review process. They are tested, according to German law, by the Federal Institute for Drugs and Medical Devices (BfArM).

In addition, DiGA are class I or IIa medical devices and are also subject to the strict quality and safety standards of the Medical Devices Act within this framework. Furthermore, only DiGAs can be prescribed on prescription by physicians and psychotherapists and billed via the statutory health insurance funds.

All information about the DVG and DiGA can be found at Website of the Federal Institute for Drugs and Medical Devices (BfArM).

The entry in the DiGA directory of the BfArM for Mindable can be found here.

Mindable is prescribed on a panel prescription (Muster 16).*

The prescription must contain the PZN 17454202 and the name Mindable. Diagnosis and prescription duration do not have to be indicated on the prescription.

If you print prescriptions via the practice management system (PVS), you can find Mindable via the PZN: 17454202.

Alternatively, you can also issue a doctor’s letter (Arztbrief) with a confirmed diagnosis. Simply use our GKV template and our PKV template.

You can find more about the prescription process here.

*Psychotherapists can apply for prescription pads at their association of panel doctors.

Your patient submits the prescription/diagnosis certificate to their respective health insurance company. This can be done online, via the health insurance app, by mail or by phone.

Important: Not in the pharmacy.

The health insurance company will send your patients a 16-digit activation code within a few working days, which they can use to register in the app and start treatment immediately.

The statutory health insurance companies cover the costs for Mindable in full. Patients do not have to make any advance or co-payments.

Private health insurants can apply for reimbursement, many private health insurances (PKV) also cover the costs for DiGA. However, there is no uniform regulation and it is up to the respective PKV to give this instead. Here it is advisable to inquire in advance directly with the respective PKV.

Self-payers can also get access to Mindable. You can find more information here: www.mindable.health/selbstzahler

After successful registration, your patient:s will receive access to Mindable’s treatment program. This includes:

Psychoeducation: Users are first informed about the general mechanisms of anxiety and panic. Subsequently, maladaptive thoughts, safety and avoidance behaviors are identified and reflected upon through interactive exercises. The goal is to understand their perpetuating effect in order to actively reshape them in the next modules.

Symptom provocation (interoceptive exposure): Users are guided through animations to actively generate panic symptoms. Habituation desensitizes body memory and lowers the alertness of the central nervous system to panic stimuli. The goal is to reduce the number of panic attacks, as well as their severity.

Confrontation (in-vivo exposure): Users deliberately put themselves in fear-inducing situations through confrontation exercises. Here, too, habituation takes effect and conditioned stimulus-response patterns can be softened. More than 350 exercises are available for individualization, as well as the option to create your own exercises. During the exercise, a life recording of the anxiety level is made. Distorted perceptions can thus be corrected.

Checkup: enables weekly recording of symptom progress using targeted questions based on DSM-5 criteria. Progress in treatment becomes measurable and visible.

Diary: regular reflections in the diary serve to raise awareness of maladaptive patterns. Patients learn to relate panic attacks and symptoms to corresponding cognitions and behaviors.

Statistics & Histories: visualize the course of treatment. Patients are empowered in their self-efficacy and health literacy.

No. Mindable is not a substitute for psychotherapy. We recommend using Mindable as an accompaniment and support to therapy. Mindable is also suitable to bridge the waiting time for a therapy place and to counteract an aggravation of the symptoms. The confrontation with anxiety-provoking situations and places requires (at first) a great deal of overcoming; we guide and accompany users in this process. However, self-motivation is an important prerequisite for success.

No. The prescription of Mindable and traditional psychotherapy are independent health insurance benefits. This does not affect the entitlement of your patients to psychotherapy.

Mindable is based on the evidence-based and S3 guideline-compliant methods of the treatment manual “Exposure-based therapy for panic disorder with agoraphobia” (Lang et al., 2018) and was developed in close collaboration with the authors. It is currently being evaluated in a prospective, multi-center, randomized control group trial (RCT) with symptomatic participants. Preclinical data already show significant changes. For more information on our current studies, please click here.

Mindable a Class I MDD medical device. We are therefore compliant with the strict quality and safety requirements of the Medical Devices Act. In addition, Mindable has been reviewed by the German Federal Institute for Drugs and Medical Devices (BfArM) and provisionally included in the DiGA directory. More information can be found here.

In principle, Mindable can be combined with taking medication. However, it is important that no medication is taken before and during the interactive exercises (symptom provocations, confrontations, etc.). In the context of the habituation, it is explicitly desired and necessary that users experience anxiety. Within the app, users are informed about habituation and the role of medication as a safety signal.

No. Mindable explicitly does not see itself as a “panic button”. Mindable therefore does not offer any functions to counteract an acute panic attack, as these are to be considered as avoidance and safety behavior in the approach of confrontation therapy. In the app, users are informed about the perpetuating mechanisms of avoidance and safety behaviors and learn to reflect on them and refrain from them.
Mindable supports the long-term reduction of fear and panic through targeted confrontation.