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Review by expert Nancy A. Haug, Ph.D.

Pros:

  • Introductory 7-day program plus some additional content at no cost
  • Statistics and meditation tracking along with optional daily reminders
  • Customizable audio and visual cues to support relaxation
  • Robust curriculum including stories to help with sleep
  • “Daily Calm” new meditation each day
  • Suitable for families and children with “Calm Kids” content

Cons:

  • Subscription-based platform to access content beyond introductory sessions
  • Requires user engagement and commitment to achieve results

 

Product Description

Calm introduces the basics of mindfulness meditation with the “7 Days of Calm,” a guided course featuring 7 sessions of 10 minutes each. Completing a session unlocks the next meditation in the series. After completing the 7 sessions, users can continue to “21 Days of Calm” and the full catalog with a paid subscription. Progress is tracked with statistics on time spent meditating.

The full catalog contains multi-day series that focus on specific goals (i.e., managing stress, focus, calming anxiety, sleep, happiness, gratitude, self-esteem). Calm has both guided sessions (e.g., body scan, loving-kindness) from 3 to 30 minutes and unguided meditations, with new programs regularly being developed. For example, “Daily Calm” is a 10-minute program for easing into the day or unwinding, and “Sleep Stories” is designed to aid the user in falling asleep. Some of this content is available without a subscription.

The Calm smartphone app features customizable settings (e.g., background nature sounds and scenes), mindfulness reminders, session history and FAQs. The app allows one button access to breathing exercises, meditations and sleep stories. The web-based program additionally offers entrance to the Calm online communities such as Twitter, Instagram, Pinterest and Facebook, and a blog which explores different aspects of mindfulness practice.

Target Audience

The introductory Calm program is geared toward novice meditators, including those new to the concept of mindfulness, like children, yet its content can be appreciated by meditators at any level of experience. Calm may benefit individuals seeking to cope with daily stressors and find relaxation. Users will also appreciate the wide variety of mindfulness programs, such as forgiveness, commuting, walking meditations, and gratitude. The secular nature of Calm makes it accessible to a universal audience, especially those committed to initiating new meditation training or revitalizing their current practice. Individuals with serious psychological conditions should not use Calm as the primary replacement for mental health treatment.

Ease of Use and User Experience

Calm contains the standard mindfulness mobile app features of a session timer, e-mail reminders, progress tracking, program training, and an app community. There are audio and video features (e.g., music, nature sounds and scenery), which complement the guided meditation tracks. The interface is relatively easy to use on a computer or handheld device. The meditation sessions display a simple timer to let users see how much time remains. Some online users complained about the nature scenery and sounds as repetitive and distracting to the experience. Others noted program glitches such as the background sounds and timer being difficult to turn off. The FAQs address these issues (e.g., users must select a silent background scene in order to turn off the sounds). Recent program upgrades significantly improve the user experience.

As a long-time meditator, the 7 Days of Calm program was a welcome addition to my daily practice, providing discipline and consistency. The facilitator has a tranquil, soothing voice and she offers the appropriate amount of guidance without extraneous commentary. I especially liked the willingness of the app developers to program in timely intervals of silence to allow the user meditation experiences without interruptions by the facilitator. The breath awareness function offered audio and visual cues on when to inhale, hold and exhale. I also appreciated the aspirational and advanced nature of the content. The facilitator lays out clear goals for the meditator, while recognizing the tribulations intrinsic to modern life. My children (ages 9 and 6 years) completed the Calm Kids and Sleep series. They found the Calm app engaging and looked forward to their sessions.

A companion book is also available, Calm the Mind, Change the World, written by the Calm app developers. The Calm Life blog is an extension of the app and book, with a stated mission to “make the world healthier and happier through the super power of calm.”

User Interface

Calm is a web-based and smartphone application for Apple iOS (9.0+) or Android (4.0+) devices (phone or tablet), which can be downloaded from Apple iTunes, Google Play or Amazon.com. It is not available for Blackberry or Windows phones. Some users noted on iTunes store reviews that the app does not work on Kindle Fire or the Apple watch. The FAQ includes “using the app” and “troubleshooting” sections. On the iPhone, there is an option to connect Calm with an Apple Health app. Calm.com, Inc. was founded in 2012 by Michael Acton Smith and Alex Tew, and is headquartered in San Francisco, CA, USA. The meditation programs are guided by Tamara Levitt, an author and producer, and the Head of Content at Calm.com.

Appropriateness of Content

Mindfulness and meditation have roots in ancient Eastern philosophical and spiritual traditions, Hindu and Buddhist religions. Jon Kabat-Zinn brought contemporary mindfulness to mainstream medicine and psychology through clinical intervention programs like Mindfulness-Based Stress Reduction (MBSR). Calm incorporates mindfulness practices from MBSR without religious or spiritual discourse. Techniques include breathing exercises, body scans, focused attention, non-judgment of one’s experience, walking and sitting meditation.

Calm provides the structure and guidance necessary to facilitate a daily meditation practice and mindful awareness. Over 25 nature scenes and sounds are used to invoke relaxation. Users are encouraged to complete a meditation session every day to maximize the benefit of the program. Once 7 Days of Calm is finished, subscribers may complete 21 Days of Calm to deepen their practice, along with other multi-day series or guided meditations. At these higher levels, users may opt to increase the session time in intervals from 3 up to 30 minutes. The guided and unguided meditations can be completed at any time.

Calm does not offer psychoeducation on the scientific evidence for mindfulness training. Although Calm can be used in clinical settings as an adjunct to psychotherapy, it is appropriate as a stand-alone, self-help tool for the general population. Some of the meditations offer focused support for anxiety, concentration, sleep and self-esteem. There is also an “Emergency Calm” meditation that provides relief for feelings of being overwhelmed or stressed.

Appropriateness of Feedback

Feedback is provided on user’s profile page. Visual progress appears under a calendar, which highlights days when Calm was utilized, and shows personalized user stats: longest “streak,” time meditating and total sessions. Users can also drill down to view their session history. Calm does not employ mood assessment ratings. As with any meditation practice, disciplined consistency is critical to achieving progress. The Calm phone app has the option to schedule notifications to remind users to meditate.

Ease of Account Management

A username and password are selected upon registering for the free program and downloading the application. Once the subscription fee is paid, the full Calm catalog is unlocked and users can select their own program. A profile button allows management of the subscription and settings. It is possible to purchase a gift subscription for another person. When I submitted a question about my subscription, I received a response and action within hours from the Calm support team.

Scientific basis

Scientific evidence supports the efficacy of mindfulness interventions to improve physical and mental health outcomes1,2.  Some psychological treatments have mindfulness components or informal practice, while others are almost exclusively based on mindfulness meditation practice. Mindfulness-based approaches are being employed not only in clinical settings, but also the workplace, schools, the military and prisons2.

Over the past five years, internet and smartphone mindfulness programs have proliferated2,3. These programs have the benefits of reaching hidden populations, low cost, portability and convenience. Emerging research has demonstrated benefits of mindfulness technology interventions. For example, one study showed reduced stress, anxiety and depressive symptoms from an online mindfulness course, although the study was limited by high attrition rates4. Another randomized trial indicated decreased symptoms of anxiety, depression and insomnia by a group receiving an internet-based mindfulness treatment compared to a control condition.5

Mindfulness meditation may produce neuroplastic changes in structural and functional brain networks, although research is still in early stages1. The underlying neurobiological mechanisms explaining the positive effects of mindfulness are not well understood. Neuroimaging studies are identifying the putative brain areas and neural circuits linked with attentional control, emotion regulation and self-awareness. One theory suggests that mindfulness increases activity and functional connectivity in the prefrontal cortex while reducing activity and functional connectivity in the amygdala region.2

Qualitative Review of Program Efficacy

Calm has not been evaluated using empirical methods, although it is increasingly recognized in the media as a preferred mindfulness app (see below). Calm is advertised in app stores as “the #1 app for mindfulness and meditation to bring more clarity, joy and peace to your daily life.” However, the source for this rating is unclear. One of my students uses Calm with youth ages 8-18 years during therapy to teach breathing and body scan. Anecdotally, she reports that Calm helps guide their practice at home and receives positive feedback.

Estimate of Efficacy Relative to Similar Products

Calm was not included in a recent review of 23 mindfulness-based iPhone apps using the Mobile Application Rating Scale (MARS)3, probably because it is too new. Calm received excellent reviews by users on iTunes (4.9/5), Google Play (4.5/5) and Amazon.com (4.4/5). Calm was deemed one of the “Best Meditation Apps of 2016,” along with Buddhify and Headspace, by Healthline.com. The Guardian selected Calm as one of the five best meditation apps in 2016. The New York Times (May 4, 2016) described Calm as “simpler in terms of features and menus than Headspace, and more relaxing in its look and feel.”

Cost

The initial 7 Days of Calm, unguided sessions, some guided sessions and tracking features has no cost. A subscription which provides access to the entire Calm catalog costs $12.99/month, $59.99/year and $299.99 for a lifetime subscription. This is comparable to other mindfulness apps and a good value for the amount of content currently offered and the rate at which new content is being developed.

References

1Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., Chapleau, M., Paquin, K., & Hofmann, S. G. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763-771. doi: 10.1016/j.cpr.2013.05.005

2Creswell, J. D. (2017). Mindfulness Interventions. Annual Review of Psychology, 68(18), 1-18.26.

3Mani, M., Kavanagh, D. J., Hides, L., Stoyanov, S. R. (2015). Review and evaluation of mindfulness-based iPhone Apps. JMIR MHealth and UHealth, 3(3), e82. doi: 10.2196/mhealth.4328

4Cavanaugh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013). A randomized controlled trial of a brief online mindfulness-based intervention. Behaviour Research and Therapy, 51(9), 573-578. doi: 10.1016/j.brat.2013.06.003

5Boettcher, J., Astrom, V., Pahlsson, D., Schenstrom, O., Andersson, G., & Carlbring, P. (2013). Internet-based mindfulness treatment for anxiety disorders: A randomized controlled trial. Behavior Therapy, 45, 241-253.

6Tang, Y., Holzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 17(1), 213-25. doi: 10.1038/nrn3916

Reviewed December 2016

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