Review: the SAM app

What is it?

Stress Autism Mate (SAM) is an app to help the user cope with daily stress. It's designed for adults; there's also a junior version for young people aged 12–18.

This review covers only the SAM app, not the junior version.

Installing it on your phone

The app is available for free on the Google Play Store or the Apple Store. You need to provide an email address and activate your account via email. You'll set a password and a 5-digit PIN code.

The app asks for permission to send notifications to your phone.

Learning to use the app

After logging in you get the choice to watch an introductory video. It's 2 minutes and 5 seconds long.

It explains that the app asks you to log how you're feeling several times a day:

1. First comes the question "What have you done in the past 4 hours?"
2. The app then asks 7 additional questions to help work out how you're feeling. Your answers are used to estimate how much stress you have.
3. The app tells you your estimated stress level
4. You get a tip for coping with your stress level

The app helps you enter and track your answers:

• A new entry when it's time, your last measured stress level, the last tip given
• Making standalone notes of your own each day
• Daily overview and weekly overview: the app helps summarize what's going well and less well
• View your personally set tips

Setting up the app before use

(One-time: the app helps with this, and you can adjust it later in the settings.)

1. Set the time each day of the week you want to fill in your first questionnaire. You then have an hour to fill in the questionnaire; after the first half hour you get a reminder on your phone.
2. There's an average of 4 hours between each questionnaire, so choose to fill it in 2, 3 or 4 times a day.
3. Set personal tips (chosen from a list): for when you're home, and for when you're not.
4. Choose whether or not you want emoticons in the questionnaire.
5. Choose whether you want a graph in color (green-yellow-orange-red) or in shades of blue.

Possible benefits of the app

This app tries to make it easier to carry out logging tasks. In general, in psychiatry we see that logging tasks offer a lot of insight into the causes of stress, and also help practice the skill of learning to consciously check in and recognize emotions/stress.

This is a very evidence-based principle that this app has adapted for clients with autism who want a simplified way to gain insight into and change their emotion regulation and stress moments.

Autism-friendly:

• Works visually wherever possible, and in a few places preferences can be chosen too
• The language is concrete, clear, sentences aren't too long, and word choice isn't overly complex
• The app clearly explains how it should be used through a short video
• Gives examples to choose from and asks follow-up questions
• Helps translate answers into measurable data, produces small graphs
• A few settings help account for executive dysfunction, such as sending reminders and choosing how often per day you want to fill in questionnaires

Possible drawbacks of the app

Less autism-friendly:

• Input is requested frequently, so watch for overloading or overstimulating the client (who may already be stressed)
• It assumes the client can answer the questions asked (consistently). Many people with autism have difficulties with interoception: the skill of recognizing and being able to name what they feel.
• The personal tips also require self-knowledge and healthy coping strategies to be used without help (watch for shutdown/meltdown, where little is possible)

Less crisis-friendly:

• Often, in crisis, there's so little energy that even regularly filling in this app could be difficult
• Also, the app's content isn't aimed at serious crisis management, but rather everyday stressors

Less ADHD-friendly:

• Keeping up with the app requires significant daily organization, being able to take the time, and self-discipline

Conclusion

This app seems to offer a lot of benefits, provided the client can bring themselves to do it.

Given that executive dysfunction (e.g. difficulty switching/starting tasks) can also occur in autism, and that mental energy or emotional self-insight is often also lower, it's worth discussing whether the client feels good about using the app. The app really only gains value if it can be kept up consistently for a while.

Explaining that these logs can be very helpful for understanding what causes the client stress can also help with engagement/motivation. This app excels at helping find answers to the questions: "What causes my stress? How do I see it coming? How can I deal with it?" When these questions are present, the app helps search for experience-based answers. This is often also easier than when the client has to recall the past 2 weeks during a session with their practitioner, sorting relevant from irrelevant. The practitioner can help reinforce this learning process during sessions by reviewing the app's answers together and asking introspective questions.

When there's no specific question from the client, it seems important to discuss whether the client also feels the logging adds value. Meaningfulness matters, especially for clients who already have little energy left. Offering the app without framing seems useful to some people with autism, but for another part not supportive or accessible enough to make a difference.

Finally, the website also makes clear that the app remains in ongoing development, with the goal of continuing to evolve to help as many people as possible. I also find this a powerful, evidence-based way of working. A lovely app, applicable in several specific situations!

Originally published on the previous Brainspark website (22 February 2025).