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Mobile Therapy Apps

If you Google “mental health apps,” you’ll immediately see that there is a burgeoning array of  mobile phone applications designed to complement, and in some cases even replace, traditional human-based therapy.

Apps like WhatsMyM3 are psycho-therapeutic assessment tools designed to measure the user’s risk for certain psychological or psychiatric disorders, including depression, anxiety, and PTSD.   Some of these assessment-oriented apps are designed to help clients come to a better understanding of themselves while others are designed to help clinicians more accurately diagnose their patients.

Other apps are designed as actual treatment tools for everything from depression, to PTSD, to alcohol addiction.  Some are designed by universities, licensed clinicians, and certified hypnotherapists, while other apps have less impressive, or at least less transparent, pedigrees.

But the important question, of course, is do these phone-based pocket therapists work?  My own tentative conclusion is that yes, these apps can be effective tools…sometimes, for some people, in certain situations, and usually in conjunction with human-to-human therapy.

But just like their human counterparts, there seems to be wide variation in the quality of “pocket therapists.”  So choose with care.

Following are some tips for choosing mental health apps wisely:

1. Read the Reviews: User reviews offer great insight into an app’s perceived efficacy and may provide clues about why it’s working well for some and not for others.  Look for apps with enough reviews to give you confidence that it’s an established tool and that the reviews are written by real users, not just friends of the developers.

2. Research the Developers: Look for a development team that includes credible and experienced clinicians.  What other apps have these developers been involved with and are those apps oriented toward mental health?  Avoid apps created by clinical amateurs.

3. Understand the Purpose: Get very specific in your understanding of what the app is concretely promising and compare that to what you’re seeking.  Some apps are diagnostic, some are for in-the-moment symptom reduction (e.g. when you feel a panic attack coming on in specific situations), some are for prevention, and some are designed to address core issues. If you get a program designed to diagnose anxiety, but you already know you’re anxious and really need symptom reduction, you’ll be disappointed.

4. Understand the Approach: How the app attempts to address the issue at hand should be clear in the app’s descriptive materials.  What is the theoretical orientation of the developers and what treatment modalities are they designing their tool around—family systems? E.M.P.O.W.E.R? Cognitive behavioral? DBT? SMART recovery?  Exposure therapy?  Biofeedback? Be sure that this is clearly articulated and that the approach makes intuitive sense—and clinical sense, if you’re a mental-health professional or savvy mental-health consumer.

5. Don’t Fire your Therapist Yet:  Part of a therapist’s job is to serve as an objective third party to monitor progress, lack of progress, regression, and risk factors.  A therapist can also help you review the objectives and approaches used in a given app to help you make sound purchasing and usage decisions.  Finally, no app can replace the interactive dynamic of a human clinician.  Relationship is fundamentally what therapy is about; an app can complement, but not replace a trust-based therapeutic relationship with another person.

6. When in Doubt, Try it Out: Especially if you have a trusted therapist to help monitor the results over time, give interesting apps a try.  They are cheap and it generally requires only a little time to know whether the app is or is not going to work for you.  Your honest review of the product—positive or negative—will help other consumers understand whether this app might or might not be for them.

7. Log your Experience: Keep a daily log of how you’re using the app and whether or not it seems to be helping.  If you sense that the app is actually making you feel worse—especially with serious issues like clinical depression, PTSD, and debilitating anxiety— stop using it immediately and debrief with your therapist.

My own impression is that these apps make the most sense for use by high-functioning patients who are deeply engaged in their own treatment decisions.  Apps that offer a clear and circumscribed function (e.g. help you sleep, reduce panic symptoms in the moment, implement DBT routines, etc.) and that are designed by clinicians as a complement, not replacement, to therapy seem to have the most promise as therapeutic tools.

Regardless of the fact that great progress is being made in the area of tech-based therapies, my own policy regarding psycho-therapeutic technology is to proceed with curiosity…and caution.

For now, the only therapist I’ll stick in my own pocket or recommend to others is one who promises little things.  Like a little help going to sleep, or some organizational assistance to help manage ADHD.