With an estimated 3.5 billion smartphone users worldwide, it’s not surprising that mobile therapy has begun to gain significant traction as a means of managing mental health. Each month, more users are logging into apps to treat issues such as stress, addiction, and depression – while connected devices such as fitness trackers sync with smartphones to deliver a more engaging, holistic experience.
But how effective is mobile therapy? And is it a good choice for you? In this article, we’ll explore the goals and many applications for mobile therapy, before introducing some popular apps that you can try out yourself.
What is Mobile Therapy?
Broadly, mobile therapy refers to the use of mobile devices, communications, and smartphone applications to provide mental health services. With rough estimates placing the size of the mobile health (mHealth) industry at around $37 billion, and over 90,000 mHealth apps for iOS devices alone, consumers are now turning to the market for a very wide range of treatments.
Due in part to their vast popularity and accessibility, a good amount of research has been done into the efficacy and uses of therapy apps compared to some other blended care components. Let’s start with some relevant definitions.
Defining Mobile Therapy
While no standardized definition exists as yet for mobile therapy or mHealth, several distinctive elements are widely agreed upon in the literature. Per the World Health Organization, mobile therapy refers to “…medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices”
According to Jovanov and Zhang, ‘mHealth’ covers the full scope of “…mobile computing, medical sensor, and communications technologies for health-care.”
These two definitions encompass a wide range of psychotherapy, counseling, and mental health services available for smartphones, which can be used:
- In addition to face-to-face (F2F) methods, to further patient or user well-being; or
- As the primary method of delivering these services, especially when the patient cannot, for whatever reason, access traditional therapy services.
The Evolution of Mobile Health
From very simple beginnings as mostly audio and text messaging-based apps, some earlier mobile therapy applications included rehabilitation programs for diabetics and cardiac patients. However, while studies looking at the efficacy of such medication adherence and self-management treatments were promising, they were relatively small, limiting their generalizability.
As smartphone usage has risen, and technology has advanced, so has the ubiquity of therapy apps on the market.
As smartphone usage has risen, and technology has advanced, so has the ubiquity of therapy apps on the market. By 2010, just two years later, almost 5,900 wellness and health smartphone apps were available; by 2017, the FDA count was around 325,000. Since their advent, various attempts have been made at regulating the industry, with regulatory efforts such as Policy for Device Software Functions and Mobile Medical Applications Guidance aimed at addressing software malfunctions and their potential to impact user health.
Today, mobile therapy has evolved to encompass a wide array of different approaches within the blended care model. We’re seeing video conferencing, social media groups, data collection apps, analytical functions, and psychological approaches such as the Experience Sampling Method becoming standard, alongside numerous studies showing good success rates and user experiences.
A little further on, we’ll look at some of these findings.
How Does It Work?
As we’ve seen, mobile health apps have a flexible part to play in blended healthcare – they can be a complement to existing treatments, such as counseling, or they can be used on their own as a less formal way for users to take charge of their own well-being.
We’ll explore a few examples of different mobile therapy treatments to see how they work.
Real-Time Symptom Monitoring
According to 2013 figures, around 6% of apps dealing with mental disorders worked by monitoring and evaluating key mental health outcomes, while 18% addressed less core issues such as relaxation, diet, and sleep. The basis for many such apps is real-time symptom monitoring, or experience sampling – a system that involves users logging and often rating their experiences of indicators such as panic, stress, or depression at points through the day.
These data reveal trends or patterns, and often apps are designed to provide feedback about potential responses to help patients or users manage their concerns. As an example, a stress management app may offer deep-breathing techniques should a user log a particularly high self-rating at a certain time of day. They may be directed to a nearby practitioner or given mental health information about how to handle a panic attack should one arise.
Real-time symptom monitoring often extends beyond self-report measures to incorporate physiological data which can be measured through sensors and which provide a more holistic overview of a patient’s state – examples include blood pressure readings, heart rate, or sleeping patterns.
Social (Media) Support
Most psychological research includes social networking initiatives such as LinkedIn, Facebook, and Twitter support groups when discussing mobile therapy. While peer support groups may be first to mind for many, social media also facilitates communication between patients and practitioners, enabling continued treatment both between sessions and in place of them when distance or mobility poses a barrier.
That is not to say that peer-counseling groups should be dismissed as a means of mobile therapy, however.
Research suggests that they too can play an important role in mental health, primarily by linking users to virtual communities where they can discuss problems, receive advice, and talk to others when the need arises. Most are free to join and often a valuable source of social support that has positive impacts on mental well-being.
An overwhelming majority of mHealth apps provide articles, lessons, and key information on particular mental issues – in a word, psychoeducation. Education on topics such as anxiety, trauma, and depression typically helps by empowering users to better self-manage their issues, enhancing health outcomes and reducing healthcare costs. Psychoeducation has 4 components. For an app to be considered psychoeducational, it must provide information on:
- Treating a condition
- Condition management
- Complying with psychological regimen; and
- Preventing progression, exacerbation, or relapse.
Many apps manage to create an engaging psychoeducational experience for users by structuring information as games, audio, video, or quizzes. Check out some of the mobile therapy apps we’ve described below for some examples.
Research On Mobile Therapy
Efficacy studies show some promising data about the efficacy of mobile therapy for the treatment of different mental health issues.
Very briefly, meta-analytic evidence suggests that apps designed to alleviate depression symptoms and help patients with self-management can significantly reduce depression symptoms. However, smartphone-based therapies may have the biggest positive impacts on people whose depression symptoms are mild to moderate.
Concerning anxiety, apps targeting anxiety symptoms have been shown to lower overall anxiety for users, providing those symptoms were sub-clinical – not psychiatric. Treatments combining mobile therapy with e- or in-person therapy, rather than standalone mobile therapy, had the biggest positive impact on users.
Efficacy studies show some promising data about the efficacy of mobile therapy for the treatment of different mental health issues.
The data on user engagement with mobile apps suggests that more attention needs to be paid to creating relevant, pleasant user experiences, as links have been found between high engagement and more noticeable health improvements.
On the downside, attrition – or dropout rates – tends to be high, with many patients starting but failing to complete mobile therapy programs on the whole.
9 Mobile Therapy Apps To Try
With many cross-platform apps offering free trials, why not have a look into one of these mobile therapy apps?
|Users can interact with accredited therapists on TalkSpace in various ways, such as instant messaging, video calls, or online journals. After subscribing, patients are matched with a personal primary therapist and can leave messages about relevant experiences – common topics include anxiety, stress, depression, or PTSD.|
Once or twice daily, counselors respond with advice or support, and the TalkSpace app is perhaps one of the most widely covered mobile therapy platforms when it comes to insurance and employer assistance.
|Price||Starts at $25 weekly|
|Good For||Professional Therapy, which can cover a wide range of issues|
|MoodKit offers more than 200 CBT-based exercises and activities designed to enhance users’ subjective well-being. Designed and created by clinical psychologists, it’s designed to encourage greater self-awareness, challenge negative thinking patterns such as cognitive distortions, and promote better mindsets.|
It’s flexible and includes a journal function that can be used to jot down patterns between thoughts, antecedents, behaviors, and coping strategies so that patients can take steps to boost their overall mood.
|Price||$4.99 on the App Store|
|Good For||CBT – General|
|Developed for young adults and teenagers, Mind Shift is an app that users can check into regularly to access CBT-based strategies for managing anxiety. It features guided meditations, coping cards, a thought journal, and belief experiments as well as science-based tools to help you set goals and achieve them.|
Free for Android and iOS, it’s designed by Anxiety Canada Association to help users deal with worry, panic, phobias, and more.
|Good For||CBT – Anxiety|
|The aptly-named Depression CBT Self-Help Guide features a range of useful tools for users of all ages who want to tackle symptoms of depression. From a screening test that measures the severity of symptoms to articles on CBT and clinical depression, it’s designed to help you engage in adaptive self-care, mood monitoring, and stress management.|
It’s also a good source of Emotion Training and Relaxation Audio tracks that can help you unlock more positive moods, but it’s currently only available on Android.
|Name||Depression CBT Self-Help Guide|
|Good For||CBT – Depression|
|Sanvello is regularly reviewed by clinical experts and is science-based, rooted primarily in CBT. It’s covered by many insurance plans and offers stress, anxiety, depression, and resilience assessments, as well as community groups, coping techniques, guided “Masterclass” journeys, and a daily tracker for recording your moods.|
Guided journeys tackle topics that help the user understand how to take better control, build confidence, and tap into mindfulness to improve their mental health and boost well-being.
|Good For||CBT – Stress, Anxiety, Depression|
|Not to be confused with WhatsApp, What’s Up contains a wealth of different resources that users can access to combat negative thinking patterns, emotions, and habits.|
It includes a thoughts and feelings diary where you can rate your emotions, a habit tracker, breathing techniques, forums, and inspirational quotes, as well as metaphors for dealing with stress. Data can be synchronized across different devices and it’s designed with a very user-friendly interface that’s customizable.
|Good For||Acceptance Commitment Therapy (ACT) and CBT – Stress, Anxiety, Depression|
|Created by the University of the West of England, Self-Help for Anxiety Management is a resource designed by psychologists to help users self-monitor and better cope with anxiety. Inside, you’ll find information on thinking, anxiety, relaxation, and health, along with practical advice to help you implement some of the techniques.|
You can construct your own personal Anxiety Toolkit using the resources provided, making it a flexible and easy-to-use app for anyone who wants to track their mood or connect with others.
|Name||Self-Help for Anxiety Management|
|7 Cups of Tea is a chat app that links users with social support in the form of volunteer “active listeners”, many of whom are trained to provide support to patients dealing with anxiety or stress. Free chats are available 24/7, and you can be matched with a different listener each time.|
Includes a free wellness test, instructive videos, mood-boosting activities, mindfulness exercises, and the option to talk to licensed therapists for an additional fee. 7 Cups of tea was created by an accredited psychologist.
|Name||7 Cups of Tea|
|Price||Free – $150 monthly|
|Good For||Social/Peer Support – Stress, Anxiety|
|With BetterHelp, users can chat with a licensed mobile therapist through audio or video calls for one monthly membership fee. Access group webinars on topics such as trauma and anxiety, and schedule sessions with your therapist or counselor.|
Users are assigned a private chat room where they can leave messages 24/7 about their lives, experiences, thoughts, and emotions – counselors then respond with personal advice and support to help.
|Price||Free app, counseling starts at $35 weekly|
|Good For||Professional Therapy, which can cover a wide range of issues|
Importance of Mobile Therapy for Practitioners
So, what’s in it for therapists? What benefits can practitioners and mental health professionals expect to enjoy by weaving smartphone and web-based apps into a blended care approach? According to the literature, there are several mobile therapy advantages for practitioners.
- App-based mental health treatments are easily accessible by most people – young adults especially. This demographic is particularly vulnerable to mental illnesses such as depression, anxiety, or stress, and the ability to reach them with online tech and social networking allows practitioners to reach more users where perceived barriers might otherwise exist.
- Mobile therapy often helps practitioners and patients overcome distance when they are too far apart to meet for F2F treatment. Good examples include videoconferencing apps that connect dedicated licensed therapists with their patients.
- Research also shows that some cultural groups are less likely to access in-person treatment in the wake of traumatic events, meaning that PTSD sufferers can often go untreated. However, such underserved demographics are just as likely to seek out and complete internet-based treatments, suggesting mobile therapy has the potential to reach a broader audience.
- Mobile therapy may also help mental health practitioners treat patients with sub-clinical symptoms – in other words, those who are suffering from a mental health issue but don’t meet the diagnostic criteria posed by clinical tests. For instance, Ly and colleagues show that anxiety apps have been effective in helping people with sub-clinical symptoms by lowering their overall anxiety.
More generally, and as part of a blended care model, patient interviews show that mobile therapy can:
- Improve patient consolidation of CBT materials, promoting better in-session and between-session alignment with mental health treatments
- Equip therapists with the means to monitor and reinforce patient exercises and progress between sessions
- Be an effective way to help clients manage depression symptoms in addition to F2F treatments – with good acceptance rates
- Be flexibly used as a means of treating individuals or groups, so that practitioners can expand their offerings and grow their businesses online
- Help clinicians easily track progress, create reports, and amend client programs accordingly using survey tools, journal features, and digital data from devices, among other things, clinicians can easily. By spotting trends and anomalies, as well as critical events that might have otherwise gone undetected, therapists can make better judgments about next steps.
- Foster accountability, empowering and engaging users through frequent check-ins, while giving them the means to track their progress and be more proactive in about their own treatment.
When it comes to blended healthcare and mobile app therapies, it’s difficult to imagine any technology completely replacing the traditional methods of providing care. However, mobile therapy apps can be useful in helping people control even mild conditions, and provide practitioners with useful data to help deliver more holistic, comprehensive, and up-to-date services as part of a blended care model.
In general, all the most apparent advantages of reduced cost, heightened convenience, and better between-session care seem very much to apply to mobile therapy – which is shaping up to play a promising role alongside online and in-person treatments.
Have you recommended a mobile therapy app for your clients before? What apps have you had great results with as a practitioner? If you’re a user, what’s your favorite app, and why? Tell us below!
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