The COVID-19 pandemic could accelerate the development of mental health apps. That’s good news for psychology because these types of apps can lead users to therapy and enhance treatment, say psychologists.
Mental health-related self-help apps now number somewhere between 10,000 and 20,000, estimates Stephen Schueller, PhD, executive director of One Mind PsyberGuide, a nonprofit organization offering accurate, unbiased information about such apps. The number can be hard to track as new apps are constantly being developed and older ones are taken off the market, says Schueller. “A lot of the growth is in products that are developed by individuals or small teams without any real intention or plan for long-term support,” he says. The number of apps with robust business plans and teams to back them—like Calm and Happify, or what Schueller calls “upper-tier products”—is increasing more slowly.
Apps could spur people’s interest in working with a psychologist, says Schueller. “Apps might be a gateway to subsequent care,” he says. “Someone might download a CBT app, realize it’s helpful, and then find a therapist to help more.”
And while some psychologists may worry that apps could replace therapy, that’s not happening, says C. Vaile Wright, PhD, senior director for health care innovation at APA, citing a study that found that just two apps—Headspace and Calm—account for 90% of active users (Wasil, A. R., et al., Journal of Consulting and Clinical Psychologyopens in new window, 2020). “I really don’t think people are turning to mindfulness apps as a replacement for therapy,” says Wright. Once people are in therapy, apps can help psychologists enhance patients’ progress. “A lot of work that happens in therapy actually happens outside the therapy office,” says Wright. “Apps can facilitate that work.” Apps can also help patients address co-occurring problems like insomnia or serve as booster sessions once therapy has ended.
There are some potential downsides, however. “Anyone can put an app up on the various app stores, so a lot of these are probably not that helpful,” says David C. Mohr, PhD, who directs the Center for Behavioral Intervention Technologies at the Feinberg School of Medicine at Northwestern University. (While the Food and Drug Administration regulates the small number of so-called “digital therapeutics” that aim to provide actual treatment, it doesn’t regulate self-help apps in the wellness space.) Ineffective apps could turn people off the idea of seeking therapy or disrupt a treatment plan a psychologist has already laid out, says Mohr. “And a few apps can be just plain dangerous,” adds Mohr, citing a study that found the content of some apps for bipolar disorder inconsistent with established treatment practice (Nicholas, J., et al., Journal of Medical Internet Researchopens in new window, 2015).
To ensure that self-help apps are a boon to psychologists and their patients going forward, clinicians need to get more involved, says Wright. “It’s important that psychologists serve as subject matter experts and consultants to companies developing apps,” she says. “Psychologists also need to be leaders in the regulatory field as well, since it’s a murky space right now.”
Marlene M. Maheu, PhD, executive director of the Telebehavioral Health Institute, agrees. “We’re either going to be part of the technological revolution—and help create it and direct it with proper values—or we’re going to be left behind,” she says.
