What does the future of mental health look like? None of us know for certain, but if trends can be used as predictors, then it looks like things are going to get a whole lot more automated. In fact, they already are.
In the last three years alone, countless apps have been developed to address mental health issues from post-traumatic stress disorder and depression to social anxiety.
The million-dollar question is this: do they work?
Because this is such an emerging field, the research and evidence base is hustling to catch up. Many of the apps out there claim to be backed by “research” and “science”, but the research and science are far from scrupulous.
Researchers Van Ameringen, Turna, Khalesi, Pullia, and Patterson conducted a review of the research to date on apps that claim to assess, monitor, educate, or treat various mental health issues.
The researchers found some efficacy for use of these apps, particularly those that are based off of existing evidence-based tools. For example, the app BoostMe utilizes proven cognitive behavioral therapy techniques to help users reduce symptoms of depression.
With the rise of apps for treating mental health issues, will psychotherapists find themselves out of a job?
The short answer is no.
The most promising evidence for the efficacy of apps is when they are used in combination with in-person psychotherapy. Apps that track information like how much you are exercising, your location, and your sleep provide clinicians and clients with great information about symptoms and how clients are spending their daily lives.
Let's say you have been struggling with a depressed mood and are no longer finding pleasure in things you once enjoyed. An app that tracks location may also reveal that you have reduced the amount of time you spend outside of your home. A clinician can look at this piece of information, collaborate with the client, and create a behavioral activation goal to leave the house at least once a day. Behavioral activation has been a proven cognitive behavioral therapy technique for depression. Apps that collect passive data such as location, exercise, and sleep can provide rich information to a therapist trying to tailor a treatment plan for a client and to a client in growing their self-awareness.
Are you considering using a mental health app, or considering using apps with clients?
Here are some pros and cons to consider, as found in Van Ameringen, Turna, Khalesi, Pullia, and Patterson's comprehensive review:
Apps are easy to access.
Mobile apps can go with you anywhere.
Allow for easy and accurate self-monitoring of symptoms, in-turn improving self-awareness. For example, tracking apps can tell you your sleep patterns, how frequently you visit certain locations, and how often you are using technology, etc.
Apps are private and allow for help-seeking without the fear of stigmatization.
Promote help-seeking by creating an awareness for when higher level of treatment may be needed. For example, Someone with depression may not believe they need treatment. A screening app for depression may help them realize that their score is high and prompt them to seek help.
Pros to using an app in combination with psychotherapy:
Apps provide adjunctive psychoeducational tools to educate patients about symptoms, diagnoses, or treatments.
Provide clinicians with more objective information about client symptoms between sessions.
Reduces barriers caused by money, time, location, or transportation.
Apps can reinforce what is learned in therapy and provide practice and homework for clients.
Apps are typically more affordable than therapy, and may provide support so a client can reduce the number of therapy sessions or space out sessions.
Lack of quality evidence on app efficacy.
Apps limited to treating primarily mild symptoms.
Lack of accountability leads to higher rates of discontinuation than in-person therapy.
Apps cannot pick up on the subtleties of how clients respond, body language, etc.
Apps do not (for the most part) use a trained professional to make clinical decisions.
There is no therapeutic relationship, which is proven to be the greatest contributing factor in positive psychotherapy outcomes.
Apps cannot discern emotions.
While not an app, technology such as virtual reality, is making huge strides in how we treat some of the most difficult to treat disorders. Virtual reality exposure therapy has been found to be effective in treating anxiety disorders, and is now being used to treat phobias and PTSD (Opris et al., 2012).
As far as we have come, tremendous stigma still exists around issues of mental health. Artificial intelligence (AI) is changing the world around us, and it’s changing it fast.
Technology offers clinicians a golden opportunity to enhance the services they provide by offering more comprehensive support for the 167 hours of the week when a person is not in therapy.
Opris, D., Pintea, S., García-Palacios, A., Botella, C., Szamosközi, S., & David, D. (2012). Virtual reality exposure therapy in anxiety disorders: A quantitative meta-analysis. Depression and Anxiety, 29(2), 85-93. doi:10.1002/da.20910.
Van Ameringen M, Turna J, Khalesi Z, Pullia K, Patterson B. There's an app for that! The current state of mobile applications (apps) for DSM-5 obsessive-compulsive disorder, posttraumatic stress disorder, anxiety and mood disorders. Depress Anxiety. 2017,34,526–539. https://doi-org.libproxy.lib.unc.edu/10.1002/da.22657