Are mental health apps of any use?
Mental Health Depression Anxiety

Are mental health apps of any use?

Dr David Bakker
Dr David Bakker

In 10 seconds? Studies have found evidence that mobile health apps can reduce depression and help improve our moods. Researchers conducted a randomized controlled trial, comparing users of mental health apps and a productivity app.

What did they find? Testing the apps on over 200 participants, they’ve found that cognitive behavioral therapy (CBT) based apps helped users to reduce their depression and increase their wellbeing - but mostly for people with moderate levels of depression and anxiety. These apps give users practical strategies like relaxation and ways to examine and challenge their own negative thoughts.

What is CBT? CBT is a type of talking therapy that can help people to deal with problems by changing their thoughts, beliefs, and attitudes. For example, if you interpret a situation negatively then you might experience negative emotions as a result. These may trigger a certain kind of behavior, which can reinforce those negative thoughts and feelings. CBT uses techniques such as cognitive reframing, acceptance/tolerance, decentering/defusion, behavioral exposure/activation, and attention training to develop ways to cope and eliminate cognitive distortions. However, CBT has its critics - a 2015 meta-analysis (encompassing 70 studies published between 1977-2014) suggested that CBT's effectiveness has waned over the years. It also noted that women benefited more from CBT than men and that patients receiving therapy from experienced practitioners had a more noticeable drop in their depressive symptoms than those treated by psychology students.

CBT breaks down perceived issues into 'components' to help understand how they affect each other. Source: The Royal College of Psychiatrists
CBT breaks down perceived issues into 'components' to help understand how they affect each other. Source: The Royal College of Psychiatrists

OK, but what about CBT apps? The more recent randomized controlled trial (2018) suggested that users experienced improvements in their mental state. Participants were asked to download one of three mental health apps, or were allocated to a control group without an app. The participants’ anxiety, depression, and mental wellbeing were measured. After 30 days, all three of the apps had increased mental wellbeing but only two of the apps were shown to significantly reduce depression, while they did not affect anxiety levels. Again, the majority of the participants, (81%) were women and the median age was 34 years.

Why is research here important? We need scientific evidence because so many mental health apps are available that haven’t been tested this way. This means that we don’t know if they actually help or harm people. The biggest and most popular mental health apps don’t have this sort of randomized controlled trial evidence, so we should be mindful of using research to inform our choices. On the upside, such apps can become a gateway to therapy for people who initially avoid reaching out for professional help.

Will that change in the future? Yes, and more testing is likely. As healthcare providers have an interest in speeding up patients’ access to care, they need these tools to complement their standard therapies. Researchers are also working to make the apps even more helpful and effective. For example, the ability to collect vital data through them will help inform providers about how people use them and how they could be an add-on to real-life therapies. Although some studies say that mental health apps can reduce anxiety, the authors of the 2018 randomized controlled trial have noted that such apps at the time were not meant to replace professional clinical support, although the evidence suggested that some of them could be useful to improve mental health and wellbeing.

How does CBT work?

CBT is most commonly used to treat anxiety and depression but can be useful for other mental and physical health problems.

The method was developed in the 1960s based on the observations of an American psychiatrist, Dr. Aaron Beck, who found that depressed people had "automatic" negative thoughts about themselves, the world, and the future.

He started to work with patients to help them identify and evaluate these thoughts and found that as a result, people have started to view their situation more realistically and feel better.

To date, CBT has been backed up by thousands of studies and is the gold standard for treating the majority of psychological problems. The basic tenets of CBT make it possible to translate to websites or apps, and evidence is growing to show that it can be almost as effective and a lot more accessible than traditional face-to-face therapy.

David distilled 6 research papers to save you 21 hours of reading time with an evidence score of 4.3 out of 5

Please note: David is the founding director of MoodMission, the company behind one of the apps examined in the referenced study.

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