Natalie Frank (Taye Carrol), a Ph.D. in clinical psychology, publishes on multiple topics in health, behavioral science, and other fields.

As many as one in four people are affected by mental or emotional disorders at some point in their lives. Historically, many of these individuals have not gotten the help they needed. Although effective treatments are available for mental health conditions, it’s been estimated that as many as two-thirds of people with a psychological disorder don’t seek help. There are many reasons for this including stigma, discrimination and fear of the consequences should others find out.

However, technological advances have led to the development of mobile apps that are geared towards improving individuals’ mental health and these are gaining in popularity. These programs have the potential to remove barriers to treatment for mental health difficulties. Such programs could reach many people who would not otherwise seek help, by providing confidence in the existence of absolute privacy and confidentiality. This potential has begun to be realized as an increasing number of people are relying on these types of apps to help them manage a variety of psychological conditions. These include such as post traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), difficulties related to eating and sleeping, and mood and anxiety problems.

Apps are available that incorporate empirically supported techniques such as Behavior Therapy, Cognitive Behavioral Therapy (CBT) and Acceptance Commitment Therapy (ACT) among others. Although experts don’t recommend pursuing assistance exclusively online, research suggests that these apps can be valuable aids, particularly, when used as a supplement to in-person therapy.

Disclaimer: The information provided here is of a general nature and cannot substitute for the advice of a medical or psychological professional. If you have thoughts of killing (or otherwise harming) yourself or others or you or someone else is in danger of being harmed, please dial 911 or the appropriate emergency number immediately. The content in this article is for informational purposes only and is not intended to replace or substitute for any professional advice or treatment.

Summary of Apps Discussed

Name of App Problem Targeted Primary Treatment Model(s) Reference Supporting Efficacy Get Happy Depression, Absenteeism, Under-productive Days Cognitive Behavior Therapy, Self Monitoring, Information Provisions Watts et al., (2013) Happify Stress, Sadness, Anxiety, Life Satisfaction Positive Psychology, Mindfulness, Cognitive Behavior Therapy, Self Monitoring, Howells, Ivtzan, & Eiroa-Orosa, (2016) Mindshift Anxiety Cognitive Behavior Therapy (adolescent and young adult). Family involvement encourages King, Cianfrone, Korf-Uzan & Madani, (2015) Recovery Record Eating Disorders, Maladaptive Eating Patterns Behavior Therapy and Enhanced Cognitive Therapy (Transdiagnostic Personalized Psychological Treatment for Eating Disorders), Self Monitoring, Information Provision Sadeh-Sharvit, et al., (2018) ADHD Angel ADHD Behavior Therapy, Self Monitoring, Information Provision. Includes possibility of family involvement Silva, Rodrigues, de la Torre Díez, López-Coronado, & Saleem, (2015) PTSD Coach PTSD, Acute Stress Responses Behavior therapy, Cognitive Behavioral Therapy, Self Monitoring, Information Provisions. Includes possibility of family involvement Kuhn, Kanuri, Hoffman, Garvert, Ruzek, & Taylor, (2017) Live OCD Free OCD Cognitive Behavior Therapy, Behavior Therapy, Self Monitoring Ameringen, Turna, Khalesi, Pullia, & Patterson, (2017) IntelliCare Depression and Anxiety Cognitive Behavior Therapy, Behavior Therapy, Self Monitoring, Active Coping . Mohr et al., (2017) Pause Stress, Anxiety, Lack of Attention, Concentration, and Focus Mindfulness, Relaxation and Medication, Cognitive Behavior Therapy Cheng, Lucero, & Buur, (2016)

Get Happy Program App

Get Happy Program

Using strategies based on the techniques included in Acceptance and Commitment Therapy, the Get Happy Program App lets you rate how happy you are in the areas of Relationships, Personal Growth, Leisure, and Work Education. Based on your ratings you will then be offered specific tips for improving your life in those areas. You can alter the settings so that the app will notify you with pop up tips that will remind you to do things that will help improve your life. Set the notification to be sent daily, every second day, weekly, or every two weeks. Choose any tips that are offered to you to share through Email, Twitter, or Facebook. The app is available for the Android, iPhone and iPod touch in the Google App Store. There is a computer version and a mobile version.

The research conducted on the outcomes of this app showed that the techniques presented significantly decreased depression, psychological distress, absenteeism and under -productive days. These changes remained significant for both the computer and mobile versions of the app at follow-up in the absence of further intervention. The creators caution you to seek professional help if your depression is severe, is preventing you from carrying out daily life role tasks or if you feel as if you might hurt yourself or someone else.

Happify App and Website

Happify App and Website

Happify App and Website- Happify is a system of different tracts that include a number of activities and information that will teach you the skills to have a happier life. The program has a strong empirical basis as it was developed by experts and researchers who studied evidence based treatments founded on positive psychology, mindfulness theory and cognitive behavioral therapy. Happify is designed to help you control your thoughts and feelings when you are sad, anxious or stressed. The program can be accessed through an app as well as a website and includes a number of interactive games and activities created for smartphones, tablets or computers. You can use the program even for small periods of time on the go or when you are taking a break at work or school.

The Happify Program provides an easy and quick method of tracking your progress towards greater happiness and saves the data in the form of a chart. A number of articles presenting the latest information on topics related to lasting happiness from a variety of viewpoints are included. You can also access a full community of others who are using the app, read their inspirational stories and post your own reflections on happiness and the meaningful ways it affects your life. Some of the skills taught in terms of how to be happy include:

Expressing gratitude

Appreciating what you have

Stress reduction

Creating happy relationships

Strengthening friendships

Becoming more socially connected

Being kind

Increasing social support

Meditation/Mindfulness

Writing down early life memories

Becoming a happy parent

Becoming a happy empty nester

This app is unique as it includes articles, exercises, games and activities for different stages of life, as well as a program for employers that will help increase productivity, engagement, focus and satisfaction among workers.

Studies on the program show that experts not involved in developing the program found subjective app quality to be quite good and users who had downloaded the program also gave the app high review. Overall, research outcomes were found to support the viability of the Happify Program for significantly enhance elements of well-being.

Mindshift App

Mindshift

The MindShift App is a free, easy-to use mobile app that was created to help adolescents and young adults cope with feelings of anxiety. The app helps youth begin to think about anxiety differently so they can work through it directly instead of avoiding the problem. MindShift aids young people in learning how to develop more beneficial ways of thinking, and to identify specific steps that will allow them to control their anxiety symptoms.

Mindshift addresses the following areas:

Making Sleep Count

Riding Out Intense Emotions

Test Anxiety

Perfectionism

Social Anxiety

Performance Anxiety

Worry

Panic

Conflict

Studies examining the efficacy of the Mindshift App have shown a decrease of depression, anxiety, conflict and intense negative emotions and improved sleep and performance from pre to post intervention. Coping strategies that are personalized to the type of anxiety from which the youth is suffering are generated. “Chill out tools” are provided which include relaxation exercises, visualization activities and mindfulness strategies. The user can choose either a male or female voice that guides them through the program.The home page is divided into sections:

Anxiety 101

My Situations

Check Yourself

Thinking Right

Inspiration

Although it is a common feature of a number of apps for developers or third parties to silently track data and the user of the app this does not occur with Mindshift so the user’s privacy is fully protected. The Mindshift App can be downloaded from iTunes or android smartphone for free.

Recovery Record App

Recovery Record

The Recovery Record App is the most comprehensive Eating Disorder treatment app currently available. It contains components such as self-monitoring, individualized coping strategies, enhanced social connection, and a portal to connect with the user’s clinician. There are rewards that you can earn by meeting goals such as access to games and puzzle pieces.

Some of the features included in Recovery Record include food/meal intake logs, thought monitoring, an energy level record and an emotion/feeling scale. Taken together these components make up a comprehensive self-monitoring system. For each meal, snack or binge recorded, this app lets the user record the context of the actual eating episode, along with related urges to eat/binge and/or use compensatory behavior and self-monitored triggers.

Users can request specific coping techniques derived from Cognitive Behavioral Therapy (e.g. distraction) for real time problems such as intense negative emotions along with acceptance-based techniques. Users are also able to write their own individualized coping techniques into the program and set clinical goals such as appointment planning, meal management, relapse prevention, and treatment. Strategy implementation assistance consists of a single-sentence description of how to carry out the strategy.

Other great features of the Recovery Record App include the ability to pair up with another user to share experiences and feelings and send encouragement, positive affirmations and quotes for inspiration and being able to post an activity to a community feed. A special benefit of this app is that there is also a clinician form which allows the individual’s provider to access their data (with their permission), communicate with the user and to make personal notes. Automated prompting helps encourage users to maintain a comprehensive record of meals and reminds them about their goals and associated meal plans for the day.You can also sync your goal setting related dates and deadlines with Google Calendar as well as set reminders for following through with goals.

Research supports the usefulness of this app for helping to maintain treatment gains and prevent relapse. It is also a useful program for problematic eating behavior that does not meet the severity criteria for a disorder. However, it is recommended that for severe eating related symptoms or disorders that individuals seek professional in-person treatment.

ADHD Angel App

ADHD Angel

The ADHD Angel was created through the joint efforts of a psychologist and an active police officer to help keep juveniles with ADHD out of the criminal justice system. The ADHD Angel App is intended to help those with ADHD in a number of areas. These include:

Reminders to take medicine

Texts that explain the basics of ADHD and can be sent to others

Information for police officers, paramedics, court officials and others as to how someone with ADHD needs to be treated

Doctor reports that can be sent before an appointment summarizing a patient’s symptoms and progress

Advice on some of the main difficulties that those with ADHD often experience

Emergency contact information for those who can help in a crisis related to ADHD

Functions to share information and data with health care providers and parents or guardians

Logs to track your daily moods

The most recent version of the ADHD Angel works in collaboration with Guardian Angel, an app that provides guardians or family members with parenting information, useful advice and descriptions of problems associated with ADHD and the ability to send electronic medication reminders. Research on the outcomes of the ADHD Angel App suggests that it is useful in increasing treatment compliance, keeping medical appointments and remembering to take medication on time.

PTSD Coach App

PTSD Coach

The PTSD Coach app was created for use by individuals with PTSD or trauma related symptoms by the VA's National Center for PTSD in partnership with the Department of Defense's National Center for Telehealth and Technology. The app presents information about trauma and provides advice, coping skills and other self help options for symptoms that commonly occur after an individual experiences a trauma. Some of the features of this app include:

Information about PTSD, trauma responses and interventions that have been shown to be effective

Methods for screening and monitoring your symptoms

Easy-to-use coping strategies that can help with help stress and trauma related symptoms

Direct links to resources for extra support and help

The creators of the app stress that the information and techniques provided are based on peer reviewed empirical research that give people who have experienced trauma useful facts and skills to manage their difficulties. They also recognize that those PTSD is a serious condition that affects not only the individual in question but also their friends and family. The app can be used to help friends and family learn about the outcomes of trauma, the causes PTSD and skills for managing their distress.

The creators of the app make a point of emphasizing that while the app is useful it should only be used as a supplement to appropriate professional medical and psychological treatment. They also warn that while people using the app can share data as the desire, but that since the data belong to each individual user, HIPAA requirements do not apply as long as the data are stored by the individual. However, if the user shares data with health care providers, the providers are required to comply with HIPAA rules.

Research offers support for the acceptability and perceived usefulness of the PTSD Coach App and demonstrates that it is an effective self-management tool for the symptoms of PTSD. Studies conducted show that users were very satisfied with the features of the app and found it moderately to very helpful for managing their symptoms. Specific areas of efficacy noted include managing acute distress and symptoms of PTSD, improving sleep, maintaining a schedule.

Live OCD Free App

Live OCD Free

This app was developed by a therapist who specializes in treating patients with OCD. The app has functions for both children and adults. The system implements a method called Exposure Response Therapy during which users practice resisting their compulsions for greater amounts of time. For example, someone with contamination obsessions might practice touching the doorknob then waiting two minutes before washing their hands, then five minutes the next time, then ten minutes the time after that.

The foundation of this intervention revolves around the individual’s belief that if they don’t carry out the compulsion in response to the obsession, some disaster will occur. Once the person understands there won’t be a catastrophe if they don’t engage in the compulsions, the link between the obsession and compulsion is broken. This means the person will no longer experience any anxiety even if the obsession returns.

In the children’s version there is a character that is named “Worry Wizard,” who wears a disguise. For each task mastered, the character removes one piece of his disguise. When the child has successfully accomplished all the tasks without anxiety, the “Worry Worm” reveals his identity.

While you don’t need to see a therapist to use this app, there is a therapist function which notifies a practitioner when the user engages in a practice session and reports on the outcome. The developer of the app does recommend setting up a single session with a therapist in order to create a plan that can be used with the app. After that, the user can decide if they want to engage in additional therapy sessions that can be beneficial when combined with the app functions. The app does include extensive user guides and video instructions so a user can easily learn how to utilize the app functions on their own.

The Live OCD Free app also has other tools such as a cognitive toolkit and coping strategies instruction for relaxation and meditation. The app also includes an Exposure Response Prevention guide with information about how to create custom individualized Exposure Response Prevention tasks for specific obsessions and compulsions. For children, there is a function which allows them to call a character named “Sage,” when they experience obsessions or when they give into an obsession and engage in the compulsion. There is also a recently launched forum that in which users can participate on the website.

Research suggests that the Live OCD Free app may decrease OCD symptoms by as much as 36% over an eight week period. Live OCD Free is a paid app costing $29.99. It is availabe for both ios android and iPhone technology.

IntelliCare Mental Health Apps

IntelliCare Mental Health Apps

Intellicare is a suite of 12 mental health apps produced by Northwestern University Medical School that can be downloaded individually or as a group. The specific apps focus on depression and anxiety symptoms and is intended for frequent but short interactions. The apps include:

Worry Not - helps you reduce worry with guided management techniques

Boost Me - gain more and a sense of accomplishment when stressed out or sad

Day to Day - small steps, easy strategies, tips and tricks letting you learn new lessons to maintain a positive mood

Social Force - learn to use social support to boost your mood

My Mantra - create messages that use strong words that you can repeat

Aspire - use your values to achieve your aspirations

Daily Feats - helps you recognize achievements

Thought Challenger - cognitive behavioral therapy for negative thoughts

iCope - create inspirational messages in your own words to help encourage you

Purple Chill - relaxation skills

Move Me - using activity and exercise to boost mood

Slumber Time - helps you learn to get a good night’s sleep with a sleep diary, bedtime checklist and mind clearing exercises among other functions

Research supports the IntelliCare system of skills-focused apps that can be used frequently and briefly to reduce symptoms of depression and anxiety. Over 90 percent of participants used the apps for eight weeks and participants experienced significant decreases in depression and anxiety symptoms. Over 95 percent of subjects downloaded at least five IntelliCare apps.

Pause Mindfulness App

Pause

Pause is advertised as an app that is founded on “ancient Tai Chi and mindfulness practice.” This app was created to combat the complex digital demands we face daily. To that end it was made to be intentionally simple so users could get the greatest benefit with the least amount of technological requirements and knowledge.

The app is billed as a “relaxation and meditation experience” that is intended to decrease stress and attentional difficulties that are sometimes initiated by the multitasking that we often find necessary today. It decreases stress through relaxation practice and a simple repetitive movement coinciding with calming visual and auditory stimuli to focus attention. Increasing attentional capacity improves task related performance which can increase work/school effort and positive outcomes and decrease the amount of time needed to complete tasks. These results can also serve to decrease stress, increase work and home related satisfaction, and your sense of self-efficacy and accomplishment.

Users are instructed to place their finger on a little blob and to move it around in a gentle manner. They are encouraged to slow their movement or continue it if they stop. This helps when their mind wanders to tasks or other things that cause the user to stop attending to the app such as email, work tasks, grocery shopping, and daily hassles they may be worrying about. As users continue to move their finger at the right speed, the blob grows in size until it fills the entire screen. At this point the app suggests the person might want to close their eyes to fully appreciate their moments of calm.

You can customize the amount of time you want your relaxation period to last, at the end of which a chime will sound to let you know it is over. The movement of the lava lamp like blob is complemented by soothing colors. There is a calming soundtrack of ambient sounds such as birds chirping and water flowing, that can be selected for what the creators call a “more immersive experience,”

Electroencephalogram brain-scanning techniques were used during development to confirm the approach was effective as indicated by changes in brain wave patterns. Researchers found that when subjects used the app brain wave patterns transitioned from patterns that indicated high stress to patterns that are characteristic of relaxation. Other research showed that the app was rated positively in terms of stress relief and relaxation, ease of use, and improved attention. The three components of the app, visual feedback, ambient audio, and slow steady movement were all mentioned as important aspects in establishing a relaxed state and restored attention.

Pause is a paid app available for both android and apple smartphones for $1.99 which can be shared by six family members.

Poll on Using Mental Health Apps

Summary and Conclusions

Mental health apps provide great potential for mental health care beyond the office of clinic. This is accomplished through a smartphone or other mobile technology that provides access to methods for evaluating, assessment, monitoring, and management strategies. These types of apps can help overcome barriers to treatment including locations or finances.

However, caution is warranted regarding these apps as current supporting research is somewhat limited in terms of their efficacy. Concern also exists that people with real mental health problems that need serious in person treatment may not get the treatment needed. This could in part result from the belief that the information provided on the app is sufficient to rid them of their symptoms.

While there are numerous self help apps available for a multitude of problems, they are not always appropriate or the best option for handling serious psychosocial problems. The general position of health care providers is that if you or a loved one are suffering from psychological or emotional difficulties that you consult with a properly trained and certified provider. They will be able to help you determine the best treatment options, possibly including but most likely not limited to online apps, for improving your overall and health related quality of life.

References

Ameringen, M., Turna, J., Khalesi, Z., Pullia, K., & Patterson, B. (2017). There is an app for that! The current state of mobile applications (apps) for DSM‐5 obsessive‐compulsive disorder, post traumatic stress disorder, anxiety and mood disorders. Depression and anxiety.

Cheng, P., Lucero, A., & Buur, J. (2016, October). PAUSE: exploring mindful touch interaction on smartphones. In Proceedings of the 20th International Academic Mindtrek Conference (pp. 184-191). ACM.

King, C., Cianfrone, M., Korf-Uzan, K., & Madani, A. (2015). Youth engagement in eMental health literacy. Knowledge Management & ELearning, 7(4), 646–657.

Kuhn, E., Kanuri, N., Hoffman, J. E., Garvert, D. W., Ruzek, J. I., & Taylor, C. B. (2017). A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms. Journal of consulting and clinical psychology, 85(3), 267.

Mohr, D. C., Tomasino, K. N., Lattie, E. G., Palac, H. L., Kwasny, M. J., Weingardt, K., ... & Caccamo, L. (2017). IntelliCare: an eclectic, skills-based app suite for the treatment of depression and anxiety. Journal of medical Internet research, 19(1).

Sadeh-Sharvit, S., Kim, J. P., Darcy, A. M., Neri, E., Vierhile, M., Robinson, A., ... & Lock, J. D. (2018). Subgrouping the users of a specialized app for eating disorders. Eating disorders, 1-12.

Silva, B. M., Rodrigues, J. J., de la Torre Díez, I., López-Coronado, M., & Saleem, K. (2015). Mobile-health: A review of current state in 2015. Journal of biomedical informatics, 56, 265-272.

Watts, S., Mackenzie, A., Thomas, C., Griskaitis, A., Mewton, L., Williams, A., & Andrews, G. (2013). CBT for depression: a pilot RCT comparing mobile phone vs. computer. BMC psychiatry, 13(1), 49.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Natalie Frank

Natalie Frank (author) from Chicago, IL on March 07, 2018:

Unfortunately, Patty, the more difficult the problem the more difficult the cure. Violence and aggression are very complex problems that result from a number of innate and environmental lifelong factors. No simple app will ever ever be able to touch them and unfortunately right now the best solutions involve early identification of individuals prone to such behavior - and often no one saw a problem until after the fact - and security and safety measures - and if the perpetrator is part of the system such as a fellow student. Too bad we can't put something in the water like we did with fluoride! Thanks for the comment.

Patty Inglish MS from USA and Asgardia, the First Space Nation on March 01, 2018:

I think these apps will become increasingly useful as greater numbers of Americans pay attention to mental health needs in our country. If we could have an app to decrease aggression connected with school shootings, that would be very useful. Some of the apps you describe might help. Thanks!

Natalie Frank (author) from Chicago, IL on February 28, 2018:

Thanks for stopping by and commenting. You're right about being careful and making sure that the person enters into the appropriate level of care for their specific problems.

Linda Crampton from British Columbia, Canada on February 28, 2018:

I've never heard of the apps that you've described. They sound interesting, but it does worry me that someone may use an app instead of getting personal help that may be more beneficial. As you've explained very well, though, I can certainly appreciate that the apps could be helpful in conjunction with professional advice.

Natalie Frank (author) from Chicago, IL on February 28, 2018:

Thanks for the comment Dora - The apps seem to be effective when used as intended especially if used in conjunction with at least one or two therapy sessions.

Dora Weithers from The Caribbean on February 28, 2018:

Thanks for the information on these mental apps and also for the warnings. If they work as expected, they should b very useful.

Natalie Frank (author) from Chicago, IL on February 27, 2018:

I agree with you Kathy. I think in the case of mild anxiety or depression such apps may be beneficial for people to use alone. But in general I would advise more caution if there is anything more serious going on. In person therapy for serious problems cannot be replaced with apps though such apps can be very useful used in conjunction with therapy, especially if the therapist is involved in their use. Thanks for the comment and the educated opinion.

Natalie Frank (author) from Chicago, IL on February 27, 2018:

You are so right, Bill. There are options out there there can help many people - it's all in knowing they exist. Thanks for the comment.

Kathy Burton from Florida on February 27, 2018:

Great article. Did not know these apps were out there. I think some of the apps with in-person treatment may be helpful but I find it hard to see using without additional support. This viewpoint may be a result of dealing with people with more serious mental and developmental disabilities in the past. But I am all for the additional assistance.

Bill Holland from Olympia, WA on February 27, 2018:

Every little bit helps, my friend. I believe we have an epidemic in this country of mental health issues, and the sooner we recognize it the better.