When I started out in private practice last year, I carved some time to explore the digital mental health app landscape. It’s a crowded market, with a multitude of platforms catering to different, specific support needs. Search for anything related to mental health, and those all-seeing algorithms will start advertising apps to you! So, I wanted to know a bit more about what was out there. What might I recommend to clients if they asked, and what might I steer them away from? I thought it likely that many clients would already be using apps. So, time to get myself up to speed!
Technology and AI are of great debate in relation to therapy and mental health support at present. Some therapists are understandably wary of how these might threaten the work we love and dedicate ourselves to. Personally, having spent this time exploring apps from the user’s perspective, I am now a little more circumspect. If something can support clients and their specific needs, then it is to be embraced. There are caveats, however, as I identified many limitations with what they’re capable of. Here then, follow some helpful tips for both therapists and non-therapists on navigating the app landscape safely and effectively.
1. Think of apps as complementing mental health professionals, rather than replacing them
Mental health apps tend to be developed to provide specific, targeted services for mental well-being needs. These include meditations, thought exercises, structured diarising and journaling. For example, there are some fantastic apps to help people quit smoking, or curb excessive drinking. This is where they really shine — simple, targeted tools, immediately available, supporting positive habits and behavioural change. They may prove a great place to start for managing low-level anxiety, maintaining everyday mindfulness routines, or addressing and curbing unwanted habits. Further, they may also be useful for ‘topping up’ some psychological skills developed in previous therapy.
However, they cannot quite replace the nuanced understanding and oversight of a mental health professional. If you feel your mental health needs have any kind of complexity to them, particularly where you feel your safety could be in question, it is in your best interests to connect with a professional. No app can replace their experience and skills, and no apps have an active, live team of mental health professionals monitoring them. One or two sessions with a therapist might be all you need to set things in a helpful direction.
2. Look into who the developers of an app are
Some apps have been developed by mental health professionals, and as such they feature quality-assured functionality, purpose, and content that is relevant to optimising your wellbeing. Some are not, and have been developed to generate revenue. As such, the ‘money-makers’ are less likely to be helpful. It can be worth digging around on an app, or researching who is behind it, to get a sense of its trustworthiness. A good sign of an app that might lack rigour is one that features lots of ‘games.’ Gamification is where developers use game-like features, a design choice that generally increases user engagement. A helpful app should be a tool you employ when you need it, not an experience that tries to manipulate your time.
A great example of a trustworthy app is Mindshift, developed by Anxiety Canada. It’s the product of a charity that both promotes awareness of anxiety disorders, and supports access to proven resources and treatment. And, it’s free for all to use. Thanks to the Canadians for making such a vital resource accessible to the rest of the world!
3. Stay safe in engagement with ‘user forums’
A couple of apps I explored connect users with message forums, places intended as supportive communities. It can, of course, be helpful to connect and share experiences in a space where people really understand, connect with those in the same difficulties. However, proceed with caution. Such spaces can actually be intensely triggering, particularly with more serious or complex mental health needs. The ‘disinhibition effect’ suggests that people frequently overshare online, with extraordinary depth of detail. Such user forums can be places to wallow, rather than process and find ways forward. More concerning is the fact there’s likely to be poor moderation and oversight in such spaces, people behind the scenes monitoring to take care of community safety.
That’s where trained mental health professionals really come to the fore. Their main priorities are to keep you from harm, manage risk, watch for any signs of danger, and help you explore complex or challenging mental health problems at a pace that is safe. It takes a long time to train as a professional for good reason, particularly in relation to risk management.
4. You don’t always have to take a subscription (and look out for offers on apps you like)
One thing I noticed in exploring the mental health app landscape is just how many apps will dangle offers to hook you as a subscriber. The first time you open each app, you are usually presented with their rates. But, in most cases, once you skip past this first set of prices and enter the main app functions you will quickly be offered a much better deal. Some were offering less than half-price! So, bear this in mind if you find a particular app that offers a tool you need or want to make use of.
It’s also worth noting that many apps, such as journaling ones, have free journal/diary equivalents already on your devices that will do the same thing. YouTube has a world of free guided meditations for mindfulness. It just takes a little digging to find good alternative tools. All helpful, if the cost of yet another subscription is a concern. And, if you do see a professional, most therapists will have go-to meditations they can connect you with in the course of your work together (if it’s relevant to your needs, of course).
5. Respect any concerns about data safety and privacy you might personally hold
Digital platforms can feel like they provide us with a magic cloak of anonymity, this feeling of freedom away from the eyes of the rest of the world. We are unchained, free to say those deepest things, stuff we cling desperately close to our core for fear of the judgement of others. It’s this disinhibition effect I mentioned earlier, that very same allure that permits otherwise lovely people to leave mean, unbecoming comments all over Facebook.
Some people don’t care about internet privacy and what’s happening with their data. Others do. If you do, then exercise caution, for your own peace of mind, on the kind of personal details you enter into apps. Maybe a physical journal would be a better option for you. With really sensitive stuff, you can always write things down to ‘get them out’ of your mind, and dispose of the writing afterwards. Bury it somewhere in nature, make a paper boat and set it off down a river. It can be very freeing to take this kind of physical, real-world action. At least you know where it’s gone! Our solutions don’t always have to be digital.
In closing
Whether practitioners like myself embrace digital mental health apps or not, there is no doubt they’re here to stay. It is the reality of the increasingly ‘hybrid’ world we now operate in. As noted at the outset, my view is that it’s best to think about what benefits we can harness from such technologies rather than rejecting them outright.
And, to return to another point made earlier, it’s best to think of apps as support tools, there when needed. If you are a person in need of support but not quite sure what tools will be most beneficial, an ethical mental health professional will be able to help you understand that more clearly. All licensed or accredited practitioners are bound by strict ethical codes that put client well-being first. The companies behind ads targeting you online are unlikely to possess the same duty of care towards you.
