A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content. (December 2019) - Wasil, Akash R.
Abstract: Smartphone applications for the treatment of depression and anxiety have acquired millions of users, yet little is known about whether they include evidence-based therapeutic content. We examined the extent to which popular mental health applications (MH apps) for depression and anxiety contain treatment elements found in empirically supported psychotherapy protocols (i.e., "common elements"). Of the 27 MH apps reviewed, 23 included at least one common element, with a median of three elements. Psychoeducation (in 52% of apps), relaxation (44%), meditation (41%), mindfulness (37%), and assessment (37%) were the most frequent elements, whereas several elements (e.g., problem solving) were not found in any apps. We also identified gaps between app content and empirically supported treatments. Cognitive restructuring was more common in depression protocols than in depression apps (75% of protocols vs. 31% of apps), as was problem solving (34% vs. 0%). For anxiety, exposure (85%, 12%), cognitive restructuring (60%, 12%), and problem solving (25%, 0%) were more common in protocols than apps. Overall, our findings highlight empirically supported treatment elements that are poorly represented in current MH apps. The absence of several core treatment elements underscores the need for future research, including randomized trials testing the effectiveness of popular MH apps. Highlights: Do popular mobile apps for depression and anxiety include evidence-based content? To find out, we coded 27 popular apps for empirically supported treatment elements. Apps included between 0 and 12 evidence-based elements (median = 3). Core anxiety and depression elements (e.g., exposure, restructuring) were rare. Content limitations suggest a need for new apps and rigorous tests of app effects.