A Review of Mobile Apps for Clients

March 2019

 

The sheer number of mental health apps available to smartphone users can make finding the right one a daunting task for both individuals and psychologists. Most are reasonably priced, or free, and offer a wealth of resources to choose from. Unfortunately, many do not have peer-reviewed research to support their claims. Additionally, some offer questionable business models and potential privacy/security concerns. 

Each of the mobile apps reviewed in this column focuses on using meditation and/or mindfulness for varying purposes such as reducing stress and anxiety, improving mood, sleep or attention. 

For each app, we first provide guidance on several background factors that should be considered in selecting mobile apps. Next our panel of psychologists share their own ratings and reviews of the apps based on several key factors such as purpose, appropriateness of content and ease of use.

The practicing psychologists on our panel have provided ratings and reviews for the following three apps.

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The Headspace mobile app is intended for anyone who wants to learn meditation as a means of reducing anxiety and stress, or to help improve attention and awareness. It is available for use on both iPhones and Android devices.

Background Ratings

Guidance on background factors that should be considered before selecting mobile apps.
Move your cursor over each background category for additional information.

Psychologist Panel Review Ratings:

Move your cursor over each ratings column for additional information.

“Headspace can be a fun and easy tool to support clients while they are adopting a regular meditation/mindfulness practice and can be discussed as part of the client’s therapy session as it pertains to identifying any barriers that might get in the way of daily meditation. The app offers an easy jumping off point for clients to be mindful at any point in their day, whether it be starting off on the right foot, managing stress or promoting calmness throughout their day, or helping them wind down at the end of their day.” — Kristi K. Phillips, PsyD

“Headspace is a fairly streamlined, user friendly and encouraging application which features training and psychoeducation to its users. It also features short informational videos, which can be shown in session to further discuss meditation and explore with clients how a meditation practice could be beneficial given their therapy goals. There are some challenges with usability and function though, such as if a user initially chooses a morning time and would like to change to an evening reminder (while in the set-up phase) for meditation the application does not allow the user to go back — rather the user has to go into settings and reset the reminder; and the user can only choose one focal area to begin rather than choosing two or more reasons for engaging with the application. With that said, Headspace is one of the apps that I feel good about telling clients who are interested in further integrating a meditation program within their lives but do not have time to attend a meditation group and also are seeking support.” — JoAnna Romero Cartaya, PhD

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The Calm mobile app promotes relaxation through meditations, sleep stories, nature images and sounds, and is designed to reduce anxiety, improve sleep and help users to feel happier. It is available for use on both iPhones and Android devices. 

Background Ratings:

Guidance on background factors that should be considered before selecting mobile apps. 
Move your cursor over each background category for additional information.

Psychologist Panel Review Ratings:

Move your cursor over each ratings column for additional information.

“This is a visually beautiful application with lots of nice features; however, it can be challenging for someone who is new to meditation or mindfulness as it provides limited psychoeducation and information regarding developing and integrating meditation practice. The app boosts lots of different options with experts and some star-powered performers to deliver its content — but it is unclear whether content is effective given lack of research — especially regarding sleep stories and how this option may assist users in having better rest. While I enjoy this application, it is one that I would recommend only to clients or other psychologists that have experience with meditation, like a lot of customization and options, and would like to have either additional options to expand their already developed meditation practice skills, especially to invest in access to all the content. I also would only recommend to those clients who are high functioning, looking to expand their practice or gain additional tracking and accountability, and also have resources to invest in the application.” — JoAnna Romero Cartaya, PhD

“Calm’s guided meditations, breathe bubble exercise, music, mindful body exercises, bedtime stories, master classes, are all helpful tools to encourage and reinforce positive thinking practices. I like the breadth of content which includes content for children/adolescents, and adults and is available in English, Spanish and German. I found the content of the Calm app is likely to help patients manage stress and anxiety better and the added ritual of adding a sleep time story can help to create a peaceful environment for a good night’s sleep.” — Kristi K. Phillips, PsyD

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The Stop, Breathe & Think (SBT) mobile app is intended to help users cope with stress, anxiety, depression and insomnia through mindfulness and meditation.

Background Ratings

Guidance on background factors that should be considered before selecting mobile apps. 
Move your cursor over each background category for additional information.

Psychologist Panel Review Ratings:

Move your cursor over each ratings column for additional information.

“The SBT app is an excellent way to help clients build a mindfulness practice. Once your clients understand the concepts of mindfulness, using SBT is a great way to help them build a sustainable practice outside your sessions. The data collection component allows both you and the client to track their mindfulness activities between sessions, which can be helpful as you design interventions for the client. SBT offers many options of sessions and activities, it would be a long time before clients will fatigue with the content.” — Charmain F. Jackman, PhD

“If you’re a therapist that uses ACT or other interventions that rely on relaxation and mindfulness this app could be useful in both facilitating homework and tracking progress of those interventions. Since anxiety treatment is based on exposure protocols, it would likely not be useful for those patients, nor would it seem well suited for depressed patients. However, to create a useful stress management program, this app likely would work quite well. Like so many apps in this genre, the ultimate question is how long your patient might use it after the first few sessions. Research on user data indicated that in a 13-month period from 2016 to 2017, 10,000 users completed 10 or more sessions, which is impressive.” — Kevin D. Arnold, PhD, ABPP

(categories rated from 1-5, with 5 being the most positive score)

Privacy/Security	If applicable, do the creators acknowledge that providers need to be HIPAA compliant? Is there a privacy policy? Is data collected, stored, shared? Is data de-identified? Can you opt out? Is there a security policy? Data encryption?	1- HIPAA relevant and ignored, no privacy policy etc.; 5- Highest levels of privacy & security
Evidence Base	Is there any research support for the product? Is it peer-reviewed? Between-group design experiments? Who provided the funding for the research?	1- No research evidence; 5- Ample research evidence
Cost & Business Model	If it is free, how is it supported? Are there in app purchases?	1- Heavy marketing/advertising; 5- Reasonably priced, clear and easy to navigate payment options
User Feedback	What are current user feedback/ratings?	1- Very negative reviews; 5- Very positive reviews

(categories rated from 1-5, with 5 being the most positive score)

Purpose	What is the proposed intervention or what does it claim to do? Is it likely to do what it claims?	1-Highly unlikely 5- Highly likely
Appropriateness of Content	Is the content appropriate? Does the content match the description and purpose? Were any clinical/psychology experts involved in the development of the material?	1- Very inappropriate 5- Highly appropriate
Cultural Responsiveness	Did the app/software consider a variety/range of cultural factors (e.g., age, race, ethnicity, gender, gender identity, sexual orientation, ability levels) in the development? Is the app/software likely to appeal to people from different cultural backgrounds? Is it available in multiple languages?	1- Very unresponsive 5- very responsive
Ease of Use	Is it easy to navigate? Is it customizable?	1- Very difficult 5- Very easy
Functionality	Does it perform well? Does it need the internet to work? Can you export/download your data?	1- Very poor 5- Very well
Overall Rating	Would you recommend this app to other psychologists? How often would you use or ask a client to use this app? What is your overall rating of this app?	1- Strongly do not recommend 5- Strongly recommend

Applications reviewed March 2019

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This column discusses various software and applications available to psychologists for their professional use. The views expressed in this column are the views of the authors and do not reflect the views of the American Psychological Association or any of its divisions or subunits. All authors have no financial interests in the apps or software discussed. APA does not recommend or endorse any practitioners, products, procedures, opinions or other information that may be mentioned in this column; those who use these applications or products do so at their own risk. Please direct updates and feedback about apps to Communications Office Staff.