Think of a therapy session and you might picture the patient reclined on a worn leather Chesterfield being questioned by a mild-mannered, caring doctor. But what if you could access this kind of psychological help without leaving the comfort of your own sofa?
That is the promise of “therapy” apps for smartphones, which hope to make treatment – or at least help – for conditions like depression and anxiety available to anyone, anywhere.
Take a look at Apple’s App Store, the largest app marketplace, and you will find more than 100 “medical” apps tagged with the word “depression”, for example. They range from apps like Moody Me, which simply help people keep track of what makes them happy to others, to iCouch CBT, which claims to “help you train your emotions and feel better” by offering more specific strategies, similar to those which patients learn in professional therapy.
It is easy to understand this surge. Smartphones are increasingly popular with more than 50% of the population in the US owning one, for example. And depression is also becoming more common. According to the World Health Organization, it’s the third greatest ‘disease burden’ worldwide, just behind lower respiratory infections and diarrheal diseases. It is expected to rise to number one in developed countries by 2030.
Apps that cost $1.99 a pop have the potential to reach millions of people who either cannot or will not engage with more traditional therapy. As a result, Dr Steve Daviss of the American Psychological Association describes iPads and iPods as the physician’s “electronic black bag”.
“They don't replace the role of a therapist, but they can augment the work we do between sessions.”
For example, a patient tapping an emoticon to say how they feel is a lot less intrusive than filling out paper diaries and can help a doctor track mood swings. And because the device is always on and in a person’s pocket, it allows people to carry out beneficial exercises regularly and discretely.
One of the firms working in this growing industry is Hoa’s Toolshop, a Swedish startup that creates digital apps for personal development. “We are developing people, not just apps,” says Hoa Ly, a clinical psychologist and Founder of the firm. “We want to make people use apps that really matter, instead of just Facebook and Instagram.”
Hoa’s flagship service, Viary, is a “behaviour-change” application designed to help users overcome depression, anxiety and other mental health disorders. To do this, it prescribes a mix of old therapy tricks with new apps which make it easy to collect and track important data on behaviours and actions.
“Data motivates people” Ly explains, “and with it personal development can become more concrete and measurable. We are translating an analog world to a digital world.”
To create Viary, Ly used elements of a common type of treatment called cognitive behaviour therapy (CBT). Specifically he uses so-called “behaviour activation”- a common treatment for depression that encourages patients to perform specific actions or behaviours that help them change their thoughts and reactions to the world and feel better.
Together with a therapist, Viary’s clients choose specific actions that will help them achieve a desired goal. For example a client may decide that exercising, eating healthier food, and listening to classical music makes them feel less depressed. Viary sets reminders for these behaviours- walk for 15 minutes every morning, take a vegetarian lunch, tune into some Beethoven etc, - and the app then collects data on these completed actions. Therapists or coaches can then monitor a client’s progress in real time and even respond.