Stawarz K, Preist C, Tallon D, Wiles N, Coyle D. (2018). User experience of cognitive behavioral therapy apps for depression: An analysis of app functionality and user reviews. Journal of Medical Internet Research. 20(6): e10120. doi: 10.2196/10120
Researchers conducted a 2-part analysis of publicly available cognitive behavioral therapy (CBT) mobile applications (apps) for depression to analyze therapeutic and engagement techniques used and user opinions of apps. First, researchers downloaded apps from Google Play and Apple app stores claiming to use CBT to address depression (N=31). Researchers mapped features of each app to representative CBT techniques or identified them as non-CBT therapeutic techniques or engagement techniques. The most common therapeutic techniques were dealing with automatic thoughts (15/31), dealing with negative thinking styles (9/31), and providing sample activities for improving mood (9/31). Half of identified therapeutic techniques reflected elements of CBT. The most common engagement technique was sharing progress (e.g., over social media or with a therapist; 8/31). Next, researchers extracted and thematically coded reviews that mentioned therapeutic features (n=1,287). Three themes emerged: context of use; importance of privacy, security, and trust; and non-CBT features. Reviewers often described CBT apps as “pocket therapists”, used as replacements for or adjuncts to therapy, including at the recommendation of a therapist. Reviewers emphasized the importance of reliability and security in CBT apps, and the emotional impact of data loss. Reviewers praised or desired privacy features, such as password protection, to protect their information. Reviewers also appreciated the subtlety of using their phone to complete CBT activities. Some reviewers appreciated non-CBT therapeutic features and wanted features that focused on positive emotions. Other reviewers wanted strictly CBT-focused apps. Therapists who wrote reviews were positive about some non-CBT therapeutic features (e.g. relaxation audio).