Mental Health Mobile Phone Application Review Database

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Divisions 56 and 46 worked collaboratively to create a Mental Health Mobile Phone Application Review database, which currently includes information on more than 40 apps for iOS and Android systems.  The focus of this database is to provide APA members with evaluated tools to augment service delivery. The database is also designed to enhance the potential effectiveness of self-help strategies, thus serving the community and highlighting the role of APA in championing ethical and empirically based interventions, which are core values of the organization. The project serves the strategic goal of expanding psychology’s role in advancing health through education and creation of what is likely to be a highly accessed database for researchers and professionals. The most updated reviews of each app can be found below. Please visit the Division 56 Website for a PDF copy of the database.

Table of Contents

ACT Coach | Anger Management | Anti-Anxiety App | Anxiety Release Based on EMDR | Anxiety Relief by Martin L. Rossman | Anxiety Self-Help-Worry Box | Anxiety Tracker | Autogenic Training and Progressive Muscle Relaxation | Beat Panic | Better Mood Tracker | Breathe2Relax | Bust Anxiety | Bust PTSD | ChillAppPlan | eCBT Trauma | EMDR for Expert | EMDR for Clinicians Pro | Equanimity | Erase Any Memory Hypnosis | Healing Trauma Restoring the Wisdom of Your Body by Peter A Levine | Hypersensitivity and Anxiety | iCBT | iChill | iCouch CBT | iCounselor Anxiety | iSleep Easy | Master Fear of FlyingMind Warrior | Mood Shifter | MoodKit | PE Coach | Personal Zen | PsyPills | PTSD and Traumatic Stress-Anxiety Recovery Strategies | PTSD Coach | PTSD Eraser | Self-Help for Anxiety Management | Stop Drinking with Andrew Johnson | Stress Check Pro by Azumio | T2Mood Tracker | The Linden Method | The Mindfulness App | Vital-EQ Respiroguide Pro | Worry Watch

App Name: ACT Coach

Operating System: iOS (iPhone)

Reviewer Sandie Larsen Thomas Elbert Jerry Gold
Useful for the following age groups: Adults Adults Adults
Easy to download (1 to 5): 5 5 5
Easy to use (1 to 5): 4 4 4
Is of benefit to motivated user (1 to 5): 5 4 5
Is in keeping with scientific literature or knowledge (1 to 5): 5 4 5
Reports efficacy evidence (1 to 5): 1 3 1

Reviewer 1 Summary

As this app notes when you download it, this is purely to be used as a companion to ACT therapy, or perhaps as a booster after completing ACT; it would not make sense to the uninitiated. But for someone familiar with ACT, it would provide a useful tool to help keep on track and remind oneself of relevant tools. There are tools for learning about ACT, for practicing mindfulness in a self-guided or audio-guided way, for living your values, keeping track mindfulness and willingness, and taking action. Although the “Living your values” tool is a bit clunky, the others are mostly quite user-friendly and intuitive. Especially helpful may be the list of tips that remind the user of various ACT sayings, metaphors, tools, and encouragements. The tracking logs would also be helpful for someone tech-savvy. Overall, I could see this being a useful companion to ACT therapy or way to continue working on ACT following therapy.

Reviewer 2 Summary

Provides a helpful training and improvement of mindfulness!

Reviewer 3 Summary

This is a convenient and easy to use app that will reinforce a client’s participation in ACT. Essentially, it reproduces the ACT experience and process electronically, and most crucially, allows the client to have an in vivo reminder of what he or she learns at the times that this is most necessary, namely at points of anxiety, crisis, or other distress. I don’t think that it is meant to be a substitute for therapy but as an adjunct or aid it is excellent. I will recommend it to those of my clients who treatment is structured around ACT principles.

App Name: Anger Management

Operating System: iOS (iPhone)

Reviewer Catherine Caska-Wallace Ariel Lang
Useful for the following age groups: Teens and Adults Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 5 5
Is of benefit to motivated user (1 to 5): 4 3
Is in keeping with scientific literature or knowledge (1 to 5): 4 4
Reports efficacy evidence (1 to 5): 2 1

Reviewer 1 Summary

One of my criticisms is that this app is really just material from a book or pamphlet that was turned into something to read on your phone – it may as well be a website. Apps generally include user interaction, and there is very little of that in this anger management app. I can imagine a user getting board and disinterested with reading page after page about anger and general tips. I also found some of their discussion about the development and maintenance of anger, as well as some of the tips, to be fairly general without a lot to back it up. As I mentioned in my positive thoughts on the app, I do feel that a number of the strategies suggested are indeed supported in the literature; however, sometimes they spoke of them too generally to be explicit or concrete enough for a user to try. This app would be improved if there were more practice tools built into it. The relaxation (“hypnosis”) tape was sufficient, though more interactive practice would be useful.

Reviewer 2 Summary

This e-book gives a good description of the problem of uncontrolled anger and provides reasonable tips for learning to better handle anger. The tips may not be well enough elaborated or have enough accompanying examples, however, for someone unfamiliar with the material to implement them. The e-book promises that daily use of the hypnosis recording will be helpful, but there is no evidence to suggest that this will be the case.

App Name: Anti-Anxiety App

Operating System: Android

Reviewer Nexhmedin Morina Alicia E. Lopez-Martinez
Useful for the following age groups: Adults Adults
Easy to download (1 to 5): 3 5
Easy to use (1 to 5): 2 4
Is of benefit to motivated user (1 to 5): 3 4
Is in keeping with scientific literature or knowledge (1 to 5): 2 5
Reports efficacy evidence (1 to 5): 2 5
Other: When the user answers “Yes” to a question, He/She is directed to an additional support resource, including research articles based on empirical evidence

Reviewer 1 Summary

This app aims at helping the user to manage and control stress and anxiety. The information is mostly based on the cognitive behavior therapy (CBT) model and contains:

  • Diagnostic questions to assess levels of stress and anxiety
  • An anxiety workbook and a personal progress tracker
  • Video therapy sessions with in depth explanations on how to deal with anxiety
  • Articles about anxiety from a CBT point of view
  • Frequent news and research articles downloaded to the phone of the user
  • A diary of anxiety related thoughts with the goal of better challenging fearful thoughts

Altogether, this app offers a large amount of information on stress and anxiety in general and on specific areas of anxiety. Longer versions of the educational articles can easily be assessed on the web, as well as video material. I believe the app to be a useful tool in assisting healthy coping with anxiety and stress. However, I also think that this app has some limitations that might limit its potential benefits:

  • The user is sometimes confronted with information about dealing with anxiety that might rather be contra productive. For example, the recommendations on 10 strategies to “beat” public speaking anxiety include “Bring hard copies of your material” or “Hold something in your hands” or “Have small mints to keep yourself from getting dry mouth”. This ignores theoretical models within CBT and more importantly empirical findings that such behaviors might backfire. These behaviors have been defined as safety behaviors that might offer only temporary relief from anxiety, yet very often they maintain the anxiety in question. Accordingly, a better recommendation in this regard would be to encounter public speaking tasks without hard copies or any other safety behavior and make the experience that one can cope with such situations without safety behaviors and that anxiety will decrease eventually.
  • Every time I opened the app I was treated like I am using it for the first time. Accordingly, I had to answer the same diagnostic questions to assess levels of anxiety every time I wanted to use the app. This is time consuming and annoying, especially if you want to use the app frequently.
  • Very often, my phone was busy with updating the app for hours.   Taken together, it is obvious that the developers of this app have worked hard to develop this tool. The app contains lots of information that has the potential of assisting individuals with anxiety complaints to better cope. Yet, the information provided is not very coherent in terms of how to best cope with anxiety complaints.

Reviewer 2 Summary

The app contains many resources (book chapters, videos, news, articles) and allows users to select those symptoms that are problematic. Once a symptom has been selected, the app offers different tools regarding this problem. Of particular interest are videos and book chapters as the language used in these resources is easy to be understood by everybody. Further, this app constitutes an excellent resource for therapists.

App Name: Anxiety Release Based on EMDR

Operating System: iOS and Android

Reviewer Bethany Brand Francine Shapiro
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 4 2
Is of benefit to motivated user (1 to 5): 4 1
Is in keeping with scientific literature or knowledge (1 to 5): 2 1
Reports efficacy evidence (1 to 5): 1 1
Other: This app provides accurate and useful information about anxiety and how to manage it. The app claims it is based on EMDR’s (Eye Movement Desensitization and Reprocessing) use of bilateral auditory and/or visual stimulation.   However, it remains to be determined if using an app without the support and guidance of a therapist can achieve similar results as EMDR, which has a substantial empirical foundation.   Some individuals may have a poor response to using bilateral stimulation without the benefit of working with a therapist. The app warns that it is not intended to be used by people who have experienced multiple traumas or who have serious medical or psychiatric difficulties. While it might help some people it can hurt others

Reviewer 1 Summary

This app is one of the most user friendly apps I have evaluated. Users can choose whether to read a fairly extensive explanation of anxiety and bilateral stimulation. The app provides a stronger rationale for the app’s technique than many anxiety-focused apps. It also allows users to choose whether they want to rate the level of anxiety before and after using the app, and if desired, it provides very useful graphs that show how the user is performing over time. This feature is informative and provides motivation to use this app to manage anxiety.     A male clinical psychologist from Australia leads the tracks that involve speaking. There are tracks without speaking that use only visual or auditory bilateral stimulation, or both. Given how small phones are, it seems questionable whether the lights that flash for the visual bilateral stimulation are far enough apart to produce the bilateral movement that is associated with EMDR.

Reviewer 2 Summary

This app purports to offer a way to “release anxiety” with three focusing exercises in conjunction with bilateral (back and forth) audio tones and eye movements.   A guided relaxation exercise is also included. Although the author claims that the app is “based on EMDR therapy,” it includes only one aspect of the treatment and none of the standard preparation, monitoring and precautions needed for safe and effective delivery. Inaccurate statements and inadequate cautions in the written descriptions are misleading. The instructions in the initial “Brain Training Session” offer no guidance about appropriate uses or potential negative outcomes. Questionable neurobiological statements are used to convince the user that “your brain likes bilateral stimulation.” However, while the research indicates that the bilateral stimulation (such as eye movements) used in EMDR therapy can be calming, they can also elicit unexpected memories and emotions. That is one reason why only licensed and specially trained mental health professionals should administer this stimulation. Hence, inviting the user to focus indiscriminately on any source of distress while using the stimulation can do more harm than good. The app offers no information to the user about this potential for ill effects, nor about the standard expert recommendations regarding treatment. In addition, some of the statements and questions included in the app exercises may elicit or increase anxiety rather than reduce it for some users. It appears the only “research” regarding this app is a single published case. No field-testing of this app for “anxiety release” with either clinicians or laypeople is reported.

App Name: Anxiety Relief by Martin L. Rossman

Operating System: iOS (iPhone)

Reviewer Ariel Lang Melissa Anderson
Useful for the following age groups: Teen and Adult Adult
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 3 3
Is of benefit to motivated user (1 to 5): 2 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 2
Reports efficacy evidence (1 to 5): 1 3
Other: Bonus text and audio alludes to the efficacy of guided imagery, but the evidence is not explicitly cited.

Reviewer 1 Summary

This app is basically a set of three recorded guided relaxation practices. The scripts focus on knowing one’s body and its innate wisdom. They may be helpful to some, but the evidence would suggest that the benefit is likely to be modest.

Reviewer 2 Summary

This app is essentially an audiobook with 5 chapters: a brief introduction; psychoeduation about relaxation, breathing, and guided imagery; and then 3 guided exercises (breathing, imagery of the inner-wisdom advisor, evocative imagery). The audio for each exercise is more than 20 minutes long. In addition to the audio files, there is also a “Bonus Text” section, which includes 3 pages of information about the techniques taught in the app.   As noted above, this app is essentially an audiobook. It does not seem to offer anything above and beyond what a typical audiobook would offer, and has missed some opportunities to take advantage of the hands-on and visual nature of smartphones. Hands-on: Once you start playing the 20-minute-long audio files, there is no further interaction with the app. Visual: The only visual during the long audio files appears to be a picture of the Dr. Rossman’s book cover; this is a missed opportunity to make the app more engaging with videos, diagrams, relaxing images, etc. If the author intends this app to function just as an audiobook, then it meets its intended purpose. However, the current product does not include the variety of functions that a typical app would provide.

App Name: Anxiety Self-Help-Worry Box

Operating System: Android

Reviewer Nexhmedin Morina Gema T. Ruiz-Parraga
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 4 2
Is of benefit to motivated user (1 to 5): 4 3
Is in keeping with scientific literature or knowledge (1 to 5): 3 4
Reports efficacy evidence (1 to 5): 3 3

Reviewer 1 Summary

This app represents a tool to help deal with worries so that they do not negatively interfere with daily life activities and sleep. The tool is based on the cognitive-behavior therapy model with the aim of assisting the user to a better awareness of worrying, to cognitively challenge worry and to ultimately change behavior. The techniques offered by this app are educational (written and spoken information about cognitions, emotions and behavior and strategies to help to better come with worries and anxiety) as well as experiential (audios on relaxation, emotion training, and mindfulness training).   In total, the app offers a great amount of information as well as relaxation and mindfulness exercises. Furthermore, the articles remind the user that a longer version of the article can be found on the web. The app also consists of referral list to cognitive-behavioral therapist if the user might need one. Yet, the list is extremely short at the present moment. I believe the app to be a useful tool in assisting healthy coping with daily worries and increasing awareness of cognitive and emotional states.

Reviewer 2 Summary

The Anxiety Self-help Worry Box App is interesting to management concerns, worries. Some strengths and limitations are highlighted below:

Strengths: * It is easy to download. * Comprises important psychological techniques to treat anxiety and some depression symptoms. * It would be an important adjuntive tool in psychological therapy. * It is in keeping with scientific literature. * It is of benefit to motivated user due to its points system. Limitation: * It is difficult to use for non-experts and requieres a significant cultural level. * Taken into account the recent literature about psychological flexibility, would be interesting to include training in resilience factors as optimizing (for example: The Best Possible Self in imaging).

App Name: Anxiety Tracker

Operating System: iOS

Reviewer Kaitlin Gallo Mark W. Miller
Useful for the following age groups: Adults and Teens Adults and Teen
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 5 5
Is of benefit to motivated user (1 to 5): 2 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 2
Reports efficacy evidence (1 to 5): 1 1
Other:

Reviewer 1 Summary

I would not recommend this app because it does not appear to have a reminder function or any rationale as to when the user should rate his or her anxiety. Anxiety may shift over the course of the day, and so rating once a day may be of little utility. Also, there are only three ratings available, which is much fewer than clients and therapists who use SUDS would be used to using.

Reviewer 2 Summary

This is a simple app that allows the user to rate his/her anxiety once-a-day using a 3 point scale. The user can add notes and generate a graph or summary statistics by month. I don’t see a way for the app to remind the user to make a rating but that could be a nice feature. Also, allowing participants to rate their anxiety just once a day is a limitation. It could be more useful to allow for entry of more data points to track discrete events. Finally, though it is very simple, there should probably be some instructions for first-time users (there were none in this version).

App Name: Autogenic Training and Progressive Muscle Relaxation

Operating System: iOS

Reviewer Michael Bordieri Michelle Woidneck
Useful for the following age groups: Teen and Adults Teen and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 5 5
Is of benefit to motivated user (1 to 5): 3 5
Is in keeping with scientific literature or knowledge (1 to 5): 2 4
Reports efficacy evidence (1 to 5): 1 3
Other: The app briefly provides the history and background underlying different relaxation approaches

Reviewer 1 Summary

The Autogenic Training and Progressive Muscle Relaxation app comes with five audio recordings of relaxation exercises that range from 6 to 16 minutes in length. Additional recordings are also available via in-app purchases. While some of the exercises are grounded in contemporary evidence based techniques (e.g., progressive muscle relaxation and to a lesser extent autogenic training), others have little connection to evidence based psychotherapies (e.g., Chakra Meditation). General information about each technique is offered but no research evidence is presented. In addition, the app lacks an easy way to track the effectiveness of the different techniques and does not allow the user to schedule reminders for relaxation sessions.   The recordings themselves are of high quality and may be helpful for individuals interested in PMR or other relaxation techniques; however, there are many other free recordings available on websites like youtube or http://www.dartmouth.edu/~healthed/relax/downloads.html.

Reviewer 2 Summary

This app provides a brief overview on different forms of relaxation and provides 5 guided relaxation exercises. The app is easy to navigate, and it provides applied exercises that the user is able to utilize at any time. The exercises mostly possess empirical support and are likely to be beneficial to the user. In regards to empirical support, however, I am unaware of the evidence for the color component in the chakra meditation. Additionally, the app suggests that slow, deep breathing facilitates relaxation. Per my understanding of the research on relaxation induced panic, this statement is no longer accurate. My understanding is that the research now suggests slow and controlled breathing over deep breathing. Regardless, this app has high utility and is likely to be beneficial to the majority of users. I would definitely recommend this app to clients/others.

App Name: Beat Panic

Operating System: iOS

Reviewer Michael Bordieri Joseph Himle Meredith Coles
Useful for the following age groups: Teen and Adult Teen and Adult Teen and Adult
Easy to download (1 to 5): 5 5 2
Easy to use (1 to 5): 5 5 4
Is of benefit to motivated user (1 to 5): 3 2 1
Is in keeping with scientific literature or knowledge (1 to 5): 3 2 1
Reports efficacy evidence (1 to 5): 1 1 1

Reviewer 1 Summary

The Beat Panic app offers a slide show style presentation designed to help someone work through a panic attack. The app provides a series of relaxation prompts such a taking four deep breaths as well as statements such as “it will pass” and “you are gaining control” for approximately five minutes and allows the opportunity for the user to repeat the presentation at the end. Despite its claim to “Beat Panic,” the app is focused exclusively on walking someone through a panic attack and does not focus on evidenced based techniques for the treatment panic disorder. In addition, it would be nice to see a version of this app that customizes the presentation for each user, perhaps by asking them to select from a list of coping strategies before a panic attack any by asking for ratings of their distress during an attack so that the presentation can be altered accordingly. These limitations aside, this app might provide a useful adjunct to a client who is in treatment for panic disorder as it provides something to focus on during panic attacks. In this role, it is certainly a preferred alternative to other acute management strategies such as benzodiazepine use.

Reviewer 2 Summary

This app is designed as a tool for use during a panic attack. The app begins immediately with a prompt to breathe slowly without any preparation or instruction on how to perform slow-paced diaphramatic breathing. It does not consider that some people find that this type of breathing approach can increase panic symptoms. The app provides some useful psychoeducation indicating that panic symptoms are not dangerous and that it is important to avoid fleeing the situation. Suggestions related to remaining in the present and messages encouraging users to continue with the day as planned are also potentially useful to users.   The app relies heavily on affirmations including many that suggest that the user is feeling calmer. Affirmations like these can be difficult for users who are are continuing to experience symptoms; particularly if their symptoms are worsening.       Overall, although the app has some useful elements, it does not match well with contemporary, evidence-based approaches to treating panic attacks.

Reviewer 3 Summary

This app is designed to help individuals through panic, or anxiety, attacks. The app is very simple, presenting a series of screens like a slide show. Some of the screens guide the user through a series of deep breaths while others present calming messages (eg that anxiety is not dangerous). These interventions are likely to reduce anxiety in the short-term but may increase anxiety over the long-term. The methods used in the app are at odds with empirically supported treatments for panic,

App Name: Better Mood Tracker

Operating System:

Reviewer Gretchen Brenes Brendan Rich
Useful for the following age groups: Teen and Adult Adult
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 3 2
Is of benefit to motivated user (1 to 5): 4 1
Is in keeping with scientific literature or knowledge (1 to 5): 4 2
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

This app tracks a large amount of data, including thoughts, feelings/emotions, activities, sleep, medication side effects, and weather. You can choose to monitor just moods. Adding events is fairly easy; attaching a mood to an event takes a little bit of practice.   Due to the size of the screen, it is very difficult to avoid touching the clock when adding your mood to an event. It is also difficult to see your mood/event history at one time-if you record a lot, then you either need to use tight filters or view the event log. A very interesting feature is the detailed information that is provided about sleep and I think many people will like this feature.

Reviewer 2 Summary

The Better Mood Tracker, like many “psychology-related” apps, aims to allow users to track their mood and correlate it with specific events. There are multiple problems with the app. Users can access the “Add Event” feature, which allows the user to identify a specific event that has recently occurred, and/or the type of weather occurring at that time. There are almost too many choices, such that the user feels overwhelmed. The “How are you” feature allows the user to identify the type of emotion currently being experienced from eight choices identified using a cartoon image depicting a Caucasian woman experiencing varied emotions. Although the gender can be changed in settings, the ethnicity cannot. The user can then use the “History” feature to see the events and moods previously entered. The “More” feature allows the user to add additional data, such as sleep history. In theory, the app allows users to monitor their mood, in particular as it relates to varied events and weather experiences. When mood, events and weather phenomenon are charted, the history feature makes them difficult to see, since many of the icons overlap. It should be noted that there were occasions where there were technically difficulties when using the app. Also, when the app is opened, the primary visible button actually takes the user off the app and to a website of unknown relationship. Most significantly, the clinical utility of this app is unclear.

App Name: Breathe2Relax

Operating System: Android and iOS

Reviewer Alicia E. Lopez-Martinez Thomas Elbert Nancy Kassam-Adams
Useful for the following age groups: Teens and Adults Adults Adults
Easy to download (1 to 5): 5 5 5
Easy to use (1 to 5): 4 5 4
Is of benefit to motivated user (1 to 5): 4 2 2
Is in keeping with scientific literature or knowledge (1 to 5): 4 2 2
Reports efficacy evidence (1 to 5): 2 1 1
Other: Cannot rate benefit question solely from looking at app – this requires empirical evidence. (I wanted to leave this rating blank for this reason, but rated as 2 because not allowed to skip it.)     No evidence presented in app (not sure I would expect that)

Reviewer 1 Summary

Is an easy tool to teach relaxation. It offers good explanations of how stress affects body, as well as an useful video showing. Furthermore, the user can personalize the music and the length of the breathing exercises. In sum, it could be a useful supporting tool for psychologists.

Reviewer 2 Summary

The app trains diaphragmatic breathing and tracks the stress level before and after the breathing exercise. In this way, the app also allows tracking stress levels across extended time periods which is a good thing.

Reviewer 3 Summary

Breathe2Relax presents easily comprehensible information (text or engaging video) about the stress response, impact of stress on health and mental health, and why diaphragmatic breathing can help. The app includes an easy-to-follow video teaching how to do diaphragmatic breathing, and an exercise leading the user through a breathing session. Pre- and post-ratings of stress are apparently tracked, although I was not asked to rate again after the 1st session in which I used it. Personalization of background and music selection is a nice touch.   This app is simple and easy to use. An important gap to my mind is that I did not see any guidance to the user about how often or in what circumstances to use the breathing exercises – how often to practice, when to use in “real life”. No evidence is presented about the effectiveness of this app, but on the other hand no claims are made that this app will result in specific outcomes (there are general – and reasonable – claims that breathing retraining can help with the stress response). Caution might be in order about the degree to which breathing retraining alone can improve health, but that is a question best addressed by an empirical trial of the app with careful measurement of use and of actual outcomes.

App Name: Bust Anxiety

Operating System: iOS

Reviewer Jason Moser
Useful for the following age groups: Adults
Easy to download (1 to 5): 4
Easy to use (1 to 5): 3
Is of benefit to motivated user (1 to 5): 2
Is in keeping with scientific literature or knowledge (1 to 5): 2
Reports efficacy evidence (1 to 5): 2
Other: Briefly discussed in Introduction but not clear what exactly the efficacy data are.

Reviewer 1 Summary

Overall, the app is very pleasant. The tone and pace of the narrator is soothing and pleasant. The Background images are nicely selected for setting a relaxing mood. I also thought it was nicely done that they covered contraindications and safety issues up front — this was responsible and clear. However, I noted a number of limitations of the app that I enumerate below.    First, it is not clear to me that the imagery exercises are evidence based. I am not aware of experimental or randomized studies showing the efficacy or effectiveness of these particular imagery exercises. Thus, I am not sure the nature of the evidence base is clear and if the evidence has been accurately represented for the interested user. I am also not aware that these sorts of exercises change anxiety “at the neurological level” and thus mentions of changing brain functioning seem odd for the user and may not be accurately representing the evidence base.     Second, a major limitation is the inability to navigate through the app to fully appreciate the number of sessions, modules, and types of exercises. I felt locked in and unable to fully explore what the app had to offer. Many times I was forced to restart the application and consent again, only to start back at the Introduction.   Third, I am not sure the symptom rating scale fully captures the symptoms typical of people suffering from a range of anxiety problems. The rating scale seems a bit more specific and perhaps tied to trauma experiences. Thus, the app may not be totally applicable to individuals across the range of anxiety problems and therefore the app is a bit misleading in advertising itself as being helpful to people with generic “anxiety”.   Finally, a relatively minor pint is that the transition between the Introduction section and the first imagery exercise is quite unexpected and abrupt.

App Name: Bust PTSD

Operating System: iOS

Reviewer Melanie Harned Brad Schmidt Mark W. Miller
Useful for the following age groups: Adult Adult Adult
Easy to download (1 to 5): 4 4 5
Easy to use (1 to 5): 3 4 5
Is of benefit to motivated user (1 to 5): 2 1 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 1 2
Reports efficacy evidence (1 to 5): 1 1 1
Other: The Disclaimer within the app makes claims about its efficacy in improving PTSD symptoms (e.g., “Bust PTSD App helps to reduce PTSD symptoms in most of the cases”, but does not provide any actual data or citations for this claim Claims to be efficacious but there is no evidence provided for this

Reviewer 1 Summary

This app only includes 1 “procedure” that users can complete repeatedly. The procedure consists of an audio recording of a (heavily accented and somewhat difficult to understand) voice guiding the user through a combined deep breathing and imagery practice. Users are also asked to complete a 3-item survey at the end of each “session” to rate the severity of their PTSD symptoms (from 0-10) on the 3 DSM-IV PTSD symptom clusters. The responses are then displayed on a “Symptoms Improvement Graph”.   Overall, this app is minimally useful because it: (1) includes only one coping skill (combined breathing/imagery), (2) does not present users with a rationale for this “procedure” and fails to orient users to what they will be asked to do prior to starting the recording, and (3) research would suggest that use of breathing/imagery alone is unlikely to yield significant improvements in PTSD symptoms.

Reviewer 2 Summary

The Bust PTSD application claims to help people experiencing PTSD symptoms as well as Depression, Panic Attacks and anxiety issues. It makes the claim to change things at the neurological level thereby affecting symptoms. Participants are supposed to place their hands together and breathe through their nose. Also, note that the program indirectly encourages individuals from discontinuing medication since it states that this program may not work when the participant in on medication. There is no scientific basis for any of the procedures described in this program. Not recommended.

Reviewer 3 Summary

This app primarily provides an audio recording of a directed relaxation-meditation session for the treatment of PTSD that lasts about 10 minutes. As far as I can tell, there is just one recording that users would then listen to over and over again. There is a way to make symptom ratings before and after these sessions and the user can add nature sounds to it. Though I recognized aspects of the treatment as CBT skills, the app did not explain what the treatment was based on and there was at least one claim made that seemed extreme, specifically: “We gaurantee that you will never feel the same way about your PTSD symptoms again.” Other weaknesses included insufficient opportunity for interaction with the app, a very long verbal introduction that was repetitive at times and, finally, the speaker has a thick Indian accent which makes his English difficult to understand.

App Name: ChillAppPlan

Operating System: iOS

Reviewer Karen Zilberstein Brian Marx
Useful for the following age groups: Children, Teen, Adult Adult
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 2 5
Is of benefit to motivated user (1 to 5): 3 1
Is in keeping with scientific literature or knowledge (1 to 5): 2 1
Reports efficacy evidence (1 to 5): 1 1
Other:

Reviewer 1 Summary

My ChillApp Plan takes an idea already in the field–that of helping individuals think through and plan ways to cope with stress–and tries to operationalize that through an app. While the idea is a good one, in that smartphone apps can help individuals think through and organize needed skills and behaviors, as well as remind them to implement them, the app itself does this in only a rudimentary way.   The apps usefulness is limited because of a number of factors First of all, it is rather simplistic. It does not offer a wide range of skills in its menu, although users can insert their own skills. The available literature on coping, however, does offer a larger, more varied list. Second of all, the user interface is difficult. The scrolling function is not smooth and often leads to the list getting closed by mistake so that multiple tries are needed to get through it. The bulletin board on which the lists get assembled is also too small to be easily readable. Reminders can only be sent up to once a day and only one list can be made, so that targeting the list to various stressful situations that might occur at different times is also not possible. The app could provide some benefit to individuals who need a simple reminder to use basic skills, but is not sophisticated enough or easy enough to use to be of broader benefit or to help much with the formulation of an overall plan.

Reviewer 2 Summary

There’s really nothing to this app except for a list of things to do to help you calm down. once the user creates his or her list of preferred ways of calming down, the user can then set the app to remind the user when to use those techniques. It’s not very sophisticated nor do I think it would be very helpful to the user. Ideally the strategies should be available at all times, not just at scheduled times, and the app should guide the user through using any of the preferred methods of calming oneself down.

App Name: eCBT Trauma

Operating System: iOS

Reviewer Christopher Erbes Kaitlin Gallo
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 4 5
Easy to use (1 to 5): 4 3
Is of benefit to motivated user (1 to 5): 2 4
Is in keeping with scientific literature or knowledge (1 to 5): 3 3
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

eCBT Trauma is a self-help app (reviewed for iOS) which encapsulates elements of cognitive behavioral therapy for treating PTSD. Features include self-ratings for PTSD (using selected items from the PTSD Checklist), tutorials on relaxation skills (resembling controlled breathing, progressive muscle relaxation training, etc), grounding skills, and standard exercises for identifying, logging, and challenging automatic thoughts. In addition, there are procedures for self-guided exposure exercises (both en vivo and imaginal). Additional buttons link to information about trauma, PTSD, and PTSD therapies both in-app and online as well as lists of advertising providers in the area of the user (should the user wish to pursue traditional treatment).   For the most part the interface is reasonably designed and easy to navigate. The treatment techniques embodied in the app are representative of the most common treatment approaches for PTSD using CBT principles. All exercises include an SUD rating before and after the exercise, which is both integral to the treatment and a nice touch. At the same time, there are a few concerns limiting enthusiasm for the app. First, the language is fairly advanced for a self-help app designed for use by non-professionals. Explanations for cognitive therapy concepts and techniques, for example, discusses a need to “quantify evidence for the conclusion” which is unlikely to mean much to someone not acquainted with these ideas. This use of abstract language and psychological terminology may pose a substantial barrier to users. There were some slight inaccuracies in the linked materials, for example statements that traumatic events occur in 10% of the population (current estimates are 50-60%), and that EMDR is the only therapy that “allows reprocessing of the event” (in the web material). As the app is structured, there is little guidance about which techniques should be pursued or in what order. For example, how is a user to know if they should start with relaxation and then move into cognitive restructuring, or the reverse, or just dive into exposure straight away? Finally, it is questionable to what extent relatively unguided applications of CBT principles will be, including especially exposure techniques such as imaginal exposure, in the absence of any supportive or guiding relationship.

Reviewer 2 Summary

This app would be a useful companion to traditional CBT for trauma. It could be a good way for therapists to assign CBT homework assignments. The lessons on the app are in line with current CBT practices for trauma. However, it is unclear, based on the current body of literature, if this manner of providing treatment (via app) is effective on its own without concurrent treatment with a professional. Also, it was strange that I provided several ratings but the subsequent graph only included one rating.

App Name: EMDR for Expert

Operating System: iOS

Reviewer Mark W. Miller Francine Shapiro
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 5 2
Is of benefit to motivated user (1 to 5): 2 1
Is in keeping with scientific literature or knowledge (1 to 5): 2 1
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

This app is basically a metronome with a blue ball that bounces back and forth in time with a clicking sound. The user can adjust the speed and number of clicks and it will record how many time it was used. It has nothing to do with psychotherapy per se, its just a stimulus device for the eye movement part of EMDR. The lack of integration with other aspects of treatment limits its value.

Reviewer 2 Summary

This app consists of a picture of a colored ball that can be programmed to move back and forth at a speed set by the user.   It is offered solely as an aid to EMDR therapists to assist clients in making horizontal bilateral eye movements as part of the therapy. However, mobile devices are not large enough to allow for an effective range of motion for the eye movements. Further, fixation on the handheld device would impede important nonverbal observations/communications for both therapist and client.

App Name: EMDR for Clinicians Pro

Operating System: Android

Reviewer Bethany Brand
Useful for the following age groups: Adult and Teens
Easy to download (1 to 5): 5
Easy to use (1 to 5): 4
Is of benefit to motivated user (1 to 5): 2
Is in keeping with scientific literature or knowledge (1 to 5): 4
Reports efficacy evidence (1 to 5): 1
Other: This app is based on Eye Movement Desensitization and Reprocessing (EMDR). The flashing lights cannot be spaced very far apart when used on a phone, so it seems questionable whether this short distance for bilateral stimulation is sufficient for generating the effect associated with EMDR.

Reviewer 1 Summary

This app is easy to use although the pacing of the bilateral stimulation cannot be adjusted to go very quickly. Of more concern is the short distance required for clients’ eyes to traverse the distance between the flashing lights. Is this sufficient to generate the effect of bilateral stimulation? While the app is less expensive than the lights and tappers one can purchase when attending EMDR trainings, it seems expensive given the product’s limitations. I was not sufficiently impressed with it to ask clients to try it.

App Name: Equanimity

Operating System: iOS

Reviewer Matthew Gallagher Sadie Larsen
Useful for the following age groups: Teens and Adults Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 4 4
Is of benefit to motivated user (1 to 5): 4 5
Is in keeping with scientific literature or knowledge (1 to 5): 4 5
Reports efficacy evidence (1 to 5): 3 1

Reviewer 1 Summary

Equanimity is an app designed to assist users in conducting regular sitting meditations. The app allows users to choose the length of the meditation they would like to complete and then prompts users to complete a journal entry following the meditation. The app has a clean and functional aesthetic, but is relatively limited in terms of features provided. The app tracks recent and total meditative practice hours, but does not include any information regarding suggested schedules for meditation or any information to help explain the benefits of meditating. The app is likely to be most useful for individuals who already regularly engage in meditation that are looking for a simple app to assist with their regular practice. Novice meditators may benefit from more robust apps that help guide users a little bit more in terms of how to develop and maintain a regular practice of meditation.

Reviewer 2 Summary

This is a popular, simple, and uncluttered app for assisting in tracking your mindfulness practice. The main feature is a timer with chimes that can be set to any length of time, with chimes at the beginning and end or at any interval during the practice. A journaling feature allows users to track and take notes on their practice. Finally, a visual format allows for a simple overview of frequency of practice over time (this is a little tricky to initially find in the app – the phone should be turned sideways while viewing the timer). This app does not provide background music or auditory guides for mindfulness practice, so it will be most useful for those who are practicing simple sitting meditation. There may be a cheaper version available (this one is $5).

App Name: Erase Any Memory Hypnosis

Operating System: iOS

Reviewer Michael Scheeringa Brad Schmidt
Useful for the following age groups: Teen and Adult Adult
Easy to download (1 to 5): 4 4
Easy to use (1 to 5): 1 3
Is of benefit to motivated user (1 to 5): 2 1
Is in keeping with scientific literature or knowledge (1 to 5): 2 1
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

The app is primarily one audiotape version of single session that lasts 20-25 minutes. The session was read by a male with a somewhat gravelly, British-type accent. The session included typical hypnosis elements of muscle relaxation and eye fixation followed by eye closure. Then one is instructed to think about a memory that one wants to delete, delete it, and then replace it with a more pleasing memory. The app itself is extremely simplistic, especially considering the $49.99 price. Besides the single audio session, there is an intro page that consists of three bullets, a button to share your experiences on social media, an “Objectives” page that is limited to sending you reminders to use the app, and a page of 14 basic “tips” that sound like fortune cookie sayings (e.g., Take up a new hobby to help occupy your mind).     Will it work? The scientific evidence for the effectiveness of hypnosis to treat PTSD is quite thin and almost entirely limited to case study reports. No evidence was presented that a self-administered, static session delivered impersonally through an app can be effective. There was no way to modify the session if the session was not effective, and there were no additional instructions on how to handle problems. Overall, the product makes the grandiose and unrealistic claim that the app can “delete negative memories.” The app is very basic and very little for the price.

Reviewer 2 Summary

This app purports to be capable of “erasing traumatic memories”. Users are instructed to relax as a narrator asks you and focus on the number 3 and other sorts of things.     Snake oil alert! Of course this app is complete garbage and should not be recommended. There is no scientific basis for the claims.

App Name: Healing Trauma Restoring the Wisdom of Your Body by Peter A Levine

Operating System: iOS

Reviewer Ariel Lang Jon Elhai
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 3 5
Is of benefit to motivated user (1 to 5): 3 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 2
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

This is an ebook and accompanying audio file rather than an interactive app. The book is a bit hard to read on a phone because of the size of the screen, but it is easy to read and understand. The intervention presented and exercises seem reasonable and could be helpful, but there is no empirical evidence as to their effectiveness.

Reviewer 2 Summary

This is a very basic app that mainly only includes features of viewing an ebook, writing a journal (for which there are plenty of better, free journaling apps), and listening to a relaxation exercise.   The app icon needs work. You can’t really make out what the icon is – it should be better designed so that someone using a smartphone can quickly identify what the app is.   The navigation once in the app is easy to follow. The ebook isn’t usable on a smartphone; perhaps on a tablet it would be ok. The ebook text is too small – it should be formatted for mobile devices – like how kindle books are formatted. The app design is basic – it’s not going to win any awards for elegant design; but perhaps this isn’t the main focus here.   The app could use some instructions. Perhaps some preface about what it’s intended for. Instructions about the importance of relaxation (healing trauma part of navigation) and journaling. It’s also unclear about the multiple other apps categories – what’s the purpose and why are they being recommended? Can the app be modified so that notes in the journal section be saved or exported or emailed? Otherwise, I’m better off using Evernote or something similar for journaling. Can the journaling part be password protected in case the user is journaling about sensitive trauma related issues? Can there be a contact part of the navigation for contacting the developer?

App Name: Hypersensitivity and Anxiety

Operating System: iOS

Reviewer Terry Northcut Lori Katz Brian Marx Melissa Anderson
Useful for the following age groups: Teen and Adult Teen and Adult Adult Adult
Easy to download (1 to 5): 4 5 5 4
Easy to use (1 to 5): 5 5 5 3
Is of benefit to motivated user (1 to 5): 3 4 2 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 3 1 2
Reports efficacy evidence (1 to 5): 1 2 1 2
Other: What is not clear is how these exercises connect to the scientific literature. For example, how do sit-ups facilitate balance and someone’s increased eye contact? The large number of improvements that this claims to help is misleading and/or not qualified how the exercises facilitate progress in these areas (e.g., help someone with adverse drug reactions or allergies to specific foods). Anecdotal only, would have liked to see more evidence reported Reports that the techniques taught are efficacious, but does not specifically cite any empirical findings.

Reviewer 1 Summary

This app is easy to download, use and seems to achieve the desired affect of relaxation. While it is not clear how these specific exercises facilitate progress in the areas it is designed to assist, they are easy to do. Efficacy evidence is not mentioned in the two videos that are on the hypersensitivity and anxiety app.

Reviewer 2 Summary

Being familiar with the techniques offered in this program and hearing patient reports of the benefits of them, I was pleased to see such an easy to use APP available for the public.   The content of the APP is good and I do believe could be helpful for those suffering from hypersensitivity and anxiety. The interface is also easy to use and straightforward. I would recommend this APP to others with some caveats. First of all, although the authors claim these techniques are effective and state that it is related to evoking certain innate reflexes, there is little rationale and no discussion regarding the mechanism for change. How and why do these techniques work? Secondly, there is no evidence presented other than anecdotal to support its effectiveness. A reference would be helpful so others can research the biomechanics of the techniques. However, most people simply want an easy to use APP that works and most likely are less concerned about research. This brings me to the final issue, which is its appeal. Unfortunately, the model used in the video does not look appealing. This model has a vacant stare and appears awkward. Maybe if she started with a smile and greeting the viewer with an introduction, or if she wore a more appropriate outfit, it would help viewers feel more comfortable in watching and using this APP. The later issue is of no small concern, because if viewers are uncomfortable, they probably won’t use it.

Reviewer 3 Summary

My main concern about this app is that it is there isn’t much to it. The instructions aren’t really instructions on how this should be used and by whom. In actuality, the instructions give the impression that the exercises could be used for pretty much anything that ails you. There’s no mention of efficacy of this treatment, assessment of symptoms, what to do in the event that the exercises don’t work, or if there are other concerns. The videos themselves could serve as a reasonable guide for self meditation but that’s just about all this app does. I was hoping for more psychoeducation and self management techniques.

Reviewer 4 Summary

This app includes two primary components: an instructions page that explains the purpose of the app, and a video page that includes 2 videos (a “how to” video and a “do it yourself” video).   From the very beginning, the purpose of this app is not clear. It is not immediately clear to me what “hypersensitivity” in the title means. On the home page, the reference to “cognitive and physical challenges” that will be improved is extremely vague. And the list of conditions in the instructions page is baffling (i.e., how can one intervention treat car sickness, poor math sense, and dislike of change?).     While the videos make good use of visual technology, each video is quite long (more than 10 minutes). The audio is extremely tinny with an echo. There are no closed captions in case Deaf or hard-of-hearing individuals want to use the app. Similar to the comments above, the purpose of the videos was not immediately clear unless you watched them – the titles of “How To” and “Do It Yourself” do not provide much guidance to the consumer.

App Name: iCBT

Operating System: iPhone

Reviewer Michael Scheeringa Meghan McDevitt-Murphy
Useful for the following age groups: Teens and Adults Teens and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 4 4
Is of benefit to motivated user (1 to 5): 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 3 4
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

iCBT promotes itself to be “three quick steps guide you through a proven effective method to help you improve your mood and alleviate stress.” The way it works is that the app opens to a page labelled “Event.” The user is supposed to describe an event that triggered a negative mood as the first step. After the user types in a brief description of the event, the app directs the user to describe the feeling about it and gives the user a menu of 24 negative moods. After choosing, a slider appears to rate the intensity of the mood (from a bright sun to a dark cloud). Next, the app directs the user to type in a “negative thought.” No menu this time; the user must type the thought. Next, the user moves to “Appraise” the thought; this is the second step. Under the negative thought that the user typed is a link to “add distortion,” which presents the user with a menu of 13 types of distortions, including All/Nothing Thinking, Awfulizing, and Overgeneralizing. Then the user is asked to instantly “add a re-appraised thought” by typing a presumably more positive thought. After the re-appraisal is the third step, the Outcome, where the user is directed to re-rate the negative feeling. Assuming one feels relatively better, voilà, the user is Done. Strengths The app uses fairly common cognitive therapy techniques of identifying negative feelings and thoughts and linking them to maladaptive cognitive styles (called “distortions” in this app). The menu of 13 types of distortions with brief descriptions can be educational to those who have not been introduced to these before. Also, people with these styles tend to forget that they think in maladaptive ways, so having a quick reference like this in an app could be helpful. For dealing with situations in the moment, working with an app may work better for some people as opposed to writing out the steps on paper or working it through in their heads. Weaknesses There is very little guidance or instructions on how to use the app. There is one page of instructions if the user taps on a small information icon. The icon is small and seemed hidden to me in the lower right corner. The graphics are minimal and fairly plain. There is little in the way of graphic design that makes one want to re-visit the app. There is nothing behavioral in the app that warrants the title of “CBT,” the “B” obviously standing for behavioral. The app is purely cognitive. The leap from picking the distortion(s) to the re-appraisal is jarring. In real therapy, the process of re-appraising is difficult, time-consuming, and takes practice. There is nothing in the app that helps the user make a re-appraisal (a typical method in psychotherapy would be to systematically examine the evidence for and evidence against a negative thought). The app appears that it may be useful only for people who are trained on how to use it. The instructions include no discussion of whether this is meant to be a stand-alone intervention or a complement to professional therapy. Finally, the claim that it is a “proven” effective method appears to be unsubstantiated. There are no data that I am aware of that the app has been tested in a controlled research study. It is not clear if the app is useful for users trying it out on their own, as a complement to someone in clinical treatment, both, or neither.

Reviewer 2 Summary

This app permits the user to do cognitive restructuring about events in their life, in much the same fashion that they would using worksheets provided by a therapist. I think this app could be useful to a client who is being treated in psychotherapy by a CBT therapist, provided the therapist has given them background about cognitive-behavioral therapy, and about cognitive restructuring. There are instructions about how to use the app, and these are helpful. However, I think a naïve user, who downloads this app seeking a self-help resource might find that they do not have enough information about maladaptive thoughts, or common cognitive distortions to make it most helpful. I also think it would be advisable for the app to provide some kind of statement about what to do in case of a crisis, and provide the suicide hotline number, and perhaps info about how to find a CBT therapist.       Overall, I think this app could be a great resource for patients who are receiving CBT!

App Name: iChill

Operating System: Android and iPhone

Reviewer Nancy Kassam-Adams Elana Newman
Useful for the following age groups: Adults Teens and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 3 5
Is of benefit to motivated user (1 to 5): 1 4
Is in keeping with scientific literature or knowledge (1 to 5): 1 2
Reports efficacy evidence (1 to 5): 1 1
Other: Can’t rate benefit without empirical evidence re: the app’s efficacy. I rated this low because I cannot imagine this would be efficacious – essentially it is a brochure in your phone with audio and 2 rating scales.

Reviewer 1 Summary

This app presents a particular approach to dealing with stress / trauma (not clear). The app consists of multiple pages / screens of text with audio (reading the text) and 2 rating scales (pre-post reading the app?). It seems to be a sort of brochure in your phone. I am not aware of any empirical support for the model it describes, nor is it clear exactly which problems or conditions the approach within the app is intended to address.

Reviewer 2 Summary

iChill is designed to teach coping skills- awareness of bodily sensations, calming skills, and grounding. It is very easy to use and the user can read the skills or listen to the skills read aloud. The user can make a note, record a memo or take a picture of calming imagery etc. The terminology used in this application seem less scientific (e.g. nervous system release, blocked stress energy) or jargony (resource intensification). The focus on shifting to a calming gesture or movement seems a bit overstated but is still reasonable. I also appreciate that there are several places where referral to the national life line is recommended

App Name: iCouch CBT

Operating System: iPhone

Reviewer Lori Katz Brendan Rich
Useful for the following age groups: Teens and Adults Teens and Adults
Easy to download (1 to 5): 5 2
Easy to use (1 to 5): 5 3
Is of benefit to motivated user (1 to 5): 5 5
Is in keeping with scientific literature or knowledge (1 to 5): 5 5
Reports efficacy evidence (1 to 5): 1 1
Other: Efficacy evidence is not mentioned on this app.

Reviewer 1 Summary

ICouch is an easy to use APP for people who want to keep track of their thoughts and feelings or “thought records” (e.g., what happened and the related thoughts and emotions, along with an evaluation of distorted thoughts and possible better choices). It also allows the user to keep a log of their records to either see a general pattern or improvement over time. It can be challenging for people in CBT treatment to keep track of their thought records if they don’t have paper or a pen at the time and may forget what they were thinking or feeling. Having an APP like this on ones phone is a great tool to keep more accurate and frequent records. However, if someone was not familiar with CBT, I am not sure how effective it would be to keep these records without an understanding of how to evaluate or modify one’s thoughts… The authors offer this tool as an option for those who may not be ready for therapy. I am not aware of any research that shows it would be effective for people with no background or guidance on CBT. A plus, it this APP includes a link to the ICouch website that offers sessions with a therapist. Nonetheless, I would highly recommend this APP to people who are in CBT treatment as it is a convenient tool.

Reviewer 2 Summary

This app focuses on guiding the reader to examine the cognitive aspects of his/her emotional state. The user can click on a “What happened?” link, which then allows the user to identify the event/stressor, identify negative thoughts associated with that situation, add an emotion and intensity to the situation, add associated thoughts, and then most impressively, select from a list of well-established common cognitive distortions that classifies the user’s negative thought. The app then allows the user to reframe his/her original thought and identify the new emotion. All entries can be saved and later reviewed. A rather effective way to get users to focus on the cognitive distortions associated with negative emotions and the coping skill of restructuring those negative thoughts.

App Name: iCounselor Anxiety

Operating System: iPhone

Reviewer Michaael Scheeringa Sadie Larsen
Useful for the following age groups: Children, Teens and Adults Teens and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 5 5
Is of benefit to motivated user (1 to 5): 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 5 5
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

An interesting thing from the start is that there is no home screen. No self promotion. No pushes throughout the app to sell you more stuff. The developers may be more interested in being helpful than selling stuff. The first screen allows the user to “Rate your Anxiety” on scale of 0-10. No matter what your rating, the second step is a list 10 “Calming Activities.” These include Take 10 deep slow breaths, Visualize success, and Be in the moment. One can pick an activity or shake the phone and one is picked at random. The shake option sounds trivial, but it felt like a nice attempt to get people to try new things. After one picks a calming activity, the next screen is text that walks the person through the steps to do that activity.   The third step is 10 options to “Change Thoughts”. One can select of 10 options (or shake), including “Remind yourself of the benefits of doing a feared activity. After picking an option, the next screen walks the person through the cognitive activity. The fourth step is 10 options called Solution, including Do a feared activity, Listen to a recording, or Take good care of your body. The fifth and final step is to re-rate anxiety on the 10-point scale. The final screen gives the pre- and post- anxiety ratings to show the user if their anxiety went up or down. Extras: Each page has a quote from a famous or quotable person. The quotes were not too kooky or obnoxious. All of the descriptions fit nicely onto a phone screen size. No scrolling to do. Overall, the options for each activity seemed well-grounded in common cognitive behavioral techniques. The graphics were nothing special, but the app ran smoothly and was intuitive to follow.   It had enough options that it could be used many times without being repetitive or simplistic. One of the best apps for anxiety self-help that I’ve seen yet.

Reviewer 2 Summary

This app asks you to rate your anxiety, then gives you several sets of tools for managing that anxiety, after which you will re-rate your anxiety. The tools do not vary depending on your anxiety rating; they are the same sets of tools whether you are “panicked” or “at ease”. However, they are useful sets of tools, including things like “deep breathing” and “muscle relaxation” in the first set of tools, then various techniques to help change your thinking in the second set of tools, then encouragement to face your fears in the third set of tools. The app could have been laid out in a more user-friendly way, and some of the tools would have been enhanced by, for instance, including audio recordings. To get the most benefit, someone who is anxious may need to work on these tools with a therapist or a parent. However, for someone who is learning to cope differently with anxiety, this app could provide a useful, portable reminder of various tools. Although it carries little explanation or reports of evidence, the tools identified are in line with general cognitive-behavioral tools for addressing anxiety.

App Name: iSleep Easy

Operating System: Android and iOS

Reviewer Bethany Brand Catherine Caska-Wallace Melissa Anderson
Useful for the following age groups: Teens and Adults Teens and Adults Teens and Adults
Easy to download (1 to 5): 5 5 4
Easy to use (1 to 5): 5 4 3
Is of benefit to motivated user (1 to 5): 4 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 4 3 4
Reports efficacy evidence (1 to 5): 1 1 1
Other: No evidence reported

Reviewer 1 Summary

iSleep Easy is a user friendly app that is likely to help many people who struggle with difficulty falling or staying asleep. A woman with a calm voice leads all of the spoken meditations. Many people who struggle with insomnia have difficulty because they become quite distressed when falling sleep takes longer than they would prefer, or because they cannot easily fall back asleep during the night. One of the meditations is designed to specifically reduce this kind of distress. Another helpful meditation is geared to help users get back to sleep if they awake during the night. Users have control over the length of time the app plays, which meditations are used ad if they are used singly or in combination, and whether there are background two types of music or five nature sounds.

Reviewer 2 Summary

I liked many aspects of this app. I found it to have a number of different options that the user can customize to choose what works best to help them sleep; however, it wasn’t always intuitive how to change the settings and took some time to find the options (i.e., that you can select a type of music or a type of nature sound by clicking on “music” when you choose a particular guided audio). I found the music and nature sounds to be very soothing and liked how you can adjust the volume and degree of music vs. voice to fit your preferences. The mindfulness activities appeared compliant with research driven mindfulness exercises, but I felt that the wording of some of the scripts would feel dismissive to patients without experience with mindfulness therapies, or who were experiencing significant distress from their psychiatric symptoms. I noted this particularly with “Put away the day” and “sleep affirmations.” While they may be enjoyable and effective to some, I found myself thinking that the script made the act of putting away your thoughts and focusing on your breath appear to simple, particularly to those without mindfulness training.

Reviewer 3 Summary

This app consists of a series of guided audio clips to help you fall asleep. The audio can be superimposed on calming music (3 selections) or nature sounds (6 selections). Alternatively, just music/nature sounds can be played. This leaves the consumer a good deal of flexibility in selecting the combination of voice and audio that works for them. I also really liked that there is a “wee hours rescue” guided audio, which is tailored specifically for those who wake in the middle of the night and cannot get back to sleep.     That being said, I do have some constructive feedback to improve the accessibility and engagement of the app: (1) It was initially tricky to figure out how to “balance” or “fade” between the voice and music/nature components of the audio. For a long while, I waited for the voice to begin to no avail, and then had to play around until I figured it out. The mechanism didn’t seem immediately transparent to me. (2) Some of the language used in the guided audio is jargony and I actually found it jarring while I was trying to get to sleep. I would suggest simplifying the language further to be more accessible and more conducive to calming the mind. (3) The pages with “Sleep Tips” and “App Tips” are essentially written English lists. I would suggest making this content more engaging, either through audio or pictures. The text on its own is not particularly engaging.

App Name: Master Fear of Flying

Operating System: iOS (iPhone)

Reviewer Sven Schild
Useful for the following age groups: Adults
Easy to download (1 to 5): 2
Easy to use (1 to 5): 4
Is of benefit to motivated user (1 to 5): 5
Is in keeping with scientific literature or knowledge (1 to 5): 4
Reports efficacy evidence (1 to 5): 4
Other: Based on CBT model and prolonged exposure.

Reviewer 1 Summary:

Master Fear of Flying is an interactive program designed for people with flying related fears. It is based on CBT/exposure therapy concepts. The program provides psycho-education, assessment tools, and a personalized recovery plan. The program is easy to use, but depending on the level of fear, requires at least 45 minutes to complete. It also requires homework assignments (e.g., thought records). Following of the auditory information is made easier by having part of the information displayed visually. Overall, I can highly recommend this app.

App Name: Mind Warrior

Operating System: iPhone

Reviewer Jennifer Wachen Carmen McLean
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 3 5
Is of benefit to motivated user (1 to 5): 3 4
Is in keeping with scientific literature or knowledge (1 to 5): 3 4
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

Mind Warrior is billed as a tool to “gain awareness and insight into triggered reactions” and to “positively engage the rewiring process through neuroplasticity.” It features Trigger Awareness guides, Action guides to practice new responses, Daily Preparation planning with guided audio visualizations, Lifestyle Goal setting, weekly reviews to track progress, a History archive, and email option to share input with a therapist or others. This app is useful in providing questions that serve as prompts to identify thoughts, emotions, and physical sensations associated with a triggered reaction. The bulleted lists of possible thoughts and feelings are useful; however, the ability to only select one emotion or physical reaction for each thought is a limitation. The lists of possible coping strategies in the Take Action section are useful as well, and the audio relaxations that are included are a nice feature. The Daily Focus and Lifestyle Goals sections involve writing of free text which would require a motivated user. These sections might serve the good purpose of focusing an individual on desired goals, but it’s unclear how useful this section would be to refer to on a regular basis throughout the day. The Weekly Review section requires similar motivation to fill in free text for each item. The History tab summarizes entries in each section over a week. The option to email this to a therapist might be a useful feature, but the format of the output could be more user-friendly. It simply lists responses for each section with a date and time stamp, but does not group them to show which triggers/thoughts/feelings are connected, so its utility seems limited. Overall, this app seems most useful as a list of options to manage triggers. It might be helpful for a motivated user to record specific triggers and to track life goals, but it is not the most user-friendly way to do this. The emphasis on rewiring and neuroplasticity seems to be an overstatement for what the app is providing, and no efficacy evidence is provided.

Reviewer 2 Summary

The app was easy to download and use / navigate. The layout and structure are pretty straightforward and intuitive. I particularly liked the audio clips of guided mindfulness exercises. Many of the strategies users are encouraged to use seem loosely based on empirically supported approaches, namely mindfulness, behavioral activation, problem solving, emotion regulation, and relaxation. These are presented in a somewhat hodgepodge fashion, so user’s can pick and choose which they would like to use. This may be too open ended for some users. More guidance about which strategies to use when may be helpful. One concern is that a user may need to be very self-motivated to get a lot out of this on their own. Another concern is that some of the emotional regulation skills are essentially distraction techniques. Encouraging avoidance of triggers may be problematic in that it prevents the user form learning that they can face the trigger, that it is safe, etc.

App Name: Mood Shifter

Operating System:

Reviewer Joe Ruzek
Useful for the following age groups: Adults
Easy to download (1 to 5): 2
Easy to use (1 to 5): 3
Is of benefit to motivated user (1 to 5): 2
Is in keeping with scientific literature or knowledge (1 to 5): 1
Reports efficacy evidence (1 to 5): 1

Reviewer 1 Summary

The app was relatively easy to use, after some false starts. The interactivity is limited, and the various services it provides are limited. There is a verbal, relaxing dictation encouraging movement of one emotion to another. The music is soothing. There is no real guidance on how to use the app, other than to listen to the narratives. It provides little education about emotions or change processes, and the information that is given is vague and not grounded in evidence or theory. The narrative con ten, while soothing, is not especially helpful in teaching a way of coping with negative moods. The app is not especially engaging and it is hard to imagine using it more than once or twice.

App Name: MoodKit

Operating System: iPhone

Reviewer Melanie Harned Dawson Church Michelle Woidneck Ariel Lang
Useful for the following age groups: Teen and Adult Teen and Adult Teen and Adult Teen and Adult
Easy to download (1 to 5): 5 5 5 5
Easy to use (1 to 5): 4 5 4 5
Is of benefit to motivated user (1 to 5): 4 5 5 5
Is in keeping with scientific literature or knowledge (1 to 5): 4 5 5 5
Reports efficacy evidence (1 to 5): 1 3 4 3
Other: It’s evidence-based but presenting the evidence is beyond the scope of this app, which is focussed on practical application of mood-altering tools. The app does not share efficacy evidence for the information of interventions within the app; however, the information and interventions are consistent with existing literature base. The user can graph his/her data and share it as well.

Reviewer 1 Summary

This app includes a variety of cognitive-behavioral treatment strategies that are consistent with evidence-based treatments for depression. A significant portion of the app is devoted to helping people identify and commit to engage in activities in various life domains (e.g., productivity, social) that are likely to improve mood (ala Behavioral Activation). It also includes a section (“Thought Checker”) that guides users through cognitive restructuring. It also uses solid CBT principles in terms of having users self-monitor mood, set goals, and track progress. Overall, the app interface is well-designed and easy to use.

Reviewer 2 Summary

Moodkit is designed to lift your mood by offering the user a range of short and easy behaviors, such as “Ask others at work or home to walk with you on a regular basis” and “Engage in an act of kindness without making it known to anyone else that it was you.” Concrete examples are then given such as “Put a coin in another driver’s expired parking meter.”   The core of Moodkit is “Activities” and they are divided into intuitive categories such as Productivity, Social, and Health Habits. You can trigger suggestions randomly between categories, or be guided through suggestions in a particular category by the app. You can also tag “favorites” and I found myself using this feature frequently, since it allows you to customize the app for the items that are most relevant to you. For instance, if you don’t need weight control advice but do need motivation to exercise, you can discard the weight suggestions and bookmark your favored exercise options as “favorites.”   You can also “commit” to a particular activity, and have your commitment and the date recorded by the app. This feels like signing a contract, and can increase accountability.   Moodkit also has a “Thought Checker” in which you record adverse experiences, identify negative emotions, and rate your degree of emotional triggering. These emotional labels help the user make meaning and gain perspective on the event. The app then provides you with a list of cognitive distortions that might have been active in your thinking. After you’ve considered them, and processed the experience, you re-rate the experience.   You can also track your mood by rating it daily, and keep a personal journal of your progress.     It would benefit from a “back” button, right now you can’t review a screen once you’ve moved to the next one. Also, you have to navigate using buttons on the screen, it doesn’t make use of advanced iOS 8 functions like swiping your touch screen from right to left to move to the next item. Overall, however, Moodkit combines a great deal of functionality for a simple app, and I believe it is a powerful way to bring the tools of cognitive therapy to accessible to users in everyday situations.

Reviewer 3 Summary

MoodKit is a multifaceted app that allows the user to record mood, thoughts, and activities, as well as journal freely and/or with templates. The app provides a list of cognitive distortions and the thought log guides users through identifying distortions and challenging/reframing thoughts. The app also provides tips for various domains of one’s life (e.g., productivity, social, enjoyment, physical, healthy tips). The journal provides an option for the user to use templates for the various tips/skills to record practice. The user is able to record how different activities and/or challenging thoughts impact his/her mood. There is a great deal of information and utility available through this app. The plethora of information may also serve as a deterrent for some users, as it could potentially be overwhelming and/or too time consuming. Overall, however, this app is consistent with the existing literature base and could be potentially very useful for the motivated user.

Reviewer 4 Summary

MoodKit is a very nice supplement to cognitive behavioral therapy (CBT) or self-help tool for someone who is familiar with the basics of CBT. It provides suggestions for better functioning in a number of areas (productivity, social, enjoyment, physical and health). These tips are simple, easy to implement and likely to be of help. MoodKit also has a Thought Checker function that guides the user through cognitive restructuring and a Mood Tracker function that allows the user to rate/chart their mood along with notes. Finally a Journal function allows for note taking or to record cognitive restructuring or mood notes. The tool is based on sound practices and easy to use. While it might not be ideal for someone who has no familiarity with CBT, it is an excellent resource for someone who wants a tool to facilitate use of the skills.

App Name: PE Coach

Operating System: Android

Reviewer Mallory Malkin
Useful for the following age groups: Teens and Adults
Easy to download (1 to 5): 5
Easy to use (1 to 5): 5
Is of benefit to motivated user (1 to 5): 5
Is in keeping with scientific literature or knowledge (1 to 5): 5
Reports efficacy evidence (1 to 5): 5

Reviewer 1 Summary

The PE Coach was supported by evidenced based materials and provided that information to the user. PE Coach was user friendly and easy to navigate to make best use of the available features. The monitoring and tracking applications were wonderful features of the application. All of the features would make great supplemental resources to ongoing mental health treatment to reiterate the importance of both the cognitive and behavioral components of treatment.

App Name: Personal Zen

Operating System: iPhone

Reviewer Jon Elhai Ariel Lang
Useful for the following age groups: Children
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 4 5
Is of benefit to motivated user (1 to 5): 1 1
Is in keeping with scientific literature or knowledge (1 to 5): 1 1
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

The icon for the app looks nice. When opening the app, the music/sounds are pleasant and relaxing.     But the focus of the app is basically a tracing game. And it’s kind of stupid – it just involves tracing some parts of grass. It’s more geared to a child in my opinion. The music is helpful to relaxation, but nothing about the game appears unique in my opinion that would induce relaxation – especially because the quicker you learn the game, the faster you will perform which is probably not relaxing.   Navigation in the app is adequate. There is a contact button for contacting the developers.

Reviewer 2 Summary

The app suggests that it will train the user to train one’s focus away from the negative and toward the positive. It is hard for me to believe that the activity (tracing a line in wiggling grass away from a hole in which a smiling “sprite” appeared) would do this. It is easy to simply ignore the sprites and just watch the grass, which would seem to remove the emphasis on focusing on the positive. Tracing the line through the grass is difficult at times, without it being clear what is being done wrong. The task quickly became boring and the graphics are unappealing.

App Name: PsyPills

Operating System: iPhone

Reviewer Michael Bordieri Robin Aupperle
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 2 1
Is of benefit to motivated user (1 to 5): 4 2
Is in keeping with scientific literature or knowledge (1 to 5): 4 4
Reports efficacy evidence (1 to 5): 2 4
Other: The app does provide some information and references supporting the REBT model; however, no empirical evidence is cited.   On a promising note, the app does track user’s mood and provides feedback as to whether the statements provided reduces the intensity of unpleasant emotions.

Reviewer 1 Summary

The PsyPills app is grounded in the Relational Emotive Behavior Therapy (REBT) model and offers a variety of customized statements to counter irrational thoughts. These “pills” are provided after a user answers a series of questions about current emotions they are experiencing, the source of their emotions, and the irrational beliefs that are accompanying their emotions.   The app provides some degree of customization to difference situations (e.g., work, family, romantic relationships) and beliefs (e.g., “it is awful, “I am flawed”, “it should not happen”); however, I found that over the week that I used it there were many times when the options provided did not fit my current situation. For example, when I was feeling guilty about not being able to stay home from work and care for my sick partner the pill provided, which focused on my happiness and satisfaction in my romantic relationship, was not particularly useful.   The app has several beneficial features including a history of past “pills” for the user to review and a reminder option that adds a check in to the user’s calendar. In addition, the app provides some psychoeducational about the REBT model and the distinction between rational and irrational thinking. There are also several limitation of the app. For example, when the app first loads, the user has to provide demographic information before continuing. While no name or directly identifying information is required, some users may be uncomfortable sharing their profession and there is no option to skip the question.   Another limitation is that users have to rate the presence of 32 different emotions the first time they load the app. This is a rather time consuming and potentially frustrating process, especially on my iPhone where I found it difficult to select the individual emotions and reliability move the sliders. These limitations aside, the app may be of some benefit for people who are familiar with REBT treatment and want to use the app to help address irrational thoughts.

Reviewer 2 Summary

The graphical interface is not very user-friendly. It feels more like they are collecting data for research purposes rather than for the user purposes.   When you first open the app – the disclaimer is too wordy and presented in a way that isn’t easy to scroll through. The feeling wheel is WAY too small – requiring the user to select each spoke on the wheel. This requires tiny fingers to select each and really good vision in order to tell which spokes have been completed and which haven’t. The app will not continue on until you have done ALL the emotions – and there is quite a few of them. I assume the user is just going to feel annoyed doing all of those each time they get on. The wording of “functional” and “dysfunctional” feelings may be consistent with our wording in manuscripts or treatment manuals, but feels very “scientific” in a self help app. The terminology needs changed to something more mainstream and less judgmental, or explanation of what this MEANS needs to be provided.   The cognitive “prescription” given for a given emotion and thinking pattern feels too simple. It sort of feels like it is diminishing the person’s feelings in some ways. For example, it stated “Accept that not succeeding at work does not change my self worth.” Good idea, but this doesn’t really convince me – feels condescending. Could be useful to use along with therapy so that the therapist could explain CBT a little more thoroughly prior to using this app (and explain some of the terminology).   There is a place where the user can “Read about” the rationale behind the app. This talks extensively about rational-emotive therapy, etc. It is in paragraph format and very difficult to read through on a smart phone. I feel like bullet point format or a video or something could be more appealing and more likely to be read. When I tried to go “home” after getting through one session – it crashed on me.   Overall, I cannot see anyone using this app unless told to do so by their therapist. Even then, I don’t really seeing it being easy enough to use for them to continue using it.

App Name: PTSD and Traumatic Stress-Anxiety Recovery Strategies

Operating System: iPhone

Reviewer Jerold Gold Melanie Harned Meghan McDevitt-Murphy
Useful for the following age groups: Teens and Adults Adults Adults
Easy to download (1 to 5): 5 3 2
Easy to use (1 to 5): 5 2 4
Is of benefit to motivated user (1 to 5): 2 2 2
Is in keeping with scientific literature or knowledge (1 to 5): 2 1 1
Reports efficacy evidence (1 to 5): 2 1 1

Reviewer 1 Summary

A good overview of PTSD, however the only interventions recommended are EMDR and self administration of brainwave training. I’m concerned about this limited scope and about the suggestion that EMDR can be self administered. There are several free and for a fee modules of music and “brainwave entrainment” techniques that purport to reduce anxiety and to reinstate self-regulation. The authors state that there is science behind these methods but do not offer sources and I’ve never seen any evidence for these interventions.

Reviewer 2 Summary

The app includes a 15-min educational overview video that endorses the use of EMDR (an EBT), but also recommends strategies that are not EBTs for PTSD including hypnosis, brainspotting, and neurolinguistics. The “intervention” part of the app requires the user to download additional media files, most of which require in-app purchases to access. These media files are just audiorecordings of music with a voiceover providing instructions for guided imagery. Another feature of this app that I think is problematic is that the two developers appear to be using it as a way to solicit business, as the end of the overview video suggested that users should contact them for a Skype or phone consultation. One section of the app also focuses on providing information about the two people’s credentials and then includes their contact information.

Reviewer 3 Summary

The PTSD and Traumatic Stress –Anxiety Recovery Strategies app is easily downloaded. When the user opens the app, they have the option of watching an introductory video, downloading some audio files, or reading more about the developers. I had several concerns about this app. First, I think the title is misleading. It suggests this app will have content in the form of “strategies” that can be used to help manage symptoms. There is nothing like this included. The introductory video begins with a disclaimer that I think could be very off-putting to someone who has downloaded the app trying to find help due to their distress. The disclaimer (which appears on screen during the video and is read aloud) seems to have a shaming tone, rather than an encouraging/reassuring tone.   The rest of the video includes some accurate content but also seems to push some “fringe” therapies, including NLP and “brainspotting.” There is no evidence presented to support these therapies. The video does not address the therapies with a stronger evidence base (CBT). The area labeled “media” presents the user with a set of files that can be downloaded (which seems cumbersome), some of which are free and others would cost money. I listened to the 3 free tracks and they all seem to be audio tracks that use “bilateral brainwave frequencies”. These are unpleasant to listen to. There is no information provided to the user about why or how these might be useful, but they have titles like “Stop anxiety” and “trauma recovery music” (which is not melodic or soothing). I should note that the developers of the app are not licensed mental health providers. One of them identifies himself as a “professional development coach” while the other identifies as a “personal development coach.” Although both appear to have earned some certifications in specific therapies (e.g., NLP, hypnotherapy), neither appears to have been formally trained as a mental health care provider from an accredited program, nor does it appear that either has been licensed as a mental health provider.           Given all of these concerns, I cannot recommend this app. I do not think it would be useful for someone suffering from PTSD, and I would worry that someone who downloaded this app in an attempt to find helpful strategies would be given false hope that these audio tracks could provide some relief. The app does not provide any helpful information to users about where to find a therapist or other resources (despite the warning at the beginning that individuals who are in crisis should talk to their doctor).

App Name: PTSD Coach

Operating System: Android and iPhone

Reviewer Thomas Elbert Matthew Price Joan M. Cook
Useful for the following age groups: Adults Teens and Adults Adults
Easy to download (1 to 5): 5 5 4
Easy to use (1 to 5): 4 4 5
Is of benefit to motivated user (1 to 5): 2 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 2 5 5
Reports efficacy evidence (1 to 5): 1 2 4
Other: Unclear what the evidence would be for this as this app is largely psychoeducational.

Reviewer 1 Summary

OS: does not work well with IOS 8.1.1 (frequently unresponsive, requiring a restart of the iOS) – seems better with Android;   app from 2011, no new releases or improvements constructed on “clinical plausibility” rather than an etiological model of PTSD, thus a bit weak from a science perspective

Reviewer 2 Summary

PTSD coach is an app that provides psychoeduction, symptom tracking, and brief “in the moment” interventions for those with symptoms of PTSD. Educational information is provided in a Q&A format with brief text responses to commonly asked questions about PTSD. The information provided is firmly grounded in the empirical literature, but is written in a manner that requires a high level of literacy. For example, a portion of text in the app received an average readability score of the 11th grade across five indices of readaiblity. The assessment tool administers the PTSD Checklist and provides a means to track scores over time. Such a tool is highly likely to help users given evidence that symptom monitoring can result in meaningful symptom reduction. The app also allows users to identify support contacts in their phone that can provide help when they are in distress. The contact information for these identified individuals is provided to the user when they enter an elevated symptom. Such a feature is likely to be useful to patients who access the app in times of distress. Overall, PTSD coach provides a suite of features that are grounded in evidence and have a strong potential to help an individual with PTSD in addition to evidence-based treatment.

Reviewer 3 Summary

This app is extremely easy to use. The various sections of the app are helpful and informative. It is helpful to separate out areas for learning, self-assessment, managing symptoms, and finding support. Each of the sections is easy to navigate and provides patients with useful information for managing PTSD and its associated symptoms.   Overall, I would recommend this app to my patients.

App Name: PTSD Eraser

Operating System: iPhone

Reviewer Mark W. Miller Norman B. Schmidt
Useful for the following age groups: Adult Adult
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 5 3
Is of benefit to motivated user (1 to 5): 3 1
Is in keeping with scientific literature or knowledge (1 to 5): 2 1
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

This is a simple app that plays an audio recording of woman’s voice leading a guided relaxation-imagery session. It is not a PTSD-specific treatment. The only language referring to an event in the past comes in the form of references to “the problem”. The focus is on identifying energy in the body that is blocked by the problem and getting it to flow again. There are sustained synthesizer chords, slow breathing sounds, and an occasional wind chime. I’m not sure that if patients will readily grasp the idea of conceptualizing their trauma history & symptoms as “blocked energy” that they can move around their body. I don’t believe there is empirical support or recognized trauma theory related to this treatment but it is possible that patients with a history of exploring “new age” ideologies, yoga, and/or hypnotism might appreciate it.

Reviewer 2 Summary

This application is worthless. Do not purchase it unless you also think snake oil can cure you of PTSD. The app purports to manipulate so-called “body energy” and has no scientific basis.

App Name: Self-Help for Anxiety Management

Operating System: Android and iPhone

Reviewer Mallory Malkin Alicia E. Lopez-Martinez Emma Barrett Mary Ann Dutton
Useful for the following age groups: Teens and Adults Adults Teens and Adults Adults
Easy to download (1 to 5): 5 4 5 5
Easy to use (1 to 5): 5 1 4 4
Is of benefit to motivated user (1 to 5): 5 1 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 4 1 5 4
Reports efficacy evidence (1 to 5): 3 1 1 1
Other: Provides links to several anxiety resources sites to provide background and evidence. Provides information regarding the etiology and maintenance of anxiety There is too many information to manage the app easily. Is is easy to get lost among the different options that the users can choose.

Reviewer 1 Summary

The Self-Help for Anxiety Management application provides a user friendly interface for motivated patients to track and manage their symptoms of anxiety. The application provides links to outside resources, as well as information regarding the etiology and maintenance of a variety of anxiety symptoms. The cycle of anxiety and symptoms of anxiety application interfaces are helpful and appropriate for a variety of developmental levels. The Self-Help resource within the application provides a variety of features that are appropriate for a hierarchy approach to anxiety and fear. The tracking features for the individual to track specific symptoms and levels of distress are helpful and easy to use. One of the features that I thought was most useful was the NOW feature, which is directed toward imminent panic or intense anxiety. It provides a guided step process to calm using breathing techniques, guided imagery, and grounding techniques. Overall I think the program has a number of useful features that are appropriate for both adolescents and adults who are motivated to reduce anxiety and learn more about their own triggers and symptoms.

Reviewer 2 Summary

The interface is attractive, but if the aim of the app is to help to managing anxiety the tool is not useful as a self-help option. At most, It could help people to identify situations that contribute to elevate some anxiety symptoms when related to inespecific situations. In any case, it could be a useful tool for psychologists when they attend people with anxiety disorders (e.g. for home practicing).

Reviewer 3 Summary

The Self-Help for Anxiety Management is a good app for the management of anxiety among teens and adults). It is presented in a pleasant and user-friendly way and it is in keeping with the scientific literature is most respects. The information presented is clear and relevant. The user can read general information on anxiety and can engage in tasks to relieve their current anxious state (e.g. ‘Help for anxiety now’) while also work to reduce their anxiety in the longer term (e.g. questioning thoughts and challenging thoughts). The app also provides useful examples and reflections and the user is able to move up through levels as they progress.

Reviewer 4 Summary

This app is easy to navigate and provides a range of “activities” including providing information, but also has a few exercises – for example, an animation that takes uniquely identified anxious or negative thoughts fade away as bubbles and another where the user types in anxious thought and it “explodes” into nothing. There are meditation and visual relaxation bits. There is also an option for recording and listening to one’s own voice. Ratings of thoughts, body sensations and affect is available along with an automatic tracking of these ratings. It is simple enough to use and could become a “go to” for someone who needs or wants to reach for something to soothe. There is an especially nice feature where a calming picture is available from a menu but then one needs to wipe the fog off the screen to view it. The act of engaging in the emergence of this lovely view was far better than merely a static viewing of a photograph. It was as if one was discovering the view – had a bit of a different effect. Overall, I liked this app quite a lot.

App Name: Stop Drinking with Andrew Johnson

Operating System: iPhone

Reviewer Catherine Caska-Wallace
Useful for the following age groups: Teens and Adults
Easy to download (1 to 5): 5
Easy to use (1 to 5): 4
Is of benefit to motivated user (1 to 5): 2
Is in keeping with scientific literature or knowledge (1 to 5): 2
Reports efficacy evidence (1 to 5): 1

Reviewer 1 Summary

The voice of the facilitator walking you through the mindfulness exercise is pleasant to listen to and relaxing. I found the affirmations during this mindfulness audio to be somewhat motivating and relevant. However, there is only so much that one can get from such affirmations and the options for the mindfulness audio were quite limited and redundant. I was disappointed that the app didn’t include any introductory information about its uses or how this may help you stop drinking, nor did it include psychoeducation on alcohol use/addiction, harm reduction, relapse prevention, urges, cravings, behavioral strategies, or even temptations and motivations to discontinue one’s use. Instead, they refer the user to other applications to download, focused on relaxation. Moreover, the audio is quite long, with the shortest option I could find being 31 minutes. Overall, I found this app to be of little clinical utility and surprisingly limited in scope considering the amount of research out there on effective substance use treatment, including more extensive use of mindfulness, for example.

App Name: Stop Panic & Anxiety Help

Operating System: Andriod

Reviewer Alex Jordan Nexhmedin Morina Nancy Kassam-Adams
Useful for the following age groups: Teens and Adults Adults Adults
Easy to download (1 to 5): 5 5 2
Easy to use (1 to 5): 4 3 1
Is of benefit to motivated user (1 to 5): 3 4 1
Is in keeping with scientific literature or knowledge (1 to 5): 3 4 3
Reports efficacy evidence (1 to 5): 1 3 1

Reviewer 1 Summary

This app consists of a few disparate parts, without any real attempt at integration into a coherent and engaging user experience. The home menu has links to articles, audio files, and a cognitive diary. The app’s therapeutic content is a grab-bag of second- and third-wave CBT approaches, most of which have decent evidence to support them.   The articles are detailed and accessible. However, some of them include long blocks of uninterrupted text with minimal interactivity, and would be better read on a website.     The audio files are a nice collection of applied relaxation, meditation, and mindfulness exercises. These are probably the strongest part of the app.   The cognitive diary is bit burdensome to use. Moreover, its interpretation of cognitive therapy is heavy-handed and may strike many users as naïve (e.g., negative self- or other-directed thoughts are labeled as “irrational,” positive as “rational”).

Reviewer 2 Summary

This app contains educational and experiential tools to learn to better cope with fear of panic attacks and fear of sensations when having a panic attack. The information is based on the cognitive-behavior therapy (CBT) model and aims at assisting the user via:

  • Articles about anxiety from a CBT point of view
  • A diary of anxiety related thought with the goal of better challenging fearful thoughts
  • Panic assistant audios to assist through panic attacks
  • Relaxation, emotion training, and mindfulness training audios to learn better relaxation and to increase nonjudgmental awareness of emotional states and bodily sensations

Altogether, this app offers a great amount of information on anxiety in general and fear of panic attacks in particular as well as on CBT as means of dealing with fear of panic attacks. Longer versions of the educational articles can easily be assessed on the web. Furthermore, the wealth of relaxation and mindfulness exercises enables the user to physically calm him-/herself and develop and maintain a better relationship to his/her emotions, thoughts, and physical sensations. I believe the app to be a useful tool in assisting healthy coping with fear of panic attacks and increasing awareness of cognitive and emotional states.

Reviewer 3 Summary

This app is a text-heavy description of CBT techniques for panic and anxiety, paired with some tools to operationalize those techniques. It is clunky, not user-friendly, and would need a very motivated user to hang in to use the core features.

App Name: Stress Check Pro by Azumio

Operating System: iPhone

Reviewer Scott Edwards Darren Holowka
Useful for the following age groups: Teens and Adults Teens and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 4 3
Is of benefit to motivated user (1 to 5): 4 2
Is in keeping with scientific literature or knowledge (1 to 5): 3 2
Reports efficacy evidence (1 to 5): 3 1

 

Reviewer 1 Summary

The Stress Check Pro app by Azumio uses heart rate variability (HRV) to quantify stress levels, from low to extreme. The app does a good job of describing the differences between eustress and distress. This is a necessary disclaimer since stress is an ever-present and natural aspect of day-to-day life, and a moderate to high stress rating might simply reflect being in a state of productive work or other peak performance. The app may be best utilized by individuals attempting to test various stress-reducing exercises (such as meditation), where pre- vs. post-intervention tests would be easy to complete in a timely and repeatable fashion.

Reviewer 2 Summary

The app is very limited in that it uses the phone camera and flash to get a measure of heart rate, which is the classified by intensity. While readings are take (2 mins) interesting facts regarding stress are presented. I’m unsure whether the readings are accurate, and it seems to require users to sign up for an account to save past readings.

App Name: T2Mood Tracker

Operating System: iPhone

Reviewer Jon Elhai Julian Ford
Useful for the following age groups: Adults Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 4 3
Is of benefit to motivated user (1 to 5): 3 3
Is in keeping with scientific literature or knowledge (1 to 5): 3 4
Reports efficacy evidence (1 to 5): 1 1

Reviewer 1 Summary

The icon looks fine and the writing is easy to read to know what the app is.   It is easy to navigate through the app. I rated indices of anxiety, depression and others. I thought the poles/labels for each dimension of symptom were easy to understand. I like how it’s possible to set up a custom category with its own items. I found it cumbersome to have to click the Save button at the top right. It would be more helpful if returning to the main screen also saved ratings. Also even after clicking Save, my responses did not seem to get saved, so I couldn’t view them in graphs. But I like the feature of graphs, it if can actually work.   It was helpful that settings allowed some customization. Some categories of symptoms may not apply to most people, so hiding them is a nice feature. It’s unclear what a user would do with the information. Perhaps if there was some psychoeducation in the app to inform what to do if depressed or anxious, or at least links to other resources, that would help. There is a link to the developer’s website but it’s unclear what kind of help they would provide. Helpful is that there is a security option in the app to include an app password.

Reviewer 2 Summary

The app provides a thorough set of mood ratings that can be repeated daily or more often, with graphic feedback showing fluctuations and patterns in mood over time. The mood ratings take some time to record because of the detail involved, and this may discourage users who want to make quick ratings — for this reason I would not recommend for adolescents. However, for highly motivated users the visual feedback can be quite informative and can provide a base for engaging in self-help or other programs to enhance mood.

App Name: The Linden Method

Operating System: iPhone

Reviewer Ariel Lang
Useful for the following age groups: Adults
Easy to download (1 to 5): 5
Easy to use (1 to 5): 4
Is of benefit to motivated user (1 to 5): 2
Is in keeping with scientific literature or knowledge (1 to 5): 1
Reports efficacy evidence (1 to 5): 1
Other: Claims are unsubstantiated and unreasonable.

Reviewer 1 Summary

The most concerning thing to me about this app is that is promises to cure anxiety for all who use it. This is certainly an irresponsible statement and appears to be unsubstantiated by empirical evidence, although there is repeated mention of anecdotal experience. It also suggests that all other approaches are ineffective, which is simply incorrect. Aspects of the approach are quite reasonable based on what is understood about the treatment of anxiety (e.g., non-avoidance, reducing reassurance-seeking) but other aspects (e.g., thought suppression, distraction) are not. In all, I think the app is likely to be helpful to some users, but it is certainly more expensive than other self-help approaches that are likely equally effective. The exaggerated claims about the product could potentially derail people from seeking alternative approaches.

App Name: The Mindfulness App

Operating System: iPhone

Reviewer Rachel Hershenberg Cheri Levinson
Useful for the following age groups: Adults Teens and Adults
Easy to download (1 to 5): 5 4
Easy to use (1 to 5): 3 2
Is of benefit to motivated user (1 to 5): 4 4
Is in keeping with scientific literature or knowledge (1 to 5): 4 4
Reports efficacy evidence (1 to 5): 2 1
Other: Limitations of the app:   1) setting reminders function is difficult to navigate. There are not multiple options for reminders (1 or nothing); the feature had a hard time finding my current location; and i could not set a location when my current location was moving (i.e., it didn’t work when I was doing it on my commute via bus to work). 2) It would be much appreciated to have voice options rather than the one woman’s voice 3) setting up the personalized meditation does not allow you to alter the 8 minute preset , only the length of the silent meditation

Reviewer 1 Summary

Overall, this is a great application that allows you to integrate mindfulness meditation into your daily life. You can set reminders on your phone to simply remind you to “breathe” or “notice the sensations in your body,” which is a good cue to incorporate skills usage into daily life and generalize skills across time and settings. In that regard, it is also a good complement to clinical work done with a therapist.   The application provides the accessibility of incorporating mindfulness into daily life, consistent with the zen buddhist tradition and treatments such as DBT. So, for example, when waiting in a long line or for public transportation, there exists an opportunity to turn on the app, plug in headphones, and practice just being – rather than engaging in excessive cognitive activity.     The limitations and frustrations associated with the application are listed above. Overall, the application has potential, but I hope the functionality of it can continue to be improved. Thank you for the opportunity to review it.

Reviewer 2 Summary

I used the app Mindfulness (not listed on the pull down menu above). I thought it was a little hard to use. I thought it was a great idea that they had random notifications to be more mindful throughout the day. However, it was hard to figure out how to set up the random notifications. I could only figure out how to set specific notifications (not all of the notifications) for a certain time or location. I could not figure out how to set them up for random times, which seemed like that would be the best idea/ most useful. The guided meditations were nice. I think they would be best used by an advanced practitioner of mindfulness and might be difficult for someone who is just starting out. The silent meditations were also nice, but again would probably be better for a more advanced practitioner.

App Name: Vital-EQ Respiroguide Pro

Operating System: iPhone

Reviewer Karen Zilberstein Ariel Lang
Useful for the following age groups: Children, Teens and Adults Children, Teens and Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 5 5
Is of benefit to motivated user (1 to 5): 4 5
Is in keeping with scientific literature or knowledge (1 to 5): 4 3
Reports efficacy evidence (1 to 5): 2 3
Other: Makes the claim that it is medically tested but does not give any evidence or refer to any studies or results. It makes a number of claims in the information area that are likely not supported by science.

Reviewer 1 Summary

The app is easy to use and understand. After downloading one merely needs to press the start button and then breathe along with the app, breathing in as the yellow dot proceeds up and out as it goes down. The app can be easily set to different speeds so that users can experiment to find the pace that works best for them. Users can also set the app to the number of minutes they want to engage in the exercise.     For those who want a simple guide to help them through breathing exercises, this provides that tool. If more help is needed to find the right pace or to monitor results, the app will not provide those functions. But as a tool to control breathing as a way to manage stress and relax, it works very well.

Reviewer 2 Summary

This is a nice little app for breathing retraining. It is very easy to use. It has of all of the settings I could think of wanting (number of breaths per minute, shorter inhalation, total time played). There is an option of turning on the sound of waves to pace the breathing without having to look at the screen. It does take a little work to figure out one’s optimal settings, but the standard settings are a good start. In all, I think this is a nice app for training people to breathe smoothly and mindfully.

App Name: Worry Watch

Operating System: iPhone

Reviewer Michelle Woidneck Elana Newman
Useful for the following age groups: Teens and Adults Adults
Easy to download (1 to 5): 5 5
Easy to use (1 to 5): 2 1
Is of benefit to motivated user (1 to 5): 3 3
Is in keeping with scientific literature or knowledge (1 to 5): 4 4
Reports efficacy evidence (1 to 5): 4 1
Other: While there is efficacy for this approach it is not cited in the current website

Reviewer 1 Summary

Worry watch allows the user to record events one is worried about and to rate whether the outcome was as bad as expected. The app is essentially a data tracker that allows the user to review the evidence for and against worry related to different events. The app allows the user to record and review data based upon outcome, context (i.e., social; career; family; etc.), date, or day. The app allows the user to review graphs of each of these areas as well. In my opinion, the most useful feature is the pie chart that allows one to visually review the percentage of events that were as bad as one anticipated, not as bad as anticipated, and unknown (i.e., the percentage of events that have been entered but are awaiting a response). There are no instructions and it takes a few minutes to figure out how to use and navigate the app. There is a feature that allows one to enter a future event and set an alert/reminder to record the outcome. This feature did not e work on my phone, as I never received an alert or reminder of any kind. While reviewing the evidence for/against anxiety is an evidence-based intervention, this app would likely require a very motivated user in order to be appealing enough to utilize. As it is, I would be unlikely to recommend this app to a client. If the alert feature was corrected and additional features added (e.g., anxiety management skills that can be utilized in the moment and/or practiced over time such as a guided meditation/PMR), then I would consider recommending the app.

Reviewer 2 Summary

Worry Watch is designed to help someone keep track of worries; specifically one can track when a worry occurs (date and time), the context of the event and how the outcome occurred. One can search by these 4 criteria to see patterns; Charts about each of these aspects of worries as an overall chart about worries over 12 months can be generated. This tool may be helpful tool for someone undergoing CBT treatment for worries to log worries and note patterns. A unique feature of this app is that it is available in English, Chinese and Japanese. Unfortunately the app is not yet in the most user friendly format.   It turns out that the instructions are available on the web (worrywatch.com) but not on the application itself which makes it clunky to use. For example, it took this (admittedly less tech savy) user a while to understand how to set up a personalized password to protect the journal and to identify the website instructions. In addition, some of the information to record could be better explained.   In terms of context information to log, the app could be improved by specifying what information might be helpful to track for context- is it the sequence of events prior, the place, etc. For now, any app user will definitely need the support of a trained therapist to maximize success using the log.