Cognitive Behavioral Therapy (CBT) Apps: A Review

Cognitive behavioral therapy (CBT) is a kind of therapy that focuses on identifying and challenging negative thoughts. Initially developed for the treatment of depression, CBT has been extended to the treatment of anxiety, insomnia, grief, and other disorders. And, crucially, CBT has been shown to be highly effective in the treatment of a variety of mental disorders.

Among the many forms of therapy, CBT is perhaps uniquely well-suited to be developed in the form of an app. At its core, CBT is a set of methods, the effectiveness of which does not depend on the personality of any individual therapist, and which can in principle be replicated and scaled.

This review focuses on several apps that make use of CBT methods to address mental health disorders. There are many apps that mention CBT in their self-descriptions, but these can be narrowed down by focusing on those apps that are free to use, available for both Android and iPhone, and have at least 50,000 installs. Among the CBT apps that meet those criteria, the following five apps are especially deserving of attention:

1. Moodpath

Created by: Aurora Health

Available for: iOS, Android

Moodpath is an elegantly designed app designed around a compelling idea. The idea is that depression and anxiety are moods, and as such they are best tracked over a period of time, rather than at an instant. Accordingly, Moodpath pushes a short questionnaire to the user three times a day for 14 days. At the end of those two weeks, the user receives an “assessment of your emotional health.” That process then repeats so that the user can continue to assess their emotional health and, hopefully, its improvement.

The CBT aspect of Moodpath figures mainly in the treatment that it offers. This consists of audio and written “courses” on managing unhelpful thoughts, dealing with life stressors, and building a positive self-conception.

Most of these courses are included only in the Moodpath “Plus” plan, which costs $7.49 month. These are not the most innovative aspect of this app – its innovation lies in its frequent and long-term mood evaluation – but they do provide CBT-grounded treatment in a convenient and accessible format.

Moodpath also promotes associations with scientists and universities (mainly in Germany), and produces a helpful “magazine” on mental health topics.

2. Woebot

Created by: Woebot

Available for: iOS, Android

Woebot is designed by an impressive, Stanford-based team– its chairman is none less than Andrew Ng. Like Moodpath, Woebot centers around checking in on the user over a period of 14 days. Unlike Moodpath, Woebot is built around a kind of intelligence – Woebot – who questions and prods the user in much the way a traditional therapist might. More specifically, in the way a CBT-trained therapist might.

In addition to its daily sessions, Woebot can do 10-minute check-ins about a variety of topics: mindfulness, stress, etc. The idea is brilliant, and feels as if we are finally on our way to realizing the promise of ELIZA. (Though it also bears emphasizing the founders’ claim that Woebot and similar intelligences are not replacements for traditional therapy.)

One small note is that the UX of the app feels a little off. It’s not always clear when the user is in a “session” with Woebot and when they are free to explore other aspects of the app. And Woebot sometimes repeats itself, as in this exchange:

But Woebot is new, and these sorts of quirks are to be expected, even from an app backed by such an impressive team. Bugs aside, it is exciting to think what the next iteration of Woebot might look like.

3. What’s Up

Created by: Jackson Tempra

Available for: iOS, Android

This app is much simpler than the previous two – which is not necessarily to say that it’s less useful. Much of the app consists of text-based resources that will be familiar to anyone who knows CBT, such as identification of unhelpful thinking patterns and exercises for managing worries:

It also includes some more interactive features. Particularly useful and CBTish is the catastrophe scale, which allows the user to put a realistic scale to their worries:

So while it does not make use of the potential of technology to the degree that Moodpath or Woebot does, this app is simple, flexible, and useful – much like CBT itself.

4. MindShift CBT

Created by: Anxiety Canada

Available for: iOS, Android

Developed by a Canadian non-profit, MindShift CBT is more focused in its approach. It focuses primarily on using CBT to treat users’ anxiety. CBT has been shown to be effective in the treatment of anxiety disorders, so this is a promising and helpful target for a CBT app.

Like some of the other apps above, MindShift CBT has a fundamentally two-part structure. The first part is a tracker that allows the user to record their mood and anxiety over time:

The second part is a library of resources that bring CBT methods to bear on the treatment of anxiety, in a compact and app-friendly way:

The app begins with an account creation process –requiring an email address and birthdate, which may be off-putting to users seeking anonymity – but after that the app has an excellent flow, with impressive engineering and design throughout.

5. Rise Up + Recover

Created by: Recovery Warriors

Available for: iOS, Android

Rise Up + Recover is another app that focuses on a specific application of CBT methods: it is specifically focused on the treatment of eating disorders. Like many of the apps above (and in turn like CBT itself), this app emphasizes the importance of tracking oneself, though it is notable for its inclusion of actions, as well as moods, as something to be tracked:

The remainder of the app consists of features that will now be familiar, such as lessons, mainly text-based, on correcting unhelpful habits of thought. There are some nice touches here, such as the chance to roll the dice to choose a “random” coping skill. The content here is focused mainly, though not exhaustively, on topics of special relevance to individuals with eating disorders, such as body image:

Throughout, the design of this app is simple but effective. Its innovations lie more in content than in design or technology. In particular, it effectively puts CBT to work in an area somewhat outside its more familiar applications. It is a valuable addition to the resources available to individuals with eating disorders.

Summary

CBT promises a form a therapy that is effective and replicable. These apps supplement CBT therapy in a way that helps to realize that promise. They generally have two features:

  1. Tracking – be it by a questionnaire or self-reporting scale – that lets the user monitor how they are feeling over time, both with an eye towards identifying mood issues and identifying them.
  2. Teaching – typically by written or audio lessons or exercises – that explain to the user how to implement CBT methods to correct their own negative or self-defeating thoughts and habits.

The tracking-teaching model is thus a kind of template for all of these CBT apps, which is not accidental since this model is at the core of CBT itself. The apps differ mainly in how they execute it.

The most polished of these apps is Moodpath. It has the most developed UI/UX, as well as a pretty wide library of lessons (though these are mostly available only with a subscription), as well as a robust network of academic support.

The most innovative of these apps is Woebot. Though it follows the tracking-teaching model, it implements it in an original way with its use of an AI assistant, in a way that may point to new directions in mental health treatment.

A special honorable mention goes to MindShift CBT, which is developed wholly by a non-profit, which anyone can donate to here.

Really, though, all of the apps described above are laudable contributions to the mental health space, and the prospects for the ongoing expansion of CBT – which is itself only a few decades old – appear bright.

Note: The contents of this post are for informational purposes only. This is not professional medical advice and it is not intended to be a substitute for professional medical advice. Always consult with a physician with any questions that you have about a medical condition, including a mental health condition. If you think you are in a medical emergency, call 911 or your local emergency services number immediately.

 

3 thoughts on “Cognitive Behavioral Therapy (CBT) Apps: A Review

Leave a Reply