Smartphone psychology: New approaches towards safe and efficacious mobile mental health apps.

Abstract

Practicing psychologists are being faced with the reality that mobile mental health apps for smartphones and tablet devices are increasing in popularity. This growth area within e-mental health has been well documented in Professional Psychology: Research and Practice. This article provides an update on the issues of safety and efficacy in mental health app development, two of the biggest concerns that practicing psychologists have about these new digital tools. Governments and medical authorities are wrestling with how to regulate the health app market to avoid harm to users. At the same time, a lack of research into the efficacy and effectiveness of most mental health apps in the various app stores leaves clinicians and consumers with uncertainty. The vast majority of the limited research to date has been completed by those involved in an app's development. Further independent research and replication are required to demonstrate legitimacy and increase the acceptance of mental health apps as valid sources of therapy. Complicating this issue is disparity about an acceptable methodology for examining the effectiveness of a mental health app. This article proposes a new approach to incorporate multiple baseline single-case designs to increase the amount of evidence and to guide larger-scale randomized controlled trials, something that could and should include practicing psychologists. This novel approach also proposes that mental health apps undergo a new "certification" process with the participation of app store marketplaces. Public Significance StatementTwo of the biggest concerns that clinicians have about mental health mobile applications (apps) are their safety and efficacy. This article examines the key issues of the difficulties of regulation and certification, the potential for apps to cause harm to their users, the complexities of organizing large-scale studies to test for efficacy and effectiveness, and the feasibility of increasing the evidence base by using novel research methods.

Apps With Maps—Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores

“…There are no known safeguards in place anywhere in the world to stop this from happening. While government agencies have started to regulate the health app space, this regulation has thus far focused on apps that only pose a risk of harm to users [ 62 ]. While this is important and a welcome addition to the oversight of mental health apps, it does not provide checks on accuracy of information in app store descriptions of apps that may not fall into the category of posing a risk of harm.…”

“…However, the research found to accompany the apps listed here does appear to vary greatly in methodology; this reaffirms the claims of heterogeneity made in those literature reviews. These reviews all call for more research and ongoing evaluation of research methodology into studying apps, as the current methodologies may not be the most appropriate [ 62 , 67 , 68 ].…”

Effectiveness of Using Mental Health Mobile Apps as Digital Antidepressants for Reducing Anxiety and Depression: Protocol for a Multiple Baseline Across-Individuals Design

“…These include the following: more economical for low socioeconomic groups to obtain mental health treatment compared with face-to-face services [ 69 ], improved access for those in rural areas where there may be limited treatment options [ 70 ], reduced stigma [ 71 ] because of anonymous assistance, access for children and adolescents who are already large consumers of smartphones and the internet [ 72 ], and it is simply a preferred way to receive mental health information for some [ 73 ]. Therefore, it is important to increase research on the efficacy and effectiveness of mental health apps using appropriate and scientifically validated methodologies in addition to RCTs, as the widely considered gold standard of RCTs may not be the most appropriate for analyzing mental health apps [ 23 , 74 ].…”

Treating Psychological Trauma in the Midst of COVID-19: The Role of Smartphone Apps

“…While the time demands of the gold standard RCT can be an impediment to research, other methodologies that do not sacrifice scientific rigor and integrity can potentially be conducted on apps in a more timely manner (38). These include scalable single-case designs involving practicing clinicians working with researchers (36). In such a model, clinicians could contribute their findings to a centralized database that may continually be updated with results that occur from individuals using their app in real-world settings.…”