JMIR Publications

ABSTRACT

Background:

To address the matter of limited resources for treating persons with mental disorders, eMental health gained in interest in the last years in particular for psychoeducation, or behavior change. Mobile health (mHealth) apps have been suggested as electronic mental health interventions, accompanying cognitive behavior therapy (CBT).

Objective:

The current study aims to identify which therapeutic aspects of CBT have been implemented in existing mHealth apps and by which technologies. We want to find out how mHealth apps impact on patients’ agency within healthcare processes. With “enabling” we refer to the enrichment of persons’ repertoire of available healthcare practices and the growth of individual capacity of self-help through the use of mHealth interventions.

Methods:

Through a literature review we identified studies that studied mHealth apps that implement techniques of CBT. Studies from three databases were screened: PubMed, IEEE Xplore, ACM Digital Library. Data from studies fulfilling the eligibility criteria were extracted and synthesized narratively. From the results of the literature review, we derived which self-help practices of patients with mental disorders are enabled by CBT-based mHealth apps.

Results:

Out of 530 citations retrieved, 34 studies were included in this review. The apps described often support diary keeping, monitoring of mood and behavior or provide exercises and information. Three of the four CBT techniques are integrated in mHealth apps. They enable patients to self-manage and self-monitor their mental state and access relevant information on their disease which helps coping with mental health problems and allows self-treatment. However, the fourth group of CBT techniques, “exposure”, is not realized in mHealth apps.

Conclusions:

mHealth apps for CBT can shift agency to patients through additional self-help and self-management tools supporting specific, but not all aspects of the treatment. Patients and therapists are not yet enabled sufficiently to identify evidence-based mHealth apps due to missing selection criteria and details on efficacy or data security and privacy. Research on ethical issues and socio-cultural biases of mHealth apps has been identified as desiderata.