Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide

New mobile apps provide 24-7 check-ins

A therapist in your pocket?

Let's face it: Therapy is hard work. Hard work for the therapist, hard work for the client.

It's such hard work that sometimes people question its effectiveness. Someone said to me this weekend, "I don't really think that therapists help anyone." After my heart stopped breaking, I thought, "Well, do they?"

Many times, I think, therapists can most help people who are interested in doing the work. Therapy is hard for clients, in part, because a situation can get worse before it can get better. It can be hard because it makes us question parts of ourselves that are sometimes easier to just leave alone. It also requires more than just the typical once-a-week visit - you have to think about the therapy after the visit, think about the changes or decisions you might need to make, and maybe even try one or two out to see what happens.

Therapy is hard for therapists because it's not just about being a good listener. Faced with severely distressed clients, clients in crisis, or even the "worried well," therapists have to work with, for the most part, the information presented to them by the client. The 50-minute hour is often barely enough time to cover the week's goings-on, much less go too in-depth.

In a true spirit of "meet-them-where-they-are," several researchers have been designing mobile phone apps to help people manage anxiety, track moods and feelings, and notice patterns in their lives. The apps also help therapists learn more about what their clients experience during the time between appointments.

Michelle Trudeau of NPR reports: "Here's how one of the apps, called ‘Mobile Therapy,' works: Throughout the day at random times, a ‘mood map' pops up on a user's cell phone screen. ‘People drag a little red dot around that screen with their finger to indicate their current mood,' says Dr. Margaret Morris, a clinical psychologist working at Intel Corp. and the app's designer. Users also can chart their energy levels, sleep patterns, activities, foods eaten and more, she says."

"Based on the information entered by the user, the app offers ‘therapeutic exercises' ranging from ‘breathing visualizations to progressive muscle relaxation' to useful ways to disengage from a stressful situation, Morris says. And the information the app captures can later be charted, printed out and reviewed. The idea is that users can look at a whole week of mood data to see if there are any connections between their mood and other factors happening in their lives, and record it into the app.

Another app has been designed by researchers Gavin Doherty and Mark Matthews at Trinity College in Dublin to be used with cognitive behavioral therapy (CBT), especially with teens.

Reports NPR's Trudeau: "An essential component of CBT is ‘homework,' which involves patients keeping a daily diary, charting their moods, energy levels, sleep, activities, etc."

"Typically, patients will bring their paper charts into their therapist to discuss them during their weekly therapy session. But many patients - especially teens - balk at doing the CBT homework, and many stop doing it."

"Previous research suggests that patients who do their CBT homework assignments and practice them between sessions are the ones who benefit the most and benefit the most quickly."

While clearly not a substitute for therapy, these apps do seem to provide a real complement to regular therapy of different types. Therapists can help people; apps can help people, too, and might even help therapists help people better.

These apps also promote self-awareness, a critical component of personal growth, and provide unique insight for therapists working with clients who might otherwise be reluctant to open up or do their ‘homework' - teens in particular.

What do you see as potential pitfalls or positive aspects?

Copyright 2010 Elana Premack Sandler, All Rights Reserved

Elana Premack Sandler, M.S.W., M.P.H., is a public health social worker specializing in violence and injury prevention and adolescent health promotion.

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