I was recently interviewed on the topic of wellbeing apps - and I have to admit, before the pandemic I was very much an advocate of face-to-face support being the gold standard...so here are my recent reflections.
On the rise of wellness apps:
Can an app ever replace proper therapy?
Is the trend a good thing?
There are some things an app cannot replace:
- “nuance” – when you get a response from a client, a person can read body language, note changes in tone of voice, and any (even slight) deviations from a “baseline” observation to enable a better tailoring of a session.
- Clarification – if the above leaves the professional unsure it is very easy to ask the question so that there is no misunderstanding
- Emergency support – a professional is better able to take emergency action should it need to happen, if nothing else they will likely have a “client agreement” which has contacts to call if the professional becomes concerned, and help can be forthcoming immediately.
- Rapport – Miller and Rollnick (2013) define rapport as building a “…mutually trusting and respectful helping relationship”. This can play a huge role in helping the client feel safe to explore their areas of concern and vulnerability, and research findings published in Psychotherapy (2018) suggested that a positive therapeutic relationship not only “causes but predicts” a positive outcome!
HOWEVER
What an app CAN do is:
- Provide 24 hour access
- Signpost you to a “real person” if needed (if the app functions in this manner)
- Reach people who are uncomfortable speaking to someone
- Enable people to feel they are not alone
- Provide intervention such as meditations and affirmations which can help as people wait for an appointment, OR simply if someone needs that bit of headspace without formal intervention
- Continue our sense of familiarity that we have with technology – most of us wear smart watches to track out fitness, an app can be a simple extension of the practice which reminds us to look after ourselves!
- And, of course, some apps which provide tools such as a gratitude journal, or guided meditations, can be of practical, immediately accessible, and usually inexpensive help to us.
Further, the app is very much a product of the world we live in, and it is likely that many people seeking support will look for an app first, and it is certainly helpful to have one available.
Where do you think the rise has come from - lack of access, cheap cost?
As with many “trends” – if there is a demand, people will supply them. As such, it may be as simple as – people want them, and, similarly to building rapport with people, they may “get on” with the voice or the interface or the key offerings of one app over another, and so having the choice can be of benefit to both user and creator.
To consider the “rise” of apps, we do need to think about the types of apps out there. Some apps are simply “online versions” of a tool a professional may suggest that would otherwise be done with pen and paper (the advantage of the app being that it can be password protected or kept more private to some extent). These might include:
- Vision board apps
- Gratitude diary apps
Useful apps
And one of the most helpful in counselling is the “WRAP app” – the Wellness Recovery Action Plan app https://play.google.com/store/apps/details?id=com.ahpnet.wrap&hl=en_GB&gl=US which enables you to write out a plan for recovery which you can then choose to share with loved ones so they know how to help. A WRAP is a wonderful tool as you not only set out your “next steps”, but you also plan just in case you need extra support and this can make a huge difference as you start on the “one step forward two back” path towards better health.
Other apps can be signpost apps – which are sometimes linked with immediate4 exercises and to some extent “crisis intervention” tools: https://www.makeuseof.com/mental-health-apps-self-harm-suicide/
And there are also apps specifically for those at the point of crisis:
https://prevent-suicide.org.uk/find-help-now/stay-alive-app/ (which has a condensed WRAP as well with contact numbers of resources and people YOU can also include that you can turn to for help).
Then there are more “specific” apps eg: Meditation (Headspace/Calm etc) and some of the more “brain training” style which are there to keep your brain active, but can be done in a calming way eg: colouring in or breathing in time to an image.
I personally enjoy using apps for meditations as well as for journaling and gratitude, but then do other things “in real life” which also boost my mental and emotional health…however, I find opening a wellbeing app a much healthier action than scrolling mindlessly through social media!
There are also some apps which, like a smart watch, can read health stats through contact via the camera, OR through using the data taken from your fitness apps – this can be very helpful to indicate if there is a problem, but when it comes to taking action on it, remember an app can help you with tracking or noticing patterns, but for diagnostics, I would recommend that your next step is your GP – or someone in person to run proper tests – partly because there are things which can be missed or misinterpreted by an app which a person and professional tools created for that specific purpose and tailored to your need, might be better placed to catch.
Does it people disconnected or is it a new way of getting well?
A wellbeing app has a purpose – and in some ways the only “connection” it is “replacing” is that with the professional…and while an app may not be able to give you a fully nuanced and expert service – sadly waiting lists are terribly long (and that’s even when people finally reach out – many won’t); there ARE “bad” practitioners out there – as there are in any profession; and if you don’t get on with the therapist you get, it can take time to find one with whom you can build a rapport…so in that respect, I do believe apps can be a good option – but they need to be seen as complimentary to face-to face support rather than a complete replacement (except in the cases of an information based app, or a resource app eg: a meditation app for example). Some apps may even encourage you to reach out to others eg the Action for Happiness Act, as part of the practices.
If you are looking for tools, or information, the app can be quicker and simpler to access, and if you are not at the point of really struggling then an app can be enough to “nudge” you back into a healthier and more optimistic frame of mind, but as I said, I would see them as a compliment rather than an alternative to help “in real life”.
How would you know if you've chosen a reputable app with good advice?
Cost is not always indicative of how reputable an app is – so as always, I would read reviews and then go down the route of a trial period if available. In fact I would even suggest an app which doesn’t have a free element or a trial element is a red flag because most therapists offer a free consultation. Only purchase when you find it suits you.
If apps are recommended by the NHS, or perhaps by the professional – then at least you have a sense that they do work for some, BUT I’m always a little wary of the apps that are “partnered” with gyms and so on because it might be that the app is recommended because of the (sometimes financial) arrangement between organisations not necessarily because it is the only one nor even the best one that is on offer.
If you know what you are looking for, this can also help when selecting an app – and I’m never afraid to download and then uninstall if I don’t like it.
And finally, I would also add, that unless the “advice” is signposting or “tool based” eg: if you’re feeling anxious, try this deep breathing exercise – again I would not use that app, because professionals (certainly in coaching, and I cannot imagine therapy is any different) are trained NOT to “give advice”, but to offer observations and ask questions to help empower the client to find their own solutions.
Dr Audrey Tang is a chartered psychologist and author with a specialty in the practical "how to take action", rather than just giving explanation and advice. Listen to her podcast Retrain Your Brain here; or her Radio Show "The Wellbeing Lounge", and catch her practical masterclasses Psych Back to Basics on DisruptiveTV & Energy Top Up for resilience. For self development tools based within positive psychology: click Her YouTube Channel . Twitter/IG @draudreyt Order The Leader's Guide to Resilience or The Leader's Guide to Mindfulness or Be A Great Manager Now