What Are the Differences Between Apps for Wellness Versus Psychiatric Conditions?

The number of apps that claim to address mental health is more than 700 when using a loose definition of the concept. The vast majority of these, however, promote wellness, and a much smaller fraction (perhaps 150-200) are designed for individuals who suffer functional impairment (Pacheco & Scheeringa, 2022).

Which one of the two types of app do you need? The distinction of functional impairment is the key difference, because this is the criterion that distinguishes disorder from non-disorder in the official taxonomy of psychiatry, and has proven a reasonable guide for who benefits from clinical types of treatments.

These are examples of functional impairment:

• Not getting along with your spouse/partner.
• Not doing what is expected of you at home (keeping up with chores or other things that needed to be done).
• Not able to participate in activities with the rest of the family.
• Not keeping up with your work or school duties.
• Unable to get along with friends or acquaintances outside of family or work.
• Unable to have fun and enjoy life.

 
Individuals with functional impairment are, by definition, not coping or achieving success in one or more areas of life. Wellness, in contrast, is for everyone who is coping fairly well but wants to cope better or achieve more in life. These include apps for meditation, mood trackers, task organizers, tips for better sleep, and daily inspirational quotes.
 
Wellness apps are always self-help. These can, of course, be used in conjunction with seeing therapists. A limitation of trying to combine self-help apps with therapists, however, is that therapists often do not know which apps are best among the many offerings, and the successful use of these apps probably requires a level of commitment from therapists to incorporate them systematically into therapy sessions to track, troubleshoot, and support the use of apps. In a field that still seems dominated by non-directive philosophies, this attempt to combine can be problematic. Apps for those with disorders/impairment can be either self-help or designed for integration with therapists.
 
Wellness apps tend to be simple and focused on one main activity (e.g., meditation or journaling), and may include mood trackers  and cognitive exercises for self-reflection. Apps for those with disorders/impairment are multi-component and ought to be comprehensive to mimic the activities of clinical treatment. These activities include assessments to deeply understand problems before starting treatments; treatment protocols that approach problems in-depth and/or from multiple angles and over a long period of time (i.e., months); quality control to ensure patients are understanding and committed to the tasks; and outcome monitoring to know if it is working.
 
Telehealth companies are technically apps but I do not discuss them here because they are primarily delivering the same intervention as in-person therapy through a remote interface.
 
In summary, while the number of apps that are labelled in app stores for “mental health” is large and confusing, knowing the differences between apps for wellness versus disorder/impairment can help you sort through them.
 
 
Michael S. Scheeringa, MD, founder of Therapy Fidelity app
 
Postscript: Therapy Fidelity is one of a handful of apps designed to be integrated with therapists.
 
 
REFERENCES
 
Pacheco CR, Scheeringa MS (online 8/19/22) Clinical wisdom in the age of computer apps: A systematic review of mental health apps. the Cognitive Behaviour Therapist 15:e40  doi:10.1017/S1754470X22000368.