Apps and Online Therapy for Depression

As a nutritionist at Yale-New Haven Hospital, Ilisa Nussbaum worked on the front lines of the pandemic in the spring of 2020. One of his responsibilities was to ensure that the nutritional needs of patients on ventilators with COVID-19 were met. She quickly realized that she needed psychological help to get through this difficult time.

“I became paralyzed with fear of things that should be relatively unscary, like walking through the railing at work that overlooks the atrium,” she recalls. But the local therapists she contacted were so busy they weren’t taking on new clients.

Scrolling through Facebook one evening, Nussbaum saw an ad for a mental health app. It was a talk therapy chatbot that helps users monitor their mood. “A little robot asked me questions and sent me articles and videos about how to deal with my emotions during the pandemic,” she says. “I found it very helpful, especially when I felt overwhelmed and helpless.”

Research shows that the app she tried may actually work. According to a 2017 study, when young adults ages 18-28 used it daily for 2 weeks, they experienced a greater than 20 percent reduction in depressive symptoms compared to a control group. JMIR Mental Health.

As the COVID-19 pandemic continues, stories like Nussbaum’s are becoming more common. A study in October 2021 The Lancet It found that nearly one-third of American adults had symptoms of depression in 2021, compared with 27.8 percent of adults in the early months of the pandemic in 2020 and 8.5 percent before the pandemic. As a result, online therapy platforms that connect users with a mental health professional at the click of a button, as well as mental health apps, are in high demand.

Advantages and disadvantages

With anxiety and depression skyrocketing, and a dearth of personal therapists, there are many reasons why people choose to take their worries to a therapist from the comfort of their couch.

“Online platforms offer easy access, and they’re often more affordable than traditional therapy,” says Lynn Bufka, PhD, senior director of practice transformation and quality at the American Psychological Association.

Research also supports online therapy. A 2018 analysis of 20 studies compared the effectiveness of online and face-to-face cognitive behavioral therapy. This type of therapy helps patients change their negative thoughts and feelings. The study concluded that online cognitive therapy was as effective as the in-person version for treating anxiety and depression.

Online therapy may have even more value during the COVID-19 pandemic because you don’t have to take precautions like wearing a mask during sessions, says Judson Brewer, MD, PhD, research and development at the Mindfulness Center. Director of Innovation says. Brown University School of Public Health in Providence, RI.

“You can see each other face-to-face, which is really important for therapists because 70-80% of all communication is non-verbal,” he says. “I can see the patient’s facial expressions, which helps me better gauge their feelings.”

Bofka says the biggest concern about online therapy is whether it can provide enough help for people going through moderate to severe depression. “If someone is going through a mental health crisis, my concern is that an online therapist won’t be able to intervene and connect them to local resources that can provide emergency help,” she says. .

Experts are more lenient about online text therapy, where you message your therapist in a secure chat window on your phone and they respond. “Emojis are a very poor substitute for body language and facial expressions,” says Brewer, who notes that there has been little research on this type of communication. Ashley Zucker, MD, chief of psychiatry in San Bernardino County, Southern California, says this format can be good for someone with very mild depression, or temporary stress or anxiety. To check.

Nussbaum feels the same way about the automated app she used. While she feels there is enough to get her through the stress of the pandemic for now, she cautions that it’s not for everyone.

“I … see the app as a stopgap for someone with depression and anxiety until they are able to enter therapy, or someone currently in treatment,” she says. as an assistant to,” she says. “If you have something specific that’s bothering you, ultimately you want to talk to a person, not a robot.”

Find the right app for you.

If you’re considering online therapy or a mental health app, Bufka says, ask the following questions:

Is the therapist licensed in your state? “It does a few things: it shows that the provider has met a minimum level of training, is in good standing, and gives you protection to file a complaint if things don’t go well. “, Bufka explains.

Is the platform HIPPA compliant? Bofka says all licensed therapists are required to abide by patient privacy laws, whether the therapy is in person or online. Their site’s privacy notice should state that they use an encrypted web-based platform that complies with the Health Insurance Portability and Accountability Act. Some sites also have a “shred” button next to each text message so you can delete your message history.

Is there research behind it? That’s especially important for mental health apps, Brewer says, because “anyone can put it on the app store.” Check the app’s website to see if there is published research behind it or if it was developed by someone at a major university.

Ultimately, online therapy and apps can become part of your overall self-care. “The best thing about the app I used was that it required my full attention — I could use it while I was making dinner or on my exercise bike,” says Nussbaum. Couldn’t see.” “Just the act of sitting down to focus on that helped my mind stop racing. It encouraged me to relax, take some deep breaths, and be mindful — all of which are very important.”

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