Getting Started in Mental Health App Development

Alicia Brown

Alicia Brown

Glen Moriarty

Glen Moriarty

Jim Sells

Jim Sells

Alicia Brown, MA
Regent University
alicpav@mail.regent.edu

Glen Moriarty, PsyD
Regent University
glenmor@regent.edu

Jim Sells, PhD
Regent University
jsells@regent.edu

Becoming involved in mental health app development may seem risky given its potential to tap into such valuable resources as time and money.  This guide is based on interviews conducted with individuals experienced in mental health app development, and we hope that it will help prepare mental health professionals for success in app innovation.

Step 1: Find an entry point and leverage your background

Finding an Entry Point

  1. Develop awareness about how certain problems lend themselves to being addressed on a mobile platform and how app stores provide opportunities for mass distribution.
  2. Decide on a role (e.g., team leader, consultant, product manager, subject matter expert, researcher).
  3. Recognize opportunities for collaboration. Many exist within government (e.g., National Center for Telehealth & Technology; Mobile Mental Health at the US Department of Veterans Affairs) and business organizations (e.g., myStrength).

Leveraging Your Background

  1. Incorporate relevant clinical, technology, and/or research experience.
  2. Be goal-focused, collaborative, and flexible.

Step 2: Learn relevant knowledge and cultivate relevant traits

Gaining Relevant Knowledge

  1. Apply psychological principles and research findings as relevant (e.g., app users are distinct from in-person therapy clients; apps may contribute to seeking in-person therapy).
  2. Learn about technology and design (e.g., usability; A/B testing).
  3. Learn about business practices and business/software startups.

Cultivating Relevant Traits

  1. Develop innovative thinking, awareness of biases, humility, and self-motivation.
  2. Cultivate skills consistent with role (e.g., managing teams; applying psychological knowledge to technology).

Step 3: Identify a target condition for the app you wish to develop

Clinical experience and knowledge can help with identifying conditions to target with an app.  Consider the following mental health problems that have been successfully targeted by a high quality app: generalized anxiety (ACT Companion; iCouch CBT), obsessions and compulsions (Live OCD Free), panic (iCBT), insomnia (BioZen; CBT-i Coach), phobias (MindShift), posttraumatic stress (eCBT Trauma; PE Coach), interpersonal concerns (DBT Diary Card and Skills Coach), and mood disturbance (MoodKit; eCBT Mood).  Once identified, evidence-based treatments can be used to develop app content and function that protects user’s privacy, offers data sharing with provider(s), allows for skill-based practice, and prioritizes user experience.

Step 4: Strategize, form partnerships, engage in design and development, maintain the app

Strategizing

  1. Establish vision by developing a business plan and revenue model, ensuring market fit, considering the use of ecological data to overcome human limitations, and/or determining if the app is to be standalone or for therapy use.
  2. Establish need by conducting a customer needs evaluation and identifying specific problems.
  3. Plan content (i.e., information; tools; questions) by embedding EBTs with an easily programmable standardized format (i.e., CBT) onto an electronic platform.
  4. Build revenue by branding versions of the app for specific mental health clinics, instituting licensing agreements, using a subscription based service, embedding other services, and/or soliciting insurance reimbursement.

Forming Partnerships

  1. Reach out to potential technology partners (e.g., programmer; software developer; design firm) and funders.
  2. Collaborate with colleagues to share the workload across a team.

Engaging in Design and Development

  1. Personalize the app by making it compelling and distinct to heighten attractiveness—avoid coming across as impersonal.
  2. Focus on the user’s experience by using an intuitive design, and capitalize on the user’s therapeutic relationship with the device.
  3. Test with subject matter experts and the target population—refine content based on input and recommendations.
  4. Build on a single platform, revise programming constantly, and optimize using AB testing to enhance effectiveness.
  5. Promote and market the app; allot adequate time for marketing.
  6. Implement and distribute the app quickly.

Maintaining the App

  1. Enhance the app by improving upon existing processes, de-bugging, and utilizing user feedback.
  2. Perform research and development (R&D) for refining and creating apps.
  3. Perform research to establish empirical support; use agile research methods to stay relevant.

Step 5: Identify and cope with common obstacles and resistance

Identifying and Coping with Common Obstacles

  1. Generate revenue by figuring out a revenue model as app purchases are insufficient, competing with the “free” expectation in app stores, addressing the success dilemma (i.e., use declines with improved symptoms), and considering venues that are cheaper than apps (e.g., a website).
  2. Keep up with evolving technology (i.e., threat of extinction) and expectations of users by anticipating near daily changes in security and technology, releasing the app in a timely manner, and accounting for varying levels of digital literacy.
  3. Find the time to be involved considering the current demands on your time.
  4. Stay competitive or risk being dictated terms or having quality be compromised by the private sector.
  5. Navigate ethical and licensure dilemmas related to social media and online correspondence.
  6. Establish empirical support and consider using alternative research methods as technology and private sector/business move faster than traditional research.

Identifying and Coping with Resistance

  1. Anticipate reluctance and fear from people in the field; try dismantling it by empathizing with the discomfort, pointing out that apps will not replace therapists, and encouraging willingness and openness.
  2. Acknowledge that a current lack of interest in and discussion about technological interventions calls for being persistent and advocating for discussions on the business of psychology.

Technology has dramatically reshaped many industries and it is only a matter of time before this occurs in the mental health field.  Traditionally, clinicians counsel face-to-face or in group therapy sessions.  The world has come online with billions owning smartphones.  Increasingly, people will access a variety of mental health apps to manage their emotional health.  Choosing to be a part of this area of innovation is a difficult decision because app development is very challenging.  However, mental health app development can be personally and professionally rewarding.  Many psychologists have relevant expertise to design mental health apps.  With right partnerships and hard work, psychologists have an opportunity to play a major role in innovating mental health care.

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