A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content

Wasil, Akash R.; Venturo-Conerly, Katherine E.; Shingleton, Rebecca M.; Weisz, John R.

doi:10.1016/j.brat.2019.103498

Cited by 160Digital Mental Health InterventionsMobile Health and mHealth ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content

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Wasil, Akash R., Venturo-Conerly, Katherine E., Shingleton, Rebecca M., Weisz, John R.·2019·Behaviour Research and Therapy

DOI 10.1016/j.brat.2019.103498

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Abstract

Smartphone applications for the treatment of depression and anxiety have acquired millions of users, yet little is known about whether they include evidence-based therapeutic content. We examined the extent to which popular mental health applications (MH apps) for depression and anxiety contain treatment elements found in empirically supported psychotherapy protocols (i.e., "common elements"). Of the 27 MH apps reviewed, 23 included at least one common element, with a median of three elements. Psychoeducation (in 52% of apps), relaxation (44%), meditation (41%), mindfulness (37%), and assessment (37%) were the most frequent elements, whereas several elements (e.g., problem solving) were not found in any apps. We also identified gaps between app content and empirically supported treatments. Cognitive restructuring was more common in depression protocols than in depression apps (75% of protocols vs. 31% of apps), as was problem solving (34% vs. 0%). For anxiety, exposure (85%, 12%), cognitive restructuring (60%, 12%), and problem solving (25%, 0%) were more common in protocols than apps. Overall, our findings highlight empirically supported treatment elements that are poorly represented in current MH apps. The absence of several core treatment elements underscores the need for future research, including randomized trials testing the effectiveness of popular MH apps.

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When appraisal was weighted by the number of active users, the reach of specific treatment elements changed.
“when the appraisal was weighted by the number of active users, the reach of specific treatment elements changed.”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Wasil et al. 2019
Mindfulness exercises were encountered by the largest proportion (96%) of monthly active users.
“this technique was encountered by the largest proportion (96%) of monthly active users.”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Wasil et al. 2019
A recent review of apps for depression or anxiety reported that evidence-supported treatment components for these conditions were poorly represented.
“a recent review of apps for depression or anxiety reported that evidence-supported treatment components for these conditions were poorly represented (Wasil et al. 2019)”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Wasil et al. 2019
Mindfulness exercises were present in only 37% of reviewed apps.
“Although mindfulness exercises were present in only 37% of reviewed apps”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Wasil et al. 2019

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Project Body Neutrality: Piloting a digital single‐session intervention for adolescent body image and depression
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Understanding users’ perspectives on mobile apps for anxiety management
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The Impact of Mobile Technology-Delivered Interventions on Youth Well-being: Systematic Review and 3-Level Meta-analysis
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Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
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Internet-based and mobile-based cognitive behavioral therapy for chronic diseases: a systematic review and meta-analysis
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There is a non-evidence-based app for that: A systematic review and mixed methods analysis of depression- and anxiety-related apps that incorporate unrecognized techniques
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Smartphone apps for eating disorders: A systematic review of evidence‐based content and application of user‐adjusted analyses
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A cognitive behavioural therapy smartphone app for adolescent depression and anxiety: co-design of ClearlyMe
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Estimating the real‐world usage of mobile apps for mental health: development and application of two novel metrics
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Digital technologies to support adolescents with depression and anxiety: review
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The Use of Mobile Assessments for Monitoring Mental Health in Youth: Umbrella Review
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The Functionality of Mobile Apps for Anxiety: Systematic Search and Analysis of Engagement and Tailoring Features
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Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial
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A randomized controlled trial of a 14-day mindfulness ecological momentary intervention (MEMI) for generalized anxiety disorder
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Efficacy of a Mobile App-Based Intervention for Young Adults With Anxiety Disorders
Bress, J. N., Falk, A. E., Schier, M. M., Jaywant, A., Moroney, E., Dargis, M. A., Bennett, S. M., Scult, M. A., Volpp, K. G. M., Asch, D. A., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.28372 · Cited by 25 · see citing works
Improving Mental Health on College Campuses: Perspectives of Indian College Students
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Three questions to consider before developing a mental health app
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Scope, Characteristics, Behavior Change Techniques, and Quality of Conversational Agents for Mental Health and Well-Being: Systematic Assessment of Apps
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A randomized controlled trial of an app-delivered mindfulness program among university employees: effects on stress and work-related outcomes
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Education on Depression in Mental Health Apps: Systematic Assessment of Characteristics and Adherence to Evidence-Based Guidelines
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Cognitive training using a mobile app as a coping tool against COVID-19 distress: A crossover randomized controlled trial
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Systematic assessment of the quality and integrity of popular mental health smartphone apps using the American Psychiatric Association's app evaluation model
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Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management
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Health Tracking via Mobile Apps for Depression Self-management: Qualitative Content Analysis of User Reviews
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E-mental health implementation in inpatient care: Exploring its potential and future challenges
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Economic evaluation of an online single-session intervention for depression in Kenyan adolescents.
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Emotional competence self-help app versus cognitive behavioural self-help app versus self-monitoring app to prevent depression in young adults with elevated risk (ECoWeB PREVENT): an international, multicentre, parallel, open-label, randomised controlled trial
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A review of smartphone applications designed to improve occupational health, safety, and well-being at workplaces
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Cognitive reappraisal in mHealth interventions to foster mental health in adults: a systematic review and meta-analysis
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In Their Own Words: Using Open-Ended Assessment to Identify Culturally Relevant Concerns among Kenyan Adolescents
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Willingness to use internet-based versus bibliotherapy interventions in a representative US sample: cross-sectional survey study
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Reinventing mental health care in youth through mobile approaches: Current status and future steps
Marciano, L., & Saboor, S. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1126015 · Cited by 17 · see citing works
Race and Socioeconomic Status as Predictors of Willingness to Use Digital Mental Health Interventions or One-On-One Psychotherapy: National Survey Study
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Efficacy of Intellect’s self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up
Kosasih, F. R., Yee, V. T. S., Toh, S. H. Y., & Sündermann, O. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000095 · Cited by 15 · see citing works
Availability of Internet-Based Cognitive-Behavioral Therapies for Depression: A Systematic ReviewPreprint
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Journalists’ Perception of the Adoption of New Communication Technologies in the UAE’s Media Organizations
Ayyad, K., Moussa, M. B., & Zaid, B. (2023) · Journalism Practice · doi:10.1080/17512786.2023.2300277 · Cited by 15 · see citing works
“If Someone Walks In On Us Talking, Pretend to be My Friend, Not My Therapist": Challenges and Opportunities for Digital Mental Health Support in Saudi Arabia
Aldaweesh, S., AlAteeq, D. A., Kleek, M. G. V., & Shadbolt, N. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642642 · Cited by 15 · see citing works
Engagement With a Relaxation and Mindfulness Mobile App Among People With Cancer: Exploratory Analysis of Use Data and Self-Reports From a Randomized Controlled Trial
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The ecology of youth psychological wellbeing in the COVID-19 pandemic.
Salmon, K. (2021) · Journal of Applied Research in Memory and Cognition · doi:10.1016/j.jarmac.2021.11.002 · Cited by 15 · see citing works
The Flow brain stimulation headset for the treatment of depression: overview of its safety, efficacy and portable design
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Serious video games and psychological support: A depression intervention among young cancer patients
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Design and development of a mobile-based self-care application for patients with depression and anxiety disorders
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Acceptability, Engagement, and Exploratory Outcomes of an Emotional Well-being App: Mixed Methods Preliminary Evaluation and Descriptive Analysis
Eisenstadt, M., Liverpool, S., Metaxa, A.-M., Ciuvat, R. M., & Carlsson, C. (2021) · JMIR Formative Research · doi:10.2196/31064 · Cited by 12 · see citing works
Emotional competence self-help mobile phone app versus cognitive behavioural self-help app versus self-monitoring app to promote mental wellbeing in healthy young adults (ECoWeB PROMOTE): an international, multicentre, parallel, open-label, randomised controlled trial
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Exploring the Role of Mobile Apps for Insomnia in Depression: Systematic Review
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LLMs in Education: Evaluation GPT and BERT Models in Student Comment Classification
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Three Questions to Consider Before Applying Ecological Momentary Interventions (EMI) in Psychiatry
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Is there an app for that? A review of popular mental health and wellness appsPreprint
Wasil, A. R., Palermo, E. H., Lorenzo‐Luaces, L., & DeRubeis, R. J. (2021) · doi:10.31234/osf.io/su4ar · Cited by 11 · see citing works
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Managing depression in India: Opportunities for a targeted smartphone app
Ramnath, S., & Suri, G. (2021) · International Journal of Social Psychiatry · doi:10.1177/00207640211032253 · Cited by 10 · see citing works
Digitized thought records: a practitioner-focused review of cognitive restructuring apps
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The role of implementation organizations in scaling evidence-based psychosocial interventions
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More than a chatbot: a practical framework to harness artificial intelligence across key components to boost digital therapeutics quality
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Evaluating Characteristics and Quality of Mental Health Apps Available in App Stores for Indian Users: Systematic App Search and Review
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Mental Health Apps for Children and Adolescents: A Clinician-Friendly Review
Schueller, S. M., Wasil, A. R., Bunyi, J., DeRubeis, R. J., & Weisz, J. R. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2023.07.1004 · Cited by 7 · see citing works
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Mindful Self-Compassion Smartphone Intervention for Worker Mental Health in Japan: Protocol for a Randomized Controlled Trial
Kurosawa, T., Adachi, K., & Takizawa, R. (2024) · JMIR Research Protocols · doi:10.2196/53541 · Cited by 8 · see citing works
Digital Media Interventions for Adolescent Mental Health
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Evaluation of mobile applications focused on the care of patients with anxiety disorders: A systematic review in app stores in Brazil
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Availability of internet-based cognitive behavioral therapies (iCBTs) for depression: A systematic reviewPreprint
Buss, J., Lorenzo‐Luaces, L., Banks, G., Horani, D., Rutter, L. A., & Wasil, A. R. (2020) · doi:10.31234/osf.io/2jwgd · Cited by 6 · see citing works
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Stigma toward individuals with mental illness among Indian adolescents: Findings from three secondary schools and a cross-cultural comparisonPreprint
Wasil, A. R., Park, S. J., & DeRubeis, R. J. (2020) · doi:10.31234/osf.io/8xcrq · Cited by 6 · see citing works
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A randomized clinical trial of app cognitive behavior therapy vs. HealthWatch for obsessive compulsive disorder
Wilhelm, S., Greenberg, J. L., Jacoby, R. J., Weingarden, H. M., Hoeppner, S. S., Klare, D. L., Snorrason, Í., Jaroszewski, A. C., McCoy, T. H., & Harrison, O. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-02230-9 · Cited by 5 · see citing works
Psych-APP-Therapie: Smartphonebasierte Interventionen in der Psychotherapie – Eine systematische Übersichtsarbeit
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Technological Advances in Treating Anxiety Disorders
Goetter, E. M., & Yuen, E. K. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.04.020 · Cited by 5 · see citing works
Understanding the Relationship Between Mood Symptoms and Mobile App Engagement Among Patients With Breast Cancer Using Machine Learning: Case Study
Baglione, A. N., Cai, L., Bahrini, A., Posey, I. R., Boukhechba, M., & Chow, P. I. (2022) · JMIR Medical Informatics · doi:10.2196/30712 · Cited by 5 · see citing works
Commonly reported problems and coping strategies during the COVID-19 crisis: A survey of graduate and professional studentsPreprint
Wasil, A. R., Franzen, R. E., Gillespie, S., Steinberg, J. S., Malhotra, T., & DeRubeis, R. J. (2020) · doi:10.31234/osf.io/6wj85 · Cited by 5 · see citing works
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Comparative efficacy of digital health interventions for depression and anxiety symptoms in adolescents and young adults: a systematic review and bayesian network meta-analysis
Wang, H., Yao, J., Jia, S., Chen, W., Guan, Y., Liu, J., Liao, M., Hu, E., & Zhang, Q. (2026) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-026-01042-3 · Cited by 4 · see citing works
Automatic Code Generation of User-centered Serious Games: A Decade in Review
Silva-Vásquez, P. O., Rosales-Morales, V. Y., & Benítez–Guerrero, E. (2022) · Programming and Computer Software · doi:10.1134/s0361768822080187 · Cited by 4 · see citing works
Developing music streaming as an adjunct digital therapy for depression: A survey study to assess support from key stakeholders
Gadd, S., Tak, C. R., & Bulaj, G. W. (2020) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2020.100048 · Cited by 4 · see citing works
Distinguishing the Effect of Time Spent at Home during COVID-19 Pandemic on the Mental Health of Urban and Suburban College Students Using Cell Phone Geolocation
Ayranci, P., Bandera, C., Phan, N., Jin, R., Li, D., & Kenne, D. R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127513 · Cited by 4 · see citing works
Protocol for a randomised controlled trial evaluating the effectiveness of a CBT-based smartphone application for improving mental health outcomes in adolescents: the MobiliseMe study
Li, S. H., Achilles, M. R., Subotic-Kerry, M., Werner‐Seidler, A., Newby, J. M., Batterham, P. J., Christensen, H. M., Mackinnon, A. J., & O’Dea, B. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04383-3 · Cited by 4 · see citing works
Mobile Sensing and Engagement Features in Arabic Mental Well-Being Apps: Systematic Search and Analysis
Aldaweesh, S., Kleek, M. G. V., & Shadbolt, N. (2023) · ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp) · doi:10.1145/3594739.3612875 · Cited by 4 · see citing works
Race and socioeconomic status as predictors of willingness to use internet-based treatments or face-to-face psychotherapy: A nationally representative studyPreprint
Lorenzo‐Luaces, L., Wasil, A. R., Kacmarek, C. N., & DeRubeis, R. J. (2022) · doi:10.31234/osf.io/bgct9 · Cited by 4 · see citing works
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Disruption of sustained attention and orbitofrontal cortex engagement by incoming social media messages vary as a function of problematic social media use
Liu, X., Liu, H., Kendrick, K. M., Montag, C., & Becker, B. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.06.13.598945 · Cited by 3 · see citing works
Mobile health intervention CanRelax reduces distress in people with cancer in a randomized controlled trial
Barth, J., Schläpfer, S., Schneider, F., Santhanam, P., Kowatsch, T., Heinz, P., Held, U., Eicher, M., & Witt, C. M. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01688-x · Cited by 4 · see citing works
Understanding Challenges and Design Opportunities for Digital Mental Well-Being in Saudi Arabia
Aldaweesh, S. (2024) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3613905.3638189 · Cited by 3 · see citing works
Boosting positive mood during stress: a Daily Coping Toolkit replication in college undergraduates
Disabato, D. J., Gawlik, E., Seah, T. H. S., & Coifman, K. G. (2025) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2025.2457625 · Cited by 1 · see citing works
We’ll App and Corporate Mandala Improves Mental Health and Creativity
Chiou, W., Lin, M., Hsieh, K.-J., Liu, Y., Huang, D., Liu, C.-Y., & Lin, R. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-49913-6_3 · Cited by 3 · see citing works
The Impact of Social-Support, Self-efficacy and APP on MBI
Lin, S.-M., Lo, L., Liu, C.-Y., Liu, C., & Chiou, W. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-49913-6_12 · Cited by 3 · see citing works
The Association Between App-Administered Depression Assessments and Suicidal Ideation in User Comments: Retrospective Observational Study
DeForte, S., Huang, Y., Bourgeois, T., Hussain, S.-A., & Lin, S. M. (2020) · JMIR mhealth and uhealth · doi:10.2196/18392 · Cited by 3 · see citing works
Preferences toward digital and non-digital mental health treatment delivery formats: A survey of Indian college studentsPreprint
Wasil, A. R., Malhotra, T., Tuteja, N., Nandakumar, N., Pandole, L., DeRubeis, R. J., Lorenzo‐Luaces, L., Naslund, J. A., & Bhatia, A. (2020) · doi:10.31234/osf.io/q8krz · Cited by 3 · see citing works
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Development and Validation of a Depression Scale for Online Assessment: Cross-Sectional Observational Study
Jeon, M.-J., Park, H., Son, Y., Hyun, J. W., & Park, J. Y. (2025) · Journal of Medical Internet Research · doi:10.2196/70689 · Cited by 2 · see citing works

Apps with maps-anxiety and depression mobile apps with evidence-based frameworks: Systematic search of major app stores
Marshall, J. M., Dunstan, D. A., & Bartik, W. (2020) · JMIR Mental Health · doi:10.2196/16525 · Cited by 83 · see citing works
Reassessing evidence-based content in popular smartphone apps for depression and anxiety: Developing and applying user-adjusted analyses.
Wasil, A. R., Gillespie, S., Patel, R., Petre, A., Venturo-Conerly, K. E., Shingleton, R. M., Weisz, J. R., & DeRubeis, R. J. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000604 · Cited by 89 · see citing works
Self-citation
Is There an App for That? A Review of Popular Apps for Depression, Anxiety, and Well-Being
Wasil, A. R., Palermo, E. H., Lorenzo‐Luaces, L., & DeRubeis, R. J. (2021) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2021.07.001 · Cited by 80 · see citing works
Self-citation
Identifying what works in mental health apps through meta-regression analyses of 169 trials
Kraiss, J. T., Fiß, F., Chakhssi, F., Aktas, F. B., Koelen, J. A., & Simões, J. P. (2026) · npj Digital Medicine · doi:10.1038/s41746-026-02466-z · Cited by 1 · see citing works
Finding a Depression App: A Review and Content Analysis of the Depression App Marketplace
Shen, N., Levitan, M.-J., Johnson, A., Bender, J. L., Hamilton-Page, M., Jadad, A. (. R., & Wiljer, D. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3713 · Cited by 282 · see citing works

Authors: Wasil, A. R., Venturo-Conerly, K. E., Shingleton, R. M., & Weisz, J. R.
Affiliations: Harvard University (US)
Corresponding author: Wasil, Akash R.
ORCID: Wasil, Akash R.
Shingleton, Rebecca M.
Weisz, John R.
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2019-12
Volume: 123
Pages: 103498
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2019.103498
OpenAlex: W2981909951
Cited by: 160
References: 55
Citations by year: 2026: 11 · 2025: 23 · 2024: 19 · 2023: 19 · 2022: 35 · 2021: 33 · 2020: 19
FWCI: 24.57
Type: journal article
Language: en
Open access: green
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
PsyArXiv (OSF Preprints) (submittedVersion)
PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
Funders: Harvard University
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: mental health apps, mobile application, depression, anxiety, evidence-based treatment, common elements, psychoeducation, relaxation, meditation, mindfulness, cognitive restructuring, exposure therapy, problem solving, digital mental health
MeSH terms: Smartphone, Anxiety, Depression, Humans, Evidence-Based Practice, Mobile Applications

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A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content

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