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State of the Field of Mental Health Apps
Open accessAbstract
Mental health apps offer unique opportunities for self-management of mental health and well-being in mobile, cost-effective ways. There is an abundance of apps available to consumers, but selecting a useful one presents a challenge. Most available apps are not supported by empirical evidence and thus consumers have access to a range of unreviewed apps, the benefits of which are not known or supported. While user ratings exist, and are likely to be considered by consumers when selecting an app, they do not actually yield information on app suitability. A possible alternative way for consumers to choose an app would be to use an app review platform. A number of attempts have been made to construct such a platform, and this paper introduces PsyberGuide, which offers a step towards providing objective and actionable information for publicly available mental health apps.
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“The time and resources required for planning and undertaking an RCT are not always appropriate for the assessment of dMH tools due to their rapid development and the accelerating time to the obsolescence of technological innovations [9,22,23].”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [9]
Experimental — accuracy not yet measuredIn the citing paper
“There is currently somewhere between 10,000 and 20,000 mental health apps [23,24], but it is estimated that only about 3% to 4% are actually evidence based.”
From Mobile Apps for Mental Health Issues: Meta-Review of Meta-Analyses (2020) · cites this paper as [24]
In the citing paper
“There is currently somewhere between 10,000 and 20,000 mental health apps [23,24], but it is estimated that only about 3% to 4% are actually evidence based.”
From Mobile Apps for Mental Health Issues: Meta-Review of Meta-Analyses (2020) · cites this paper as [24]
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- Ben-Zeev, D., Brian, R. M., Jonathan, G., Razzano, L., Pashka, N., Carpenter-Song, E. A., Drake, R. E., & Schrer, E. A. (in press). Randomized controlled trial of mHealth vs. clinic-based interventions for serious mental illness: Patient engagement, satisfaction, and clinical outcomes. Schizophrenia Bulletin.
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Six Human-Centered Artificial Intelligence Grand Challenges
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“AI has been incorporated into digital interventions, particularly web and smartphone apps, to enhance user experience and optimize personalized mental health care (Neary & Schueller, 2018), and has been used to develop prediction/detection models for mental health conditions (Carr, 2020).”
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“There is currently somewhere between 10,000 and 20,000 mental health apps [23,24], but it is estimated that only about 3% to 4% are actually evidence based.”
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“Potential users should be directed to web-based resources such as PsyberGuide [75] to explore ratings and reviews for digital mental health products [71].”
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Self-citationBy the numbers: ratings and utilization of behavioral health mobile applications
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“The developing evidence base for MHapps suggests that apps accessed via smart devices are increasingly able to play an important role in mental health care provision [13,14].”
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“For example, PsyberGuide (Neary & Schueller, 2018) provides a Credibility Score for apps based on an app's level of research support, description of its intervention, number of user ratings, and level of clinical judgment in the development of the app (PsyberGuide, n.d.).”
MethodRamos, G., & Chavira, D. A. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2019.10.004 · Cited by 143
Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review
Werntz, A., Amado, S., Jasman, M., Ervin, A., & Rhodes, J. E. (2023) · Journal of Medical Internet Research · doi:10.2196/42864 · Cited by 158
“Moreover, although there have been growing efforts to increase the standards and rigor of the field [24], most studies have focused on feasibility and acceptability [25-27], with fewer than 5% empirically validated [28,29].”
Kopelovich, S. L., Monroe‐DeVita, M., Buck, B., Brenner, C. J., Moser, L. L., Jarskog, L. F., Harker, S., & Chwastiak, L. (2020) · Community Mental Health Journal · doi:10.1007/s10597-020-00662-z · Cited by 139
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“Some apps in PsyberGuide also have expert reviews (Neary & Schueller, 2018).”
BackgroundInfluentialRamos, G., Ponting, C., Labao, J. P., & Sobowale, K. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103990 · Cited by 131
Digital apothecaries: a vision for making health care interventions accessible worldwide
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Self-citationThe Digital Psychiatrist: In Search of Evidence-Based Apps for Anxiety and Depression
Marshall, J. M., Dunstan, D. A., & Bartik, W. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00831 · Cited by 107
“Patients are usually ready to listen to advice from their mental health treatment providers (9), and if the evidence base for mental health apps is widened, clinicians may be more willing to recommend them (35).”
BackgroundFrom Treatment to Healing:Envisioning a Decolonial Digital Mental Health
Pendse, S. R., Nkemelu, D., Bidwell, N. J., Jadhav, S., Pathare, S., De Choudhury, M., & Kumar, N. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3501982 · Cited by 115
Sorkin, D. H., Janio, E. A., Eikey, E. V., Schneider, M., Davis, K., Schueller, S. M., Stadnick, N. A., Zheng, K., Neary, M., Safani, D., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/26994 · Cited by 108
“…various efforts have been launched that either evaluate or offer evaluative frameworks for mental health apps (including One Mind PsyberGuide [40], ORCHA [41], and the American Psychiatric Association app evaluation framework [42]), no widely accepted or coordinated effort at regulation and…”
Self-citationThrouvala, M. A., Griffiths, M. D., Rennoldson, M., & Kuss, D. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17134842 · Cited by 122
AI-Based and Digital Mental Health Apps: Balancing Need and Risk
Hamdoun, S., Monteleone, R., Bookman, T., & Michael, K. (2023) · IEEE Technology and Society Magazine · doi:10.1109/mts.2023.3241309 · Cited by 104
“While these dedicated applications vary widely, from platforms that connect users with healthcare professionals to diagnostic tools to self-assessments, this article specifically explores the implications of digital mental health applications in the form of chatbots [3].”
BackgroundUnderstanding People’s Use of and Perspectives on Mood-Tracking Apps: Interview Study
Schueller, S. M., Neary, M., Lai, J., & Epstein, D. A. (2021) · JMIR Mental Health · doi:10.2196/29368 · Cited by 102
“The landscape of health technology is growing rapidly; estimates suggest that over 300,000 health app exist, with over 10,000 of those for mental health and wellness [5].”
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“To mitigate these challenges, companies have created technology-based mental health apps, with the goal of alleviating symptoms of various mental disorders [8,9].”
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“…and tools to help evaluate digital interventions, including the American Psychiatric Association’s App Advisor [180], One Mind’s PsyberGuide [181], Organisation for the Review of Care and Health Apps’s App Library [182], Mobile App Rating Scale [183], mobile health app trustworthiness…”
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Howe, E. S., Suh, J., Morshed, M. B., McDuff, D., Rowan, K., Hernandez, J., Abdin, M., Ramos, G., Tran, T., & Czerwinski, M. P. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3502027 · Cited by 90
Marshall, J. M., Dunstan, D. A., & Bartik, W. J. (2019) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867419876700 · Cited by 93
“…(https://psyberguide.org/), a United States–based website managed by One Mind, a research organisation dedicated to brain research under the umbrella of reputable departments of the University of California and Northwestern University (for further details, see Neary and Schueller, 2018).”
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“Publicly available MARS ratings by experts on a wide range of health topics on databases like Psyberguide and mHAD [71] could assist in informed health care decisions.”
BackgroundIs 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
Uptake and effectiveness of a self-guided mobile app platform for college student mental health
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Psychiatry in the Digital Age: A Blessing or a Curse?
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“Recent efforts have attempted to formally evaluate these tools, and a developing body of evidence suggests that apps can be effective in the treatment of mental health disorders [1-3].”
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“EMIs are also often a first step for many individuals to test personal preferences and affinity to psychological treatment and may lead to face-to-face or other professional therapeutic services later [61].”
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“App store ratings are subjective, personal, and nonstandardized and have been shown to be an indication of app popularity, but not clinical outcomes [29].”
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Digital Overload among College Students: Implications for Mental Health App Use
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“Similarly, the majority of mental health apps on the market have not been empirically tested (Neary and Schueller 2018), but this is not entirely surprising as evidence-base and users’ perceptions of usefulness are distinct (Schueller et al. 2018).”
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“Although many eHealth interventions already exist, such as mobile health app for smartphones, very few are evidence-based [40,41].”
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Self-citationmHealth applications: potentials, limitations, current quality and future directions
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“Yet, while some mHealth apps are efficacious, the vast majority have not undergone rigorous testing or expert vetting (Leigh & Flatt, 2015; Neary & Schueller, 2018; Powell et al., 2014; Torous & Powell, 2015).”
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“In high-income countries, there has been an explosion of mHealth apps addressing mental health and psychological well-being [94].”
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Devakumar, A., Modh, J., Saket, B., Baumer, E. P. S., & Choudhury, M. D. (2021) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3411764.3445670 · Cited by 32
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“Mental health technologies have also been identified as promising platforms for supporting mental health for underserved communities [19, 67], emerging adults, and university students [53, 75, 102].”
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“In addition, although the use of self-help tools such as mental health apps is a growing phenomenon [132], few studies have examined this form of web-based help seeking.”
Hall, C. L., Bergin, A., & Rennick‐Egglestone, S. (2024) · Journal of Medical Internet Research · doi:10.2196/58939 · Cited by 35
“Most app store offerings have no scientific support or involvement in their development process [13], with the consequence that some can recommend harmful strategies, such as consuming strong alcohol during a bipolar episode [14].”
A process for reviewing mental health apps: Using the One Mind PsyberGuide Credibility Rating System
Neary, M., Bunyi, J., Palomares, K., Mohr, D. C., Powell, A. C., Ruzek, J. I., Williams, L. M., Wykes, T., & Schueller, S. M. (2021) · Digital Health · doi:10.1177/20552076211053690 · Cited by 26
“People who contribute app ratings are a self-selected sample likely to represent technologically-savvy users(5) or those with a particularly negative or positive experience to share.(6) App developers can also leave ratings for their own apps or pay others to do so and there is no way to distinguish genuine consumer r…”
BackgroundSelf-citationIdentifying Moments of Change from Longitudinal User Text
Tsakalidis, A., Nanni, F., Hills, A., Chim, J., Song, J., & Liakata, M. (2022) · Proceedings of the conference - Association for Computational Linguistics. Meeting · doi:10.18653/v1/2022.acl-long.318 · Cited by 31
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“Despite an abundance of mental health apps [28,29], digital interventions that fit the specific workplace context are still highly sought after [27,30].”
BackgroundLaird, B., Puzia, M., Larkey, L., Ehlers, D. K., & Huberty, J. (2021) · JMIR Formative Research · doi:10.2196/30294 · Cited by 24
“The use of smartphone apps to deliver meditation and manage stress is rapidly increasing [11] owing to their reach, accessibility, and low cost [12-15].”
BackgroundThree questions to consider before developing a mental health app
Wasil, A. R., Weisz, J. R., & DeRubeis, R. J. (2020) · World Psychiatry · doi:10.1002/wps.20757 · Cited by 24
Meditation and mental health apps: relaxation, yoga, and meditation apps
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“14 For example, young adults may hesitate to seek treatment from an on-campus mental health counselor for fear of being labeled "mentally ill," so an app could grant greater privacy from peers.”
Digital Technology to Enhance Clinical Care of Early Psychosis
Bell, I., & Álvarez‐Jiménez, M. (2019) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-019-00182-y · Cited by 27
Dingwall, K. M., Povey, J., Sweet, M., Friel, J., Shand, F., Titov, N., Wormer, J., Mirza, T., & Nagel, T. (2023) · JMIR Human Factors · doi:10.2196/40111 · Cited by 21
“Overwhelmingly, playing the games (P5, 9, 22, 23, 24, 25, 26, 29, 31,32, 33, 35, 38) was mentioned as a favorite part of the app, as was watching the videos (P9, 11, 22, 24, 26,27, 29, 38).”
Reyes, A. T. (2022) · Issues in Mental Health Nursing · doi:10.1080/01612840.2021.1953652 · Cited by 21
“In recent years, the concepts of mindfulness and acceptance have been increasingly integrated into mental health mobile apps to manage posttraumatic stress disorder (PTSD) symptoms (Marshall et al., 2020; Neary & Schueller, 2018).”
BackgroundmHealth in affective disorders: hype or hope? A focused narrative review
Hidalgo‐Mazzei, D., Llach, C.-D., & Vieta, E. (2020) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000302 · Cited by 22
“Alternatively, app rating guidelines and app rating platforms have been developed to filter, identify and describe the significant number of mental health apps, with varying levels of success and scientific rigour (Neary and Schueller, 2018).”
BackgroundMobile applications for mental health self-care: A scoping review
Ahmed, A., Ali, N., Giannicchi, A., Abd-Alrazaq, A. A., Ahmed, M. A., Aziz, S., & Househ, M. S. (2021) · Computer Methods and Programs in Biomedicine Update · doi:10.1016/j.cmpbup.2021.100041 · Cited by 22
Efficacy, Safety, and Evaluation Criteria of mHealth Interventions for Depression: Systematic Review
Duarte‐Díaz, A., Perestelo‐Pérez, L., Gelabert, E., Robles, N., Pérez-Navarro, A., Vidal‐Alaball, J., Solà-Morales, O., Sales-Masnou, A., & Carrión, C. (2023) · JMIR Mental Health · doi:10.2196/46877 · Cited by 27
“Several mHealth apps are currently available [19-21].”
Dinkel, D. M., Caspari, J. H., Fok, L., Notice, M. R., Johnson, D. J., Watanabe‐Galloway, S., & Emerson, M. R. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibab075 · Cited by 21
“First, increasing provider knowledge on mental health apps is likely critical to patient app use [25].”
InfluentialRohde, J., Marciniak, M. A., Henninger, M., Homan, S., Ries, A., Paersch, C., Friedman, O. B., Brown, A. D., & Kleim, B. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305103 · Cited by 20
Understanding and Supporting Self-Tracking App Selection
Lee, J. H., Schroeder, J., & Epstein, D. A. (2021) · Proceedings of the ACM on Interactive Mobile Wearable and Ubiquitous Technologies · doi:10.1145/3494980 · Cited by 20
Lahutina, S., Frankova, I., Gruen, M., Vermetten, E. H. G. J. M., Zohar, J., Spitschan, M., & Bajbouj, M. (2024) · Neuroscience Applied · doi:10.1016/j.nsa.2024.104089 · Cited by 32
“…convenient to use because they are portable, they do not require special conditions of use, many of the applications are personalized, can provide ongoing support, promote user self-help strategy (Ventola, 2014; Neary and Schueller, 2018; Lecomte et al., 2020; Hwang et al., 2021; Eis et al., 2022).”
Rismawan, W., Marchira, C. R., & Rahmat, I. (2020) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20201104-02 · Cited by 22
Karlsen, I., Svendsen, P. A., & Abildgaard, J. S. (2022) · BMC Public Health · doi:10.1186/s12889-022-13821-6 · Cited by 21
Jacob, C., Lindeque, J. P., Müller, R., Klein, A., Metcalfe, T., Connolly, S. L., Koerber, F., Maguire, R., Denis, F., Heuss, S., et al. (2023) · npj Digital Medicine · doi:10.1038/s41746-023-00982-w · Cited by 17
“10-Data-protection compliance Assesses whether the tool explicitly reports being compliant with the relevant data privacy and protection laws (e.g., GDPR, HIPAA … ), and the treatment of any personal data is compatible with the Patient Data Act, Personal Data Act, and other applicable privacy laws,…”
Comparing Professional and Consumer Ratings of Mental Health Apps: Mixed Methods Study
Hudson, G., Negbenose, E., Neary, M., Jansli, S. M., Schueller, S. M., Wykes, T., & Jilka, S. (2022) · JMIR Formative Research · doi:10.2196/39813 · Cited by 18
Self-citationSocial media interventions to improve well-being
Skeggs, A., & Orben, A. C. (2025) · Nature Human Behaviour · doi:10.1038/s41562-025-02167-9 · Cited by 26
“Furthermore, current interventions are often developed rapidly, increasing the risk of a high-availability, low-evidence-base crisis, similar to that found in digital mental health care, where thousands of unsupported interventions exist in the public marketplace 20,21 .”
Chow, P. I., Showalter, S. L., Gerber, M. S., Kennedy, E. M., Brenin, D. R., Schroen, A. T., Mohr, D. C., Lattie, E. G., & Cohn, W. F. (2018) · JMIR Research Protocols · doi:10.2196/11452 · Cited by 16
“Findings from systematic reviews indicate that despite a plethora of mental health apps available in app stores, only a few are empirically supported [8,9,39] and the few that target cancer populations have little to no empirical support [6].”
Jagemann, I., Stegemann, M., von Brachel, R., & Hirschfeld, G. H. F. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06134-y · Cited by 17
“This is due to the growing shortage of psychotherapists and psychiatrists worldwide [13–15], leading to an increasing range of digital offerings, such as mental health apps, which can complement or even replace traditional psychotherapy [16, 17].”
BackgroundEagle, T., Mehrotra, A., Sharma, A., Zuniga, A., & Whittaker, S. (2022) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3555155 · Cited by 16
Empower Psychotherapy with mHealth Apps: The Design of “Safer”, an Emotion Regulation Application
Diano, F., Sica, L. S., & Ponticorvo, M. (2023) · Information · doi:10.3390/info14060308 · Cited by 18
“To ensure the effectiveness of using the mobile application in psychotherapy, it is important to develop the application with the supervision of mental health professionals, such as psychologists or psychiatrists [6,59,110].”
BackgroundInsights From Longitudinal Evaluation of Moodie Mental Health App
Alslaity, A., Chan, G., Orji, R., & Wilson, R. (2022) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3491101.3519851 · Cited by 14
“Common issues are that most of the available mental health apps do not have feasibility data based on real-world use over a long time period, lack the advisory of a health care professional, or are not evidence-based and direct research support [24].”
BackgroundExamining young adults daily perspectives on usage of anxiety apps: A user study
Balaskas, A., Schueller, S. M., Cox, A. L., Rashleigh, C., & Doherty, G. J. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000185 · Cited by 15
“Apps can support individuals in managing their own mental health, and can be used privately and “on the go” [22].”
InfluentialSelf-citationA systematic review of features and content quality of Arabic mental mHealth apps
Alnaghaimshi, N. I. S., Awadalla, M. S., Clark, S. R., & Baumert, M. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1472251 · Cited by 15
Trusting the bot: Addressing the ethical challenges of consumer digital mental health therapy
Martinez‐Martin, N. (2020) · Developments in neuroethics and bioethics · doi:10.1016/bs.dnb.2020.03.003 · Cited by 14
Stiles‐Shields, C., Reyes, K. M., Archer, J., Lennan, N., Zhang, J., Julion, W. A., & Karnik, N. S. (2022) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-022-00278-y · Cited by 14
“Third, while apps are abundant in the marketplace, it is difficult for teens to determine which are credible, evidence-based, and/or appropriate for their needs (Neary & Schueller, 2018; Psihogios et al., 2020).”
BackgroundGoldkind, L., & Wolf, L. (2021) · Families in Society The Journal of Contemporary Social Services · doi:10.1177/1044389421997796 · Cited by 15
Eve, Z., Turner, M., Di Basilio, D., Harkin, B., Yates, A., Persson, S., Henry, J., Williams, A., Walton, G., Jones, M. V., et al. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2938 · Cited by 14
Trauma apps and the making of the ‘smart’ refugee
Abdelrahman, M. (2023) · Environment and Planning D Society and Space · doi:10.1177/02637758231173416 · Cited by 13
“This marketization essentially means that there is a dearth of rigorous research on these apps, which, in some cases, has led to what some researchers have euphemistically called ‘wrong self-management advice’ for the users (Neary and Schueller, 2018).”
BackgroundShvetcov, A., Kupper, J. F., Zheng, W. Y., Slade, A., Han, J., Whitton, A. E., Spoelma, M. J., Hoon, L., Mouzakis, K., Vasa, R., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1422027 · Cited by 16
“Numerous mental health self-help mobile applications have been developed to combat university students ’ poor mental health (11).”
BackgroundSmartphone-Based Therapeutic Exercises for Men Affected by Premature Ejaculation: A Pilot Study
Optale, G., Burigat, S., Chittaro, L., & Riva, G. (2020) · Sexual Medicine · doi:10.1016/j.esxm.2020.05.003 · Cited by 13
Expanding, improving, and understanding behaviour research and therapy through digital mental health
Cohen, Z. D., & Schueller, S. M. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104358 · Cited by 10
Self-citationEisenstadt, M., Liverpool, S., Metaxa, A.-M., Ciuvat, R. M., & Carlsson, C. (2021) · JMIR Formative Research · doi:10.2196/31064 · Cited by 12
“To this end, there has been a growing demand for and development of well-being apps that have accelerated in recent years [19,20].”
BackgroundTaylor, G., Bylund, C. L., Kastrinos, A. L., Alpert, J. M., Puig, A., Krajewski, J., Sharma, B., & Fisher, C. L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19052619 · Cited by 12
Miller, E., & Thabrew, H. (2024) · Digital Health · doi:10.1177/20552076241302204 · Cited by 11
RetractedSuicide Prevention Mobile Apps for Indian Users: An Overview
Sudarshan, S., & Mehrotra, S. (2021) · Cureus · doi:10.7759/cureus.16770 · Cited by 15
“However, among the massive number of apps potentially available to users, only a small proportion have been empirically validated, making it tedious for users to identify an app suitable for their concerns [5, 14].”
Background
Metadata
- Authors
- Neary, M., & Schueller, S. M.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Schueller, Stephen M.
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 25
- Issue
- 4
- Pages
- 531-537
- ISSN
- 1077-7229 (ISSN-L)
- PMC
- PMC7584258
- OpenAlex
- W2789479890
- Cited by
- 247
- References
- 25
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 28 · 2023: 44 · 2022: 39 · 2021: 37 · 2020: 24 · 2019: 18 · 2018: 7
- FWCI
- 26.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (K08MH102336)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- mental health apps, app selection, user ratings, mobile mental health
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