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Cited by 107Digital Mental Health InterventionsMobile Health and mHealth ApplicationsTelemedicine and Telehealth Implementation

Implementation of Cognitive Behavioral Therapy in e–Mental Health Apps: Literature Review

Open access
Denecke, Kerstin, Schmid, Nicole, Nüssli, Stephan·2022·Journal of Medical Internet Research
DOI 10.2196/27791PMC PMC8949700

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Abstract

Background: To address the matter of limited resources for treating individuals with mental disorders, e–mental health has gained interest in recent years. More specifically, mobile health (mHealth) apps have been suggested as electronic mental health interventions accompanied by cognitive behavioral therapy (CBT). Objective: This study aims to identify the therapeutic aspects of CBT that have been implemented in existing mHealth apps and the technologies used. From these, we aim to derive research gaps that should be addressed in the future. Methods: Three databases were screened for studies on mHealth apps in the context of mental disorders that implement techniques of CBT: PubMed, IEEE Xplore, and ACM Digital Library. The studies were independently selected by 2 reviewers, who then extracted data from the included studies. Data on CBT techniques and their technical implementation in mHealth apps were synthesized narratively. Results: Of the 530 retrieved citations, 34 (6.4%) studies were included in this review. mHealth apps for CBT exploit two groups of technologies: technologies that implement CBT techniques for cognitive restructuring, behavioral activation, and problem solving (exposure is not yet realized in mHealth apps) and technologies that aim to increase user experience, adherence, and engagement. The synergy of these technologies enables patients to self-manage and self-monitor their mental state and access relevant information on their mental illness, which helps them cope with mental health problems and allows self-treatment. Conclusions: There are CBT techniques that can be implemented in mHealth apps. Additional research is needed on the efficacy of the mHealth interventions and their side effects, including inequalities because of the digital divide, addictive internet behavior, lack of trust in mHealth, anonymity issues, risks and biases for user groups and social contexts, and ethical implications. Further research is also required to integrate and test psychological theories to improve the impact of mHealth and adherence to the e–mental health interventions.

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  • CBT values the relationship with the therapist, and there is still insufficient evidence regarding mobile or web-based interventions that do not require the user to communicate directly with the therapist.

    “CBT, which values the relationship with the therapist, still lacks sufficient evidence regarding mobile or web-based interventions that do not require the user to communicate directly with the therapist [33].”

    From Third-wave cognitive behavioral therapies for caregivers of cancer patients: a scoping review. (2023) · cites this paper as [33]

    The Results section (CBT Techniques in mHealth Apps; page unavailable) says direct communication with a therapist helps establish a standard setting for delivering CBT, though it is not itself a CBT technique. The Discussion (Principal Findings; page unavailable) identifies gaps in evidence for mHealth app efficacy, but does not specifically conclude that evidence is insufficient for mobile or web-based interventions without therapist communication, or state that CBT values the therapist relationship. (LLM, conf=0.83)

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  • Interventions using digital devices are accessible at any time and place, making them advantageous for cancer caregivers, who have a sizable temporal burden.

    “Interventions using digital devices are accessible at any time and place, making them tremendously advantageous for cancer caregivers, who have a sizable temporal burden [33].”

    From Third-wave cognitive behavioral therapies for caregivers of cancer patients: a scoping review. (2023) · cites this paper as [33]

    The Discussion (Principal Findings; page not provided) says a mobile app is available 24 hours a day and can be used for monitoring and tracking at any time and place. The paper does not address cancer caregivers, their time burden, or whether this availability is especially advantageous for them. (LLM, conf=0.88)

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Authors
Denecke, K., Schmid, N., & Nüssli, S.
Affiliations
Bern University of Applied Sciences (CH)
Corresponding author
Denecke, Kerstin
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2022-03-10
Volume
24
Issue
3
Pages
e27791
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/27791
PMC
PMC8949700
OpenAlex
W4205619630
Cited by
107
References
86
Citations by year
2026: 27 · 2025: 33 · 2024: 23 · 2023: 19 · 2022: 5
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ARBOR - Bern University of Applied Sciences Repository (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • BFH: ARBOR
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
cognitive behavioral therapy, mobile health apps, e-mental health, digital mental health interventions, cognitive restructuring, behavioral activation, problem solving, user engagement, self-management, mental illness, digital divide, internet addiction, ethical implications
MeSH terms
Humans, Mental Health, Technology, Cognitive Behavioral Therapy, Telemedicine, Mobile Applications

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