Mental-health and wellbeing apps

Domain IX · Biomedical, neuro & digital

What it is

Mental-health and wellbeing apps are not one therapy but a large, fast-changing market of self-help, mood-tracking, skills-practice, peer-support, telehealth and chatbot products. This guide is therefore a framework for the psychotherapist's own work with apps: finding out what clients already use,…

Format

• This is a framework, not a manualised treatment; no session count is specified in the sources. The phases below organise the APA model and the UK assurance tools into a clinical sequence.
• Phase 0: Digital history (first or second session, 5–10 minutes). Goal: learn which apps, wearables, online services and AI tools the client already uses for mood, sleep, sex, substances, relationships or support, what they share there and what they get from it. Move on when you know whether any…

Who practises it, and how they are trained or regulated

• Regulatory and assurance landscape (as of October 2026, per the pages listed in Sources).
• United States: APA notes that the FDA has taken a largely hands-off approach to regulating mental health apps. Products marketed as prescription digital therapeutics have separate FDA pathways; product status changes (e.g. Pear Therapeutics' bankruptcy; Woebot Health's closure of its consumer app). Many wellness apps and direct-to-consumer services are not covered by HIPAA; the FTC has acted against companies over…
• England: DTAC is NHS England's baseline assessment for buying digital health technology, covering clinical safety (DCB0129 documentation), data protection, technical security, interoperability, and usability and accessibility. It is used alongside, not instead of, medical device regulation. An updated form was introduced on 24 February 2026, with the old form not to be used from 6 April 2026; the hosting website was…

Evidence status, as the guide reports it

• Version followed: the American Psychiatric Association (APA) App Evaluation Model as published on the APA App Advisor pages (six steps: Background, Access, Privacy and Security, Clinical Foundation, Usability, Integration toward patient-centred goals; expert-panel update of April 2025 adding health…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Client agreeing to please you; unclear expectations; feature overload. Working if the client can restate the purpose and review date.
• Recommending apps from habit or marketing; untracked changes in ownership or privacy policy. Working if your recommendations are dated, documented and reviewed.
• Abandoned accounts still holding data; the app becoming the client's only support after discharge. Working if decisions are deliberate and the client knows how to seek help again.
• Distress, dissociation or trauma-related reactions during practice (see Domain XIII); subscription costs. Working if the client reports the practice as usable and not distressing.
• Clients changing medication on the basis of app feedback; conflicting advice from app and clinicians. Working if information reaches the right professional with the client's agreement.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.