Views
The columnist Aperture
Focus on plant loss The strange arteries
more, says Beronda criss-crossing Earth’s
L. Montgomery p27 surface p28
Comment
Smart therapy?
Difficulties getting face-to-face psychiatric therapy have led to the rise
of tech alternatives, but how helpful are they, asks Eleanor Morgan
A
CROSS all forms of
psychiatric therapy, there
is a focus on developing
a relationship between patient
and therapist. This is known
as the therapeutic alliance, a
crucial factor in the success of
sessions. But such therapy can
be expensive, hard to access and
have long waiting times, so many
people don’t get to experience
this kind of relationship.
Tech companies have stepped in
to fill the gap, and people wanting
fast support can now use an app
rather than having to wait feeling
frustrated or demoralised. In
many ways this is good, but there
are reasons to be cautious about
the boom in easy access therapy.
Therapy apps often use
computerised cognitive
behavioural therapy models,
mindfulness and journalling to
help people manage low-mood and
anxiety. The popular self-therapy
app Bloom offers guided exercises
to help users examine their
thoughts and behaviour, featuring
a library of pre-recorded video
clips, with titles such as “Learning
to love yourself”. Happify claims
that “your emotional well-being
can be measured”, scores it for you
and provides games and tasks, like
cognitive behavioural therapy-
informed thought exercises, to
help you improve your mood.
Such discreet, low-cost
interventions may help increase
self-awareness and offer a sense of
SIMONE ROTELLA
control, but a recent meta-analysis
of mobile app mental health
interventions – based on data from
Letters Culture
Dealing with coughs
and sneezes isn’t
always easy p30
nearly 50,000 users – didn’t find
convincing evidence that apps
improved low mood or reduced
anxiety or suicidal thoughts (PLoS
Digital Health, doi.org/gpgmn3).
There can also be a placebo
effect: a 2018 study compared
the guided meditation app
Headspace – one of the most
popular on the market, with
2 million subscribers in 2020 –
against a “sham” app that focused
on guided breathing without a
mindfulness aspect. Participants
reported improved outcomes like
critical thinking (being able to
analyse uncomfortable thought
patterns, say) with both versions.
Culture columnist
An intriguing look
at the role of luck
in our lives p32
A therapy app may seem a
proactive step, and capturing
someone’s thought patterns is
technically possible via clinical
questionnaires like the GAD-7,
which apps may create their own
versions of. The results can then
be used to gauge improvements.
However, self-reporting bias
means we only ever have a minor
understanding of what is going
on. We can’t explore the deeper
meaning of someone’s emotional
problems with standardised
questionnaires, least of all
without another human present.
Then there is the issue of data.
If we are sharing vulnerable
Sally Adee explores
the power of
memes in sci-fi p34
information with an app, it
would be good to know how that
information will be handled. A
2019 study found that nearly half
of such apps didn’t have a privacy
policy. The study references the
meditation app Happify, stating
that it “requested 18 permissions,
including access to users’ text
messages and contacts list”. On
reviewing Happify’s current
privacy policy, there is no mention
of text messages, but other
information still gets collected.
Bloom states that it may
partner with third parties to share
information in order to provide
or improve its services. This may
seem like inoffensive language
when you want to get started on
trying not to feel bad. Then you
see Bloom advertising on huge
billboards with statements like:
“To all 8k users who felt tired.
We’re here to wake you up.”
Tech companies analysing our
private thoughts and plastering
them up on the streets feels like a
wake-up call. The therapy sector
needs a radical overhaul for many
reasons, and the tech solutions
offered in this unregulated field
may help in some way, for some
people. But at what cost? ❚
Need a listening ear? Visit bit.ly/
SuicideHelplines for hotlines and
websites around the world.
Eleanor Morgan is a
journalist and trainee
psychotherapist
@eleanormorgan
9 April 2022 | New Scientist | 25