Types of Behavioral Therapies, About CBT, and Apps 

The treatment options listed here require the assistance of a mental health or medical provider or other licensed professional.

• CBT: Cognitive-behavioral therapy focuses on identifying, understanding, and changing thinking and behavior patterns related to anxiety in regular meetings with a licensed, CBT-trained therapist. Therapists who practice CBT may use interpersonal therapy (IPT) to help their clients develop coping skills, encourage them to record their thoughts throughout the week as they occur, and attempt exposure therapy if appropriate for their disorder (read more below).
• DBT: Dialectical behavioral therapy is a specific type of CBT. The term “dialectics” refers to a philosophical practice of examining multiple or often contradictory ideas, combining acceptance and change simultaneously. For example, a patient can accept where she is in her life and also feel motivated to improve it. DBT places an emphasis on mindfulness, enabling people to recognize and attempt to understand thoughts as they occur.
• Exposure Therapy: As this term suggests, exposure therapy gradually exposes an individual to the feared situation in a safe, controlled environment. Eliminating the actual fear is the ultimate goal. Practitioners begin by having the patient repeatedly imagine the feared situation or object and potential responses to it. Often used in treating OCD, phobias, and PTSD, this therapy may incorporate virtual reality or computer simulations to create a more realistic yet completely safe method of exposure.
• Group Therapy: The phrase “group therapy” describes a few therapeutic environments with participants beyond a single patient and provider. In addition to normalizing an individual’s experience by relating to others, group therapy may offer an alternative for those who are unable to afford one-on-one therapy.
• Hypnosis: Hypnotherapists may be doctors, therapists, psychologists, social workers, nurses, or other licensed professionals. Hypnosis helps people achieve a very relaxed state through breathing, guided imagery, or muscle-relaxing techniques and make them more amenable to suggestions. The hypnotherapist may use imagery or simple verbal suggestions to reduce the severity of anxiety symptoms. Some people may see positive results after one or two sessions. If hypnosis shows promising results, a hypnotherapist may also teach ways to practice self-hypnosis.

–Anxiety.org

Additional Behavioral Therapies

• Interpersonal therapy focuses largely on improving relationships and helping a person express emotions in healthy ways. This approach often works well for depression. A variation of it called “interpersonal and social rhythm therapy” often works well for bipolar disorder because it also helps develop a daily schedule that supports recovery.
• Family therapy helps family members communicate, handle conflicts, and solve problems better. Forms of family therapy often are used for treating eating disorders and bipolar disorder.
• Psychodynamic therapy helps people develop a better understanding about their unconscious emotions and motivations that can affect their thoughts and actions.
• Art therapy can include using music, dance, drawing, and other art forms to help express emotions and promote healing.
• Psychoeducation helps people understand mental health conditions and ways to promote recovery.

–Mental Health America

And don’t forget about the power of meditation, mindfulness, music and pet therapy, praying, and other non-pharmacological interventions!

About Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. It’s most commonly used to treat anxiety and depression but can be useful for other mental and physical health problems.

How CBT Works

• CBT is based on the concept that your thoughts, feelings, physical sensations, and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.
• CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts.
• You’re shown how to change these negative patterns to improve the way you feel.
• Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past.
• It looks for practical ways to improve your state of mind on a daily basis.

Uses for CBT

CBT has been shown to be an effective way of treating a number of different mental health conditions. In addition to depression or anxiety disorders, CBT can also help people with:

• obsessive-compulsive disorder (OCD)
• panic disorder
• post-traumatic stress disorder (PTSD)
• phobias
• eating disorders – such as anorexia and bulimia
• sleep problems – such as insomnia
• problems related to alcohol misuse

CBT is also sometimes used to treat people with long-term health conditions, such as:

• irritable bowel syndrome (IBS)
• chronic fatigue syndrome (CFS)

Although CBT can’t cure the physical symptoms of these conditions, it can help people cope better with their symptoms.

What Happens During CBT Sessions

• If CBT is recommended, you’ll usually have a session with a therapist once a week or once every 2 weeks.
• The course of treatment usually lasts for between 5 and 20 sessions, with each session lasting 30 to 60 minutes.
• During the sessions, you’ll work with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings, and actions.
• You and your therapist will analyze these areas to work out if they’re unrealistic or unhelpful and to determine the effect they have on each other and on you.
• Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviors.
• After working out what you can change, your therapist will ask you to practice these changes in your daily life and you’ll discuss how you got on during the next session.
• The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life.
• This should help you manage your problems and stop them from having a negative impact on your life, even after your course of treatment finishes.

Pros and Cons of CBT

Cognitive-behavioral therapy (CBT) can be as effective as medication in treating some mental health problems, but it may not be successful or suitable for everyone.

Some of the advantages of CBT include:

• it may be helpful in cases where medication alone hasn’t worked.
• it can be completed in a relatively short period of time compared with other talking therapies.
• the highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books, and apps.
• it teaches you useful and practical strategies that can be used in everyday life, even after the treatment has finished.

Some of the disadvantages of CBT to consider include:

• you need to commit yourself to the process to get the most from it – a therapist can help and advise you, but they need your cooperation.
• attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time.
• it may not be suitable for people with more complex mental health needs or learning difficulties, as it requires structured sessions.
• it involves confronting your emotions and anxieties – you may experience initial periods where you’re anxious or emotionally uncomfortable.
• it focuses on the person’s capacity to change themselves (their thoughts, feelings, and behaviors) – this doesn’t address any wider problems in systems or families that often have a significant impact on someone’s health and well-being.
• Some critics also argue that because CBT only addresses current problems and focuses on specific issues, it doesn’t address the possible underlying causes of mental health conditions, such as an unhappy childhood.

The Concepts of CBT

Cognitive-behavioral therapy (CBT) can help you make sense of overwhelming problems by breaking them down into smaller parts. In CBT, problems are broken down into five main areas:

• situations
• thoughts
• emotions
• physical feelings
• actions

CBT is based on the concept of these five areas being interconnected and affecting each other. For example, your thoughts about a certain situation can often affect how you feel both physically and emotionally, as well as how you act in response.

How CBT is different

CBT differs from many other psychotherapies because it’s:

• Pragmatic: it helps identify specific problems and tries to solve them.
• Highly structured: rather than talking freely about your life, you and your therapist discuss specific problems and set goals for you to achieve.
• Focused on current problems: it’s mainly concerned with how you think and act now rather than attempting to resolve past issues.
• Collaborative: your therapist won’t tell you what to do; they’ll work with you to find solutions to your current difficulties
• Stopping negative thought cycles: there are helpful and unhelpful ways of reacting to a situation, often determined by how you think about them.

–NHS

In addition to self-improvement, here are some apps that also may be helpful:

Apps for Lowering Stress and Promoting Mindfulness and Wellness

• Breathe & Relax: Feel better right away with the easy, enjoyable Breathe & Relax app. It will help you develop the habit of breathing in a natural, relaxed way throughout the day. Experience stress relief, relaxation, and more energy with three simple tools:  Breathing Exercises, Four Breathing Break Audio, and Breathing Reminders. ($1.99 iOS; $1.49 Android)
• Breathe2Relax: Created by the National Center for Telehealth and Technology, this app teaches users how to do diaphragmatic breathing. Its features include educational videos on the stress response, logs to record stress levels, and customizable guided breathing sessions. (Free; iOS and Android)
• Calm: Named by Apple as the 2017 iPhone App of the Year, Calm is quickly becoming regarded as one of the best mental health apps available. Calm provides people experiencing stress and anxiety with guided meditations, sleep stories, breathing programs, and relaxing music. This app is truly universal; whether you’ve never tried meditation before or regularly practiced it, you’ll find the perfect program for you. (The initial 7 Days of Calm, unguided sessions, some guided sessions, and tracking features have no cost. A subscription that provides access to the entire Calm catalog costs $12.99/month, $59.99/year and $299.99 for a lifetime iOS and Andriod) subscription.)
• eCBT calm: Implementing some of the many strategies of cognitive behavioral therapy, this app helps users assess their stress levels, practice mindfulness and relaxation skills, and connect their thoughts to feelings and behaviors. The end result is experiencing increased calmness in everyday life and more awareness of actions and emotions. This app can also be used to help manage symptoms of anxiety. ($0.99; iOS)
• Happify: This app offers an array of engaging games and activity suggestions to promote gratitude and a positive mood. It was designed with input from 18 psychologists.  The website also links to bonus “feel good” videos that are sure to make you smile. (Free trial, or $60 for the year):
• Happier: Happier is an app that works to keep users optimistic by introducing them to a community of like-minded people, and giving them a place to journal thoughts and feelings. This app can also sync with the Apple Watch. (Free; iOS)
• Headspace: This app uses winsome animations to teach you the basics of mindfulness and meditation. The sessions themselves are voiced by Bristolian co-founder Andy Puddicombe, who as a 20-something, ditched his university career in sports science to travel to Asia and become a Buddhist monk. (Free for the starter program. Monthly subscription $12.99 month. $7.99-per-month for annual package, $399.99 for Lifetime subscription; iOS and Android)
• iSleep Easy: The iSleep Easy app contains a wide variety of guided meditations to help you fall asleep and sleep deeply. You can listen to the meditations with or without several choices of music or nature sounds. In addition, you can create your own sleep program using a Playlist feature which allows you to listen to up to six meditations in one session, choosing which music or nature sound you’d like in the background and how long they will continue after the voice guidance stops. If you prefer to listen to music or nature sounds alone, a Sound Mix feature allows you to listen to a combination of music plus a nature sound, or two nature sounds together. ($3.99 iOS; $3.99 Android)
• Insight Timer: Insight Timer is one of the most popular free meditation apps out there, and it’s easy to see why. The app features more than 4,000 guided meditations from over 1,000 teachers—on topics like self-compassion, nature, and stress—plus talks and podcasts. If you prefer a quieter meditation, you can always set a timer and meditate to intermittent bells or calming ambient noise. (Free; iOS and Android)
• Learn to Meditate: The Meditation Oasis® Learn to Meditate app is designed to make learning meditation easy and enjoyable. You will be able to meditate along with the guided meditations from day one, and you will have all the support you need to address any questions or challenges you may have along the way. By the end of the five weeks, you will have everything you need to continue meditating on your own. This meditation style does not require concentration or mastering complicated instructions. You will simply be tapping into a natural ability already within you. ($3.99 iOS; $3.49 Android)
• Meditation Rx: Find relief from the stress of serious illness with the Meditation Rx app. Whether you are ill or are supporting a loved one through an illness, you will find guided meditations especially designed to suit your needs. The app helps you to deal with the stresses of being ill, being in a medical setting, undergoing difficult procedures, hearing bad news, and more. ($2.99 iOS; $2.99 Android)
• Music Oasis: Enjoy this uplifting instrumental music whenever you need calming, relaxation, or soothing. Use it for meditation, yoga, massage, falling asleep, or any time you want to relax. The Music Oasis app was created in response to many requests from people who have enjoyed its beautiful music in the background of the guided meditations in the popular Meditation Oasis® podcast and apps–29 music selections, Nature Sound feature: option to mix the music with choice of 5 high-quality nature sounds, Playlist feature: play a preset playlist or create your own custom playlists, Timer feature: use a timer to determine how long the music plays. ($1.99 iOS; $1.99 Android)
• MyLife Meditation (formerly Stop, Breathe & Think) This app can help cultivate mindfulness in 5 minutes. Mindfulness can improve mood, lower stress, and help increase self-compassion. In addition, this app can also help to improve focus by bringing one’s attention to the present moment, including thoughts and sensations, and encouraging a judgment-free outlook. (Free; iOS and Android)
• Optimism: Optimism is designed to help identify and work through users’ feelings as they arise, rather than when they are in the midst of trouble. According to the app makers, it helps users learn triggers so once can recognize early warning signs. It does this primarily through mood and trigger tracking, and also lets users create reports to share with a treatment team. (Free; iOS)
• Relax & Rest: Enjoy the deep relaxation, stress relief, and benefits of meditation without prior experience. Now upgraded to include all the features of the original popular iPhone version. Three meditations of varying lengths allow you to relax deeply regardless of how much time you have available to meditate. Written Meditation Tips help support your experience with guided meditations. ($1.99 iOS; $1.99 Android)
• Simply Being: Enjoy the deep relaxation, stress relief, and benefits of meditation without prior experience. Simply Being has been developed by Richard and Mary Maddux, creators of the popular Meditation Oasis podcast. It allows you to choose from 4 meditation times and gives you to option to listen with or without music/nature sounds. You can also listen to music or nature sounds alone. ($1.99 iOS; $1.99 Android)
• Super Better: SuperBetter can help increase resilience – the ability to stay strong, motivated, and optimistic even in the face of difficult obstacles. Playing SuperBetter can encourage users to get through tough situations. The apps’ goal is to help people achieve the goals that matter most to them. Available in both mobile and online versions. (Free; iOS and Android)
• Take a Break: You can enjoy the deep relaxation, stress relief, and benefits of meditation now without prior experience. Take a Break has been developed by Richard and Mary Maddux, creators of the popular Meditation Oasis podcast. Featuring two popular meditations from the podcast, the app gives you the option to listen with or without music. (Free; iOS and Android)
• Talkspace: Users can text message a trained and licensed mental health professional every day of the week and as many times as they want. The app offers services for individuals and couples. It starts with a free, no-commitment assessment online that answers questions about the process and is for adults 18 and older. ($25/week; iOS and Android)
• Walking Meditations: The Meditation Oasis® Learn to Meditate app is designed to make learning meditation easy and enjoyable. You will be able to meditate along with the guided meditations from day one, and you will have all the support you need to address any questions or challenges you may have along the way. By the end of the five weeks, you will have everything you need to continue meditating on your own. This meditation style does not require concentration or mastering complicated instructions. You will simply be tapping into a natural ability already within you. ($1.99 iOS; $1.99 Android)

Apps for Specific Mental Health Concerns

ACT Coach

• • • Good for: Anxiety, depression.
    • ACT Coach teaches users how to tolerate negative thoughts and feelings by virtually guiding them through awareness exercises and giving tips on how to ditch self-doubt. With an extra focus on mindfulness, this app also provides a log to track progress. (Free; iOS)

At Ease

• • • Good for: Anxiety
    • This application contains a unique approach to relieving anxiety and worry which combines voice-guided breathing meditations, exercises, and journaling. At Ease is intended to make deep and lasting change rather than applying a temporary “band-aid”. Most people will experience immediate relief using guided breathing meditations, but the long-term benefit of At Ease will come from using the breathing meditations, exercises, and journaling regularly over time. ($2.99 iOS; $2.99 Android)

Bipolar Disorder Guide

• • • Good for: Bipolar Disorder.
    • This app is for people recently diagnosed, and for their friends and family. The Bipolar Disorder Guide app has considerable educational value. Its main feature is an informational guide to this mood disorder, with chapters focused on treatment options, coping mechanisms, support group resources, and more. ($0.99; iOS)

BrainWave Tuner

• • • Good for: Bipolar Disorder, Depression, Insomnia, Chronic Pain.
    • This app offers a unique approach to managing mood. The BrainWave Tuner uses audible brainwave frequencies to help people manage their moods, pain, stress, and more. The app is based on a similar technology as Electroencephalography, or EEG, which is routinely used in healthcare settings to measure neuronal activity in the brain. The app offers programs designed for meditation, destressing, focusing attention, and inducing sleep. There are also ambient sounds that can be played in the background, making it useful for general relaxation. ($3.99; iOS and Android)

DBSA Wellness Tracker

• • • Good for: Bipolar Disorder, Depression, and Medication Management.
    • The DBSA Wellness Tracker comes from the Depression and Bipolar Support Alliance. Its user-friendly interface was designed to help users manage all aspects of their health. Users can track daily activity, moods, medications, and other symptoms. It’s a great tool to share with one’s doctor, providing a place to store all of your observations, triggers, and symptoms. (Free; iOS)

DBT Diary Card and Skills Coach

• • • Good for: Bipolar Disorder, Suicidality, Self-Injury, Emotion Regulation.
    • Dialectical behavior therapy, or DBT, is a type of therapy that is used to treat a variety of mental health disorders. This app uses the principles of DBT, with a skills coach and a behavior tracker that work in conjunction to help users slow down, analyze thoughts and feelings, and apply what has been learned for better moods and outcomes. ($4.99; iOS)

Depression CBT Self-Help Guide

• • • Good for: Depression.
    • This app allows users to monitor dips in mood, learn about clinical depression and treatments, try guided relaxation techniques, and learn strategies to challenge negative thinking. (Free; Android)

iMoodJournal

• • • Good for: Bipolar Disorder, Depression, Insomnia, and Medication Management.
    • Alerts remind users to check in and choose from a colorful scale of mood labels. There are also hashtags to help organize thoughts and triggers. Users can visualize hashtags on a chart to identify any correlations between how they feel and sleep patterns, medications, or other identifiers. The app can also link to Facebook for those who want to check in with friends and family. ($1.99; iOS and Android)

InFlow: Mood Diary

• • • Good for: Depression, Bipolar Disorder, Anxiety, and more.
    • In Flow is one option for tracking the effects of a mental health diagnosis, and the effectiveness of treatments. Users can share emotions with friends and can learn to identify trends and triggers. (Free; Android)

Mightier

• • • Good for: Children ages 6-14 who have difficulty self-regulating and controlling their emotions.
    • Mightier uses the power of video games to help kids 6-14 build emotional strength and resilience. Mightier helps kids who have a tough time with tantrums, feelings of frustration, anxiety, or even a diagnosis like ADHD learn to manage their emotions. (Free; iOS)

MindShift

• • • Good for: Anxiety, OCD, Pain.
    • This is a straightforward stress management tool that helps users re-think about what’s stressing them out through a variety of on-screen prompts. At the same time, the app encourages new ways to take charge of anxiety and tune into body signals. (Free; iOS and Andriod)

Moodlytics

• • • Good for: Bipolar Disorder, Depression.
    • With Moodlytics users can track their ups and downs with text, emoji’s, or photos. Users can also journal their feelings, set reminders, set mood goals, log moods from days passed, and create charts that break down just how often they’re feeling a certain way. (Free; iOS and Android)

Moodtrack Diary

• • • Good for: Bipolar Disorder, Depression.
    • The Moodtrack Diary app is designed to help users get a handle on mood swings, or at least learn how to better predict and manage them. There is a graphing feature that allows users to view moods over time and may help identify trends and cycles. (Free for Android; $0.99 for iOS)

nOCD

• • • Good for: OCD
    • Designed with the help of OCD specialists and patients to incorporate two treatments: mindfulness and Exposure Response Prevention Treatment. You can receive immediate, clinically-supported guidance when an OCD episode strikes, take weekly tests to assess the severity of your OCD, and have motivational support along the way. (Free; iOS)

Operation Reach Out

• • • Good for: Depression and suicidality.
    • This mood tracker and resource locator was designed by Emory University researchers to aid in suicide prevention. Users create a personal profile that includes emergency contact information, current medications, safety plans, and reminders for appointments or medications. Plus, the app uses GPS to locate mental health care services nearby, should any user enter crisis mode. (Free; iOS and Android)

PTSD Coach

• • • Good for: Anxiety (including PTSD), Trauma.
    • Available as an app or on the Web, PTSD Coach lets users select the specific issue they want to deal with (from anxiety and anger to insomnia and alienation), and then gives them guidance on how to lift their mood, shift their mindset, and reduce stress. (Free; iOS and Android)

Quit Pro

• • • Good for: Substance abuse.
    • This app is a tracker for users’ smoking habits. Users can monitor cravings over time, the places they puff the most, the triggers that lead them to light up, and the money saved by resisting a cigarette, this comprehensive app can help individuals develop better control over this habit. (Free; iOS and Android)

Quit That!

• • • Good for: Substance Abuse and addiction. 
    • Helps users beat their habits or addictions. Whether you’re looking to stop drinking alcohol, quit smoking, or stop taking drugs, it’s the perfect recovery tool to track and monitor your progress. Track as many vices as you want and find out how many minutes, hours, days, weeks, or years it’s been since you quit. (Free; iOS)

Recovery Record

• • • Good for: Eating disorders including Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
    • Recovery Record helps you chart your progress and check in with your mood throughout the recovery process. The food logging system is easy and discrete and you can connect the app to your dietician or therapist. (Free; iOS and Android)

Rise Up + Recover

• • • Good for: Eating disorders including Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder
    • Use cognitive behavioral therapy (CBT) techniques to help monitor your diet and exercise and determine what your triggers are. The app is easy to use, with lots of motivational quotes to keep you going and you can set yourself helpful reminders. Users can also share their progress and daily entries with their therapist/dietitian.  Free (iOS & Android)

T2 Mood Tracker

• • • Good for: Bipolar Disorder, Depression, Anxiety, PTSD, and a Brain Injury.
    • The T2 Mood Tracker, created by the National Center for Telehealth and Technology, allows users to rate their moods by sliding a bar to the right or left, and add notes about medications and treatments. (Free; iOS and Android)

SAM

• • • Good for: Anxiety, OCD.  
    • SAM’s approach is to monitor anxious thoughts, track behavior over time, and use guided self-help exercises to discourage stress. The app also offers a “Social Cloud” feature that allows users to confidentially share their progress with an online community for added support. (Free; iOS and Android)

Worry Watch

• • • Good for: Anxiety, OCD.
    • The idea behind Worry Watch is to enable users to track what kick-starts their anxiety, note trends in their feelings, observe when the outcomes are harmless, and keep tabs on insights to stop future rumination and anxiety. Worry Watch is password protected. ($1.99; iOS)

References:

K Schreiber (2015, April 13). 81 Awesome mental health resources when you can’t afford a therapist [Web log post]. Retrieved from http://greatist.com/grow/resources-when-you-can-not-afford-therapy

  –Use of Apps for Mental Health and Wellness