Microprocessing

Could Your Therapist Be Replaced with an App?

While the field of internet cognitive behavioral therapy holds a lot of promise, the best mental health care still requires a human touch

Credit: fergusowen/iStock/Getty Images Plus

In Microprocessing, columnist Angela Lashbrook aims to improve your relationship with technology every week. Microprocessing goes deep on the little things that define your online life today, to give you a better tomorrow.

Every evening, I receive a text message from a robot. Its name is Woebot, and sometimes the messages are as simple and straightforward as “Hello there, my friend!” Yesterday, the text was a bit odd: “I flossed my grills today.”

The bot’s earnestness is strange and cute, but it’s not just there to entertain me with bizarre quips. Woebot’s job is to coach me through my stress and anxiety in 10-minute segments each night.

Woebot is a part of a burgeoning field of therapy called ICBT, or internet cognitive behavioral therapy. Cognitive behavioral therapy is a decades-old, highly studied, and remarkably effective form of psychotherapy that focuses on problem-solving and emotional troubleshooting. Yet whether because of geographic distance from a therapist, financial issues, or insurance struggles, many Americans lack access to the mental health care they need. Hence the appeal of ICBT: If much of the costly and time-consuming therapy patients currently receive could be outsourced to a program, considerably more people could access needed mental health treatment.

At least that’s the hope. But there are significant limitations to getting ICBT to the general public. It isn’t yet clear to researchers and app developers how to best implement ICBT outside of clinical trials; what works in a research setting may not necessarily translate to the less-controlled real world. And a lack of regulation or even guidelines means developers have little incentive to use actual scientific findings when designing their apps.

There’s a large body of research showing that ICBT can work. It can relieve symptoms of anxiety, depression, and even harder-to-treat issues like obsessive compulsive disorder or body dysmorphic disorder (BDD), an underdiagnosed…