My Journey

My Journey: Android (free)

Developer Website: http://www.sabp.nhs.uk/eiip/app

Millennials, and even a lot of older adults, spend a lot of time with their phones. It’s one of the main reasons that I think smartphones will eventually become the second most important adjunct to therapy (or the second most important adjunct to pills, depending on your point of view). It’s also the reason I’m coming back to this exercise after settling in after the big move. One reason for this is the easy availability of these devices as a reference or worksheet. There are a growing number of tools that are useful as references, or which can even offer immediate feedback about what someone is experiencing.

This last task is what apps like LifeArmor and My Journey are designed for. My Journey is an app designed by Early Intervention in Psychosis service, a project of England’s National Health Service. I was really intrigued by an app designed for individuals with psychotic disorders – a high need group that does not have the broad range of support apps or online resources that other issues may have. The app is designed to offer education, in-the-moment assessment, and tips for individuals who are experiencing problems with mental health. It offers a few different tools for people to use, including a mood and symptom screener, a medication chart, activity reminders, a jargon reference, a short list of support websites, and a place for emergency numbers.

The first three tools are helpful organizers. They are nice because three different types of important information are at your fingertips. The medication chart is utilized by adding a medicine and a number of times per day that you are supposed to use it. There is a weekly chart for each medication; you tap it repeatedly each time you take the medicine for that day, and it cycles back to 0 so you can reuse that week. You can put in as many emergency contact numbers as you would like, and dial them directly from the app. The reminders can be anything; you can add them from the bottom of any question, such as reminding yourself to get out when reviewing a question about isolation.

The final tool is a list of symptoms. The screener asks about some general mental health symptoms. I really like the list they chose and the way they are presented. Symptoms are not tied to any particular disorder or label. Examples include:

1. Do you find it hard to relax?
2. Are you worried about going out?
3. Have you been spending more time alone?
4. Are your friends or family worried about you?
5. Have you had more arguments with friends or family?
6. Have you felt that people are watching you?

Each of these questions is answered by dragging from a thumbnail photo you choose to a “yes” or “no” answer. If you answer yes, you are asked to rate the strength of this change from 0 to 10. The app asks you so submit a rating, but there is no way to access this data once it is “submitted.” This is one of the places where the app starts to break down, at least for me; I’m used to clients having these tools to use as a sort of journal. One nice thing about many apps that feature this type of screen is the ability to review how things change over time. You could do that with this app, but you would have to take notes elsewhere.

On the flip side, that also means that this app doesn’t keep much data that a client would want to actively hide. The only thing that would possibly be private is the list of emergency numbers, which would potentially include a therapist, a suicide hotline, or other material that might be better off private. There is no password or security in the app, so if you are using this you will want to be able to discuss security for phone or tablet.

The UI is clean and very easy to follow, something with which Android is sometimes still playing catch-up (at the same time, the price point of many Android phones makes them more accessible than their iOS counterparts). The language within the app is very easy to understand. As I noted, it would be nice if there was an option that would allow us to keep a log of data, so that I could for example ask clients to answer these questions every few days to get a good measure of a client’s experiences or their responses to daily stressors. I like the open nature of the reminders; I could use that function to remind about medication, activities, journaling, or other weekly assignments. Some of the website links go to pages that do not exist. Note that since this is an app that is localized to the UK, the reference websites may be UK-centric and the “emergency services” listing will not be of use outside the UK.

In general, this app contains a lot of material that I might like a client to have early in their treatment. However, a lot of the information is less detailed than some similar apps. Many of the tips are helpful but may not be detailed enough for a client to easily use. The symptom checklist is well-done, but the inability to keep data may limit the usefulness of it.

One odd note: the Google Play website indicates that the app is not compatible with any of my devices (two smartphones and a Nexus 7). This could be a localization issue. I sideloaded the app on my phone and had no trouble using it.

Ratings:

Content: 3.5/5 -it could be helpful to integrate medications with reminders to cut out a step. Electronic reminders are likely an excellent way to increase compliance. The symptoms screener would be much more useful in many cases if it could keep some data. A few bugs such as broken websites. It is one of a very few apps I have seen designed to help individuals with psychotic disorders, which is exceptional.

User Interface: 4.5/5 – Easy to navigate, easy to use.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

Advertisement

On Passwords

I’m hoping that most visitors to the site take a moment to visit A Few Words on Security; I think it’s an ethical necessity (and a legal necessity, in many cases) that we are able to address electronic security in the application of this type of technology to therapy. Therefore, I will also regularly link to articles like this one (or this one),  which contain useful and updated information about changes that we need to be aware of. Technology, in most cases, moves so quickly that we can’t wait for our yearly CE binge to get up to date on everything that has changed in the past year.

The linked post discusses password strength, some myths about passwords, and the factors that go into making a good password that you can actually remember. If you’re stuck in one of those settings where you have to have a 16-character password with a number, punctuation, and three different capital letters spread out throughout the thing, I feel for you and share your pain. But did you know that such policies actually encourage us to use less secure passwords? Many people at my worksite tell me that they just change the number at the end every month. If their password isn’t that great to begin with, then this policy certainly doesn’t help. This gets more important as computing power increases, and “brute force” password cracking is not as difficult as it once was.

The short version, though I encourage you to read the whole original post: a memorable combination of words or characters that correspond to an easy-to-remember sentence. The author of the post uses the example Jog Step Rat, for that time that he stepped on a rat while jogging. Memorable, I’m sure. Another example would be something like tGWlf14t18. Looks like gibberish, but the Great War did last from 1914 to 1918.

I’m just glad that my bank doesn’t have any limitations on what I can use as my password. Not that there aren’t other ways to hack banks, but every little bit helps. There are some good tools that will estimate password strength, but you don’t want to rely on them too much, either. (Two examples are the password strength test page and the password strength checker).

This discussion is also best summed up by this comic:

A technical explanation of the comic is available here.

The Pinterest Collage

When I’m working with my students, I commonly point out that our clients, even many adults, don’t have the emotional vocabulary to successfully describe many of their feelings. In the past few months, I’ve come to believe more and more in having clients use smartphone or online tools rather than the paper that I (and most of us) have used for years.

Along this theme, here is an interesting use for Pinterest. I’ll let the article speak for itself. Like any exercise such as this, it will only be as useful as you can make it in regards to your client. It could be a useful exercise in a number of different empirically-supported approaches. I understand that there is a lot of gender-based bias running around about Pinterest, so it may be harder to get some of your male clients to do it. But, as always, I’m always about using what’s familiar to my clients, rather than shoehorning them into an exercise that I happen to like.

And while I’m not quite sure what a “relationship counselor” is, it’s still a sound idea.

Tactical Breather

Tactical Breather: Android (free); iOS (free)

Developer Website: National Center for Technology and Telehealth

You may not know this, but the Department of Defense and the VA system have spent a lot of effort over the past seven or eight years attempting to find new ways to treat PTSD. Some of these efforts are pretty far outside the box. Despite the fact that the culture surrounding PTSD does not seem to have changed much (see page 22), a number of their efforts are pretty cutting-edge. This includes a selection of mobile apps designed to help in the treatment of PTSD and mild TBI.

Each of these apps is built to perform one or two specific tasks. I’m going to cover one that may be the most applicable to the largest number of clients that you might be seeing. Like me, you probably have a script that you go through about what the body does when it becomes highly anxious or nervous, and use this script as an introduction to a deep breathing exercise. When I plan to teach a client something complex like progressive relaxation, I always start with deep breathing – a task that is easy to explain but which is a different and new experience for many clients. I have a series of audio programs that I like to have clients use, but that type of thing is much better suited to a longer progressive relaxation/imagery exercise than to a short, in-the-moment crisis.

Tactical Breather is a tool that is designed to do one thing – guide a person through a deep breathing exercise. It’s a tool that can be used quickly in any environment for as long as a client needs it (I usually instruct my clients to do an exercise for at least two minutes, and longer if necessary). There is an introduction (which I would go through with my client), a brief tutorial about what the exercise is and how it is supposed to work, and the “breathe” button, which is of the most importance. Hitting the “breathe” button triggers visual prompts and a spoken dialogue guiding you through this process. Settings allow you to change the audio to a male or female voice, mute or unmute the audio, include vibration-based prompts, and allow you to choose whether or not you upload “anonymous data” to an unspecified place. Also in the settings is an excerpt from Lt. Col. David Grossman’s book “On Combat.” This excerpt discusses physiological and neurological responses in high stress combat or near-combat situations.

The ability to use it in any environment is key – it’s “normal” for someone to whip out their smartphone and stare at it for a few minutes; even if your client is in a movie or something else dark, the screen is minimal and doesn’t make much light. Either good luck or by design, it’s a good feature. The vibration prompts are also nice – the app gives a brief vibration at every count in case you need nonverbal prompts. It will be very helpful for clients to have a nonverbal cue when they can’t listen to the verbal prompts.

Home Screen – Android

Breathing Prompt – Android

Regarding data security, this app does not keep any local data. There are no details about where the anonymous usage data is sent – presumably the authors of the app. I hope that their data doesn’t get skewed by widespread use of this app. It would be good to show this setting to your clients in case they wish to turn it off.

The UI is good and easy to navigate. It would be nice if there was text to accompany the introduction and tutorial for those (like myself) who would prefer to read them. A visual count during the breathing would be nice as well. An optional timer could be useful, so that a client could know when their two to five minutes are up. This might be particularly helpful for newer clients, who aren’t as aware of when their body is telling them that they are relaxed.

In summary, this is an app that could have an extremely wide audience, including people with a range of anxiety disorders. This (and many of the apps that have been developed as part of this program) can be a very helpful, concrete tool for your clients to use.

Ratings:

Content: 5/5 – Covers a deep breathing exercise and does it well.

User Interface: 4/5 – Easy to use, but a couple of add-ons could he extremely helpful.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

eMoods Bipolar Mood Tracker

EMoods Bipolar Mood Tracker: Android (free/donationware); iOS/Kindle “coming soon”

Developer Website: http://emoodtracker.com/

There is good evidence that various types of therapy, including CBT, are helpful in reducing the impact of Bipolar Disorder on the lives of clients and their families. In most CBT, some sort of thought log is a central piece of the homework that the client is given. When treating a client for Bipolar Disorder, it is also helpful to have “big picture” data on trends in your clients’ mood state. This can help you identify triggers, situations in which your client did not take their medicine, changes in sleep cycle (which are notoriously difficult to self-report without notes), and other data that can help frame treatment. Knowledge about this data, among other things, will in time help your client to identify situations in which manic episodes may be likely to happen. It can also help them plan to head off severe changes in mood when possible. Early identification of a possible change in mood state, combined with rush outpatient treatment for medication and crisis management, can hopefully minimize the risk of hospitalization for your client.

One tool that I have commonly used with Bipolar clients is the BEAM, a mood chart that tracks medication, sleep, weight change, anxiety/irritability, and other notes about a client’s functioning. It has all of the weaknesses of any self-report, but clients can learn to complete it accurately with very little practice.

There are a few such tools in the smartphone app space that attempt to do something similar. One of these is the eMoods tracker, which is designed specifically with Bipolar Disorder in mind. The developer notes that they worked from the list of information that is collected by the mood chart that is utilized by the Massachusetts General Hospital Bipolar Clinic and Research Program. This app has all of the information that you will find on the BEAM, aside from a place for weight (which could go into a daily note anyway). At the top is a place to enter amount of sleep, ranging from zero (red flag, right?) to 24. Clients identify themselves as have No, Mild, Moderate, or Severe symptoms in four areas: Depression, Elevated mood, Irritability, and Anxiety. There is also a checkbox for “psychotic symptoms” and whether or not someone attended a therapy session on that day. Each entry line has a small help screen with descriptive reminders for each category. Toward the bottom is a place for daily notes, which is limited to 300 characters due to the formatting of the output .pdf; the help section states 60, but this is in error. Last comes a place to enter medications. The information can be entered once per day, and can be changed later – although I usually encourage clients to do these tasks at the end of the day.

You can view summaries within the app via the “calendar” and “graph” tabs, which give you either a list of the past 40 days or a monthly graph of mood states (see screenshot). You can also email a report in .pdf format. It is a four-page report that looks similar to the BEAM. There is a setting for daily alarms, but its functionality is severely limited at this point. The app states that improved reminders are “coming soon.” It would be great to be able to manage medications completely within this app, as opposed to using a separate app.

On a side note, the developer’s website has a link to a website with international suicide hotline numbers – something that I frankly had not thought of before.

Disclaimer – I like that the developer addresses external data security from the outset

Data Entry

Depression Help Screen

Description of Psychotic Symptoms

Sample Chart from Google Play

Regarding data security, this app definitely keeps data that your client would want to keep away from prying eyes. There is no password or other security built into the app, so you should instruct them on how to keep their phone secure if they are not already doing so. (If you can’t discuss and demonstrate this option, I would argue that you are not fulfilling informed consent requirements of treatment. Clients of course are still free to not bother).  This app does email reports. You can leave your name off of the report, which may be helpful to you if these will often be sent to you. While email of course states who it is from, it may still be comforting to have a de-identified report.

The UI is pretty clean and very easy to follow. The reports are also easy to understand. Given the format of the pdf report, it would be nice if daily written entries could be longer. Another drawback is the medication entry. If there are meds that are taken BID or TID, they will need each to be entered individually (and probably labeled as morning/midday/night). It would be helpful to be able to add a medication once and be done with it. There was one notable bug – I think that the app attempts to fill in common medications, but the list can’t be seen under the keyboard.

In general, this is a well-laid out app that covers most of the data that you would probably want to track in a client with Bipolar Disorder. Technically, it could also keep track of unipolar depression or anxiety, but there are other apps that might better fit that niche.

If you or your client use this with regularity, I urge you to purchase the “donate” app in the Google Play store. I’m really a fan of this model of software sales, and from a practical perspective this is the best way to keep this app in active development. I much prefer this model to one where we get free apps which include ads.

Ratings:

Content: 4.5/5 – Covers most data of interest; better medication entry and reminders would be an improvement.

User Interface: 4.5/5 – Easy to navigate, minimal, nonintrusive bugs, good disclaimers and reminders for clients who are filling out the day’s data.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

Clinical Scales from Psychiatric Times

Clinical Scales: iOS (free); Android (free)

http://www.psychiatrictimes.com/features-and-resources

One of the things that I often find myself reminding my students is that people can or will often tell a piece of paper something that they can’t or won’t tell another person. (can’t, because they don’t have the language; won’t, because they might be embarrassed or unsure where to begin). This is one reason that I am a fan of short symptom batteries such as the BDI – something that can give me a more objective representation of a client’s symptoms, and which can often be useful in marking their progress over time.

As an example, a few years ago I saw a woman who presented as very depressed. We immediately started some behavioral activation exercises, laid the groundwork for some cognitive work, and referred her for medication. She showed promising response after the first few weeks – she was regularly completing her behavioral homework and her physical and interpersonal presentation was less depressed. It was clear, though, that she didn’t believe my feedback about her improvement until I compared her PHQ-9 score that week to her score the first day that she came in.

Because of this, I’m pretty consistently on the lookout for validated, low-cost (or free) instruments. The idea of being able to do it paper-free appeals to me on a couple of levels as well. I was happy to come across this app, which offers short, checklist-style screeners for:

• ADHD (Vanderbilt Parent and Teacher Scales, Adult ADHD Self-Report Scale)
• Bipolar Disorder (The Bipolar Spectrum Disorder Scale)
• Depression and Anxiety (PHQ-9, Patient Health Questionnaire, GAD-7 (Anxiety), Major Depression Inventory, Hamilton Anxiety Scale, and the Geriatric Depression Scale)
• Autism (CHAT)

Keep one thing in mind as I continue: none of these are standalone diagnostic tools. This goes double for the ADHD and Autism checklists, which are too limited in scope and too face-valid to give a reliable diagnosis of either disorder (Not that the CHAT identifies itself as a diagnostic  tool). Not all of these are great, or even good, measures. I performed a cursory lit search on these scales, and (for example) the material that I found on the Hamilton Anxiety Scale was not particularly promising. (If you’re interested and you follow the link, you will find that that the Geriatric Depression Scale has its own standalone Android and iOS apps). I have tried to include links to research or at least a bibliography on these instruments so that you can review them and make your own choice as to their use. I typically did not include links to resources that are not freely available.

Home Screen

Selection Screen

PHQ-9 Administration

Results Screen

Results Email

The app is pretty straightforward to use.  Run the app, pick your measure, and go. You can navigate backwards and forwards among test items. At the end, it gives you a score and a possible interpretation (see screenshot). This app does not keep records locally. If you want a paper trail, you have to email the results to copy and paste into a chart. A sample email result from the CHAT is shown in the screenshot gallery. There is no identifying information in the email, minimizing the risk of sending results in this fashion. Just don’t get confused if you do a lot of these in a row.

There are no specific issues regarding personal data for this app, as it keeps none and the emailed results have no identifying information other than an email address of your choice.

The UI is  clean and straightforward. On my Android phone (a Galaxy S2 running 4.0.4), there was a weird bug which prevented me from using the home screen button on the top right. I actually had to get out of the app, force-close it, and re-run the app to get back to the home screen. This is enough to keep me from using the app on Android (my regular phone). I did not have similar issues with the iOS app. However, it’s worth trying as this bug may not be replicated on other Android devices.

Content – 4/5 – Measures are of varying utility, but cover the basics. Many of you may already have preferred measures of depression, anxiety, etc. that are not included.

UI – 2/5 (Android) 5/5 (iOS)  – Intuitive to use, with the irritating Android bug noted.

** Disclaimer: While some of these apps may be helpful to you, NOTHING  that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

Depression CBT Self-Help Guide

Depression CBT Self-Help Guide: Android (free)

Developer Website: http://www.excelatlife.com/

While a lot of these reviews are (and will be) of more “general” apps that can easily be applied as therapy or reference tools, there are a number of purpose-built apps that actually make an attempt to utilize psychological science. This app is both a thorough homework tool and resource for CBT of depression and anxiety and an illustration of some of the pitfalls of free apps. I’ll explain more as we go along.

First, the good – the available content in the app is quite thorough. The author identifies herself as a clinical psychologist who has been in practice for 20 years or so, and it shows. The app covers everything that I might want to assign as CBT-based homework for depression, anxiety, and other issues. I give a lot of homework to my patients, and think it’s much easier for some of them to enter information into a smartphone than to keep track of some random sheets of paper. It contains a very thorough thought diary/challenge tool, a reward system, links to relaxation audios, and even a brief depression measure, the PHQ-9, which is designed for primary care settings but is validated and even has guidelines for outcome measurement.

When you run the app for the first time, there is a disclaimer about seeking real treatment if necessary, etc., etc. The home screen includes a nice picture of a butterfly (funny thing about apps with random graphics this week) and has five tabs at the bottom – Info, Audios, Diary, Test, and Points. There are other backgrounds to choose from if the butterfly is just too warm and fuzzy for you.

I’ll start by skipping to the thought diary, which meets my purposes as a therapist wonderfully, but will probably be overwhelming to your clients at first. Part of this is because it’s a lot of information to fit onto a small phone screen. Part of this is the reason that I teach clients to do thought logs in parts rather than all at once – because it’s often too much to master all at once. The logging tool has entries for

• Event
• Emotion
• Intensity
• Distress rating
• Thoughts related to the event
• Irrational beliefs related to the event (with a handy list of definitions)
• A space for the client to challenge their belief
• A rating score on their belief of that challenge, and
• A place to enter a plan or other comments in relation to the event

Like I said, extremely thorough. Emotions and irrational beliefs are picked from checklists that are completely customizeable – wonderful to someone like me who much prefers to use the client’s language whenever possible. Finally, the entry screens have help buttons (the red question marks) which give lists of instructions, irrational beliefs, etc. You can also create a list of standard challenges to help your client get started. Unfortunately, there is no way to do this piecemeal, meaning that you can’t just enter a thought into the diary and save it. I often like to do this because I  think that learning to identify negative thoughts and irrational beliefs are steps that usually require their own homework before the client is able to do the whole A-B-C-D process alone.

The Info tab contains a selection of articles on depression and instructions for use of the app – a good reference for clients, but it’s not like I’m going to tell them to download the app, go home, and figure it out. The articles (as well as the audios) are hosted on the developer’s website.

The audios include a selection of relaxation exercises, a lengthy but informative psychoeducational audio about depression, and another audio that is designed to help clients recognize different emotions – a unique idea that I hadn’t really thought about before.

The Test tab is where you will find the PHQ-9. It will keep results so you can identify improvement over time. Like many depression measures, the PHQ-9 asks about experiences over the past two weeks, so keep this in mind when using it. It will give you a list of past scores as well as graphing them for you.

Finally, the Points tab is where you can apply a behavior plan. As you may have already guessed, it’s called a “points” section because you give yourself points for applying the behavioral part of CBT. This section is a little more limited than the diary. There is a significant list of behavioral items to choose from, but they are keyed to the app and the list is not customizable. I’m not sure I would be able to get very much use out of it.

Home Screen

Diary Entry

Irrational Beliefs List

Customizable list of emotions

Entered Data

PHQ-9 Item

Regarding data security, this app obviously keeps data that you or a client will not want random people to be able to read. This is a good time to discuss passcodes or the Android pattern lock** with your client (and you should be able to show them how to set this up if you’re sending them home with this app). You can password-protect the app itself in the settings. It requires a six-letter password. If password-protected, the app will run but you will not be able to access any of the tabs (including Diary and the PHQ) without a password. While the setting states “password protect diary,” it actually protects everything within the app. There is a data backup feature in the app, and information can also be sent via email, presumably either to the client or to you. There is also a selection in the settings about disabling the reporting of usage data, and there is no explanation of what this usage data may be. It’s easy enough to opt out, but I don’t like that you have to. Overall, data security is fairly well-protected, but I would never have a client keep an app like this on their phone without password protecting the device. This is especially true for an Android phone, whose file system is pretty easy to access.

The UI is kind of cluttered and is the weak point of this app. I will certainly grant the author the important point that an activity log is difficult to fit onto something the size of a smartphone screen. This is especially true because some of the screen real estate is taken up by ads (more on this later). It’s actually not as cluttered as it could be. Looking at the app reminds me of the many too-flashy websites that we had to suffer through in the mid-to-late 90s.  It’s easy enough for me to read, but I’ve also done most of my book reading on my phone for a few years now, so I’m used to it.

A particular note about the ads. As you may or may not know, ads on many smartphone apps tend to be “targeted” as much as possible. While I get some “harmless” ads for Kindle and other apps down there, at least once I got an ad for “serotonin supplements,” which was kind of worrisome to me. Despite the clear utility of this app, I would never assign it to a client without clear directions to disregard the ads. I would much prefer to have a paid app without ads. I did contact the author about this a few months ago, and she stated that this was a planned update, but wasn’t able to give a timetable.

Overall, I really like the app and would use it given opportunity and the ability to give the client clear directions regarding security and a special warning about the ads. It’s very customizable in most areas, and I like the amount of detail that you are able to get out of it.

Ratings:

Content: 5/5 – Almost everything you might want; would like to customize behavior scoring system.

User Interface: 2/5 – While this is partly for the UI, I really ding it for the ads.

** Android pattern lock, which for a long time stumped experts, now has a reportedly easy hack. If you use pattern lock, disable USB debugging on your Android phones ASAP!

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

DSM Reference

DSM Reference : Android (free)

http://www.kiddiecatpsych.com/

I’ll have to admit – I haven’t seen my full-length DSM in years. I may have left it behind a couple of states ago.  When I need to review diagnostic criteria, I most often use the BehaveNet site (although they’ve recently redesigned their menus in a way that’s annoying to me). I have yet to find an error in over five years of using it regularly. I have always wanted something like that reference for my phone – I find that checking a reference on my phone during therapy is much less intrusive than turning around to the computer, and more convenient at many other times.

If you’ve ever wanted a pocket replacement for your “pocket” spiral-bound DSM, this is about as close as it gets; at least for free. This app looks like a good replacement for BehaveNet and/or your spiral-bound baby DSM.  It looks like a complete, searchable list of codes and titles as well as a mini-guide to the five axis model and a GAF reference. I discovered that it does include lists of criteria as well when I accidentally tapped on a particular diagnosis. I did not do an exhaustive comparison, so I don’t know if it’s 100% accurate.  It’s also searchable, although you need to use the specific name of a disorder (e.g., use “depressive” instead of “depression”). Note that I usually double-check things with a DSM the first time I use a particular diagnosis with a reference tool like this – it’s good policy to assume that it’s not always accurate.

Diagnosis Listing

Search Results

GAF Listing

Search Bug

ADHD Criteria

This is the splash screen. I have no idea what the cat’s about. It’s a useful app anyway.

There are no specific issues regarding personal data for this app, as it keeps none.

The UI is clean, intuitive, and easy to navigate. It’s much more intuitive and easier to use than other DSM references I’ve looked at (like this one). The user experience continues to be a problem with some Android apps, and it’s nice to not see that here. The search page has a bug – if you search for a term like “depression” which doesn’t technically exist as a proper name for a disorder, it will give you no results (which is right) and the keyboard will re-enter your term with every key press (which I assume is not the developer’s intention). The back button takes you out of the app instead of to your previous page. Having some in-app navigation buttons would be of help. Finally, the listings do not have any formatting, which makes them a little more difficult to read.

A side note: the developer’s page looks kind of abandoned and doesn’t mention the app at all. I don’t know when or if it will get updates, which means that it might never be updated to DSM-5 when it comes out.

Content – 5/5 – I’ve wanted a usable pocket DSM on my phone for ages.

UI – 3/5 – Pretty intuitive to use, with a couple of frustrating bugs as noted.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

Story Dice

Story Dice: iOS iPhone/iPod/iPad ($1.99); Android (including Kindle Fire) ($1.99); Nook ($1.99)

http://thinkamingo.com/story-dice/

In addition to things that make good reference or education tools for you and your clients, I’m also interested in the use of what some might consider “softer” apps in therapy. Story Dice is one of those apps – something that you might see in a family game night, or as something that you can play with your kids in the car. It certainly doesn’t smell of the “science” of therapy. But this app, and others like it, can be very helpful if used properly.  I think that this will turn out to be especially true of children – give most children the choice between a board game and the same task on an iPad, and I would wager that a majority would choose the iPad. (I think that this may have some positive impact on homework for adults, too, but that’s a different topic for a different day).

My students, my colleagues, and I are constantly searching for tools or games that I can use to help introduce children and adolescents to the realm of therapy. One of my favorites involved passing a ball around a group of children while the person holding the ball answers progressively harder questions, starting from “My favorite food is…” and moving on towards “I notice …. when I get angry,” or “I worry about…” I see an app like Story Dice being useful in a similar manner – starting with a basic storytelling exercise, or thinking of a song that has the picture in it, and moving up to something like a story about school, or about home, or anything else that might have been identified as a problem area.

Home screen

The app is pretty much what it sounds like – a set of virtual “dice” that have different pictures on them. One benefit of app over a set of “real” story dice that you might get is the library – over 100 pictures, according to the developer. All options are accessed via the small “i” at the top right of the screen. You can use between one and ten dice per roll; you could pick based on the amount of story that you might expect to get out of a child of a particular age. If you use this, I would attend to the “helpful tips” section. It has some good ideas for structuring an exercise using this tool. I’m partial to the “my perfect day” exercise that they describe, although not necessarily for the development of critical thinking skills. Hearing a story of a child’s “perfect day” could be enlightening. This and other apps would also be good for encouraging play between parent and child.

Some sample dice

This is a relatively simple app that doesn’t have any surprises. The only thing that I would like to see is the ability to choose a subset of pictures to use with a particular client. But that’s speaking as a clinician, not necessarily the target demographic for the app (although educators might like that as well)

There are no specific issues regarding data security for this app – it keeps no data.

Content – 4/5 – Would be better for my particular use if pictures were selectable from a library.

UI – 5/5 – Not much UI to speak of, but a very clean looking app.

Note – Review is of iPad version of this app.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.

3D Brain

3D Brain: iOS iPhone/iPod/iPad (free); Android (free); Windows Phone (free)

http://www.g2conline.org/

If you’re like me at all, you’re at least a little interested in the new things we’re learning every day about the interaction between brain structure, brain function, and mental health issues. In addition to the cool factor, though, I occasionally find that an explanation of brain structures that are involved in various mental health issues can be very helpful in de-stigmatizing some disorders. For example, discussion of biological differences in the prefrontal cortex and other areas of the brain has helped me re-frame ADHD for some parents who think that their child is just “bad.” Those of us who remain relatively familiar with the brain can easily forget that most people have no idea what we’re talking about when we say “cingulate gyrus.” This leaves you with the choices of:

a) pointing at your head

b) using some sort of visual aid

The 3d Brain app is actually a port of the same map of the brain that is available at the developer’s website (http://www.g2conline.org/2022). It contains 29 maps (on iOS and Android) highlighting different brain structures. It also has a short description of the structure, a case study highlighting a piece of research about the structure, main functions of the structure, effects of damage, and disorders associated with that portion of the brain. Of course, there is also the diagram itself, which can be rotated on vertical and horizontal axes (only horizontal on Android). There is also a label button, which will label all colored structures in the image; note that many labeled substructures do not themselves have an explanation. Still, it’s a good lay description and illustration of portions of the brain that might be associated with some disorders.

iPad – Frontal Lobe

iPad – Cingulate Gyrus

Android – Prefrontal Cortex

There are no specific issues regarding data security for this app – it keeps no data.

The app UI on both iOS and Android are pretty straightforward – menus to select a portion of the brain, and clearly marked areas of the screen to get text info or color-coded labels. The iOS app hasn’t been updated for some time (since 2010), and this is notable for a field that seems to change almost daily. The Windows Phone app was released in 2011, and the Android app in early 2012. The references and information appear to be similar across iOS and Android. I did not perform an exhaustive search on the references included in the description of each area. I would have liked to be able to access a complete reference list from the app, in case I wanted to read any of the literature that they cite. There are also a few typos in the text here and there (e.g., “frontals lobes”).

Content – 4/5 – information is easy to understand and fairly thorough; it’s unclear how often the research cited in the app will be updated (if ever).

UI – 5/5 – easy to navigate and accessing information is fairly intuitive. diagrams are excellent.

** Disclaimer: While some of these apps may be helpful to you, NOTHING that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.