Using Apps to Supplement PTSD Treatment

It took the American Psychiatric Association (APA) until 1980 to add PTSD to its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) but now coping apps developed by psychologists and psychiatrists working alongside developers are getting venture capital, government funding and downloads all over the world.

Happify’s 'Uplift' Section

The PTSD track “can help users heal from the past, embrace the present, and create a bright and meaningful future,” explains Happify Director, PR, and Communications Britta Franson. “The activities in the track are drawn from several disciplines including Time Perspective Therapy, which evolved from Cognitive Behavioral Therapy (CBT).”

In fact, the Happify app’s “Uplift” section trains your mind to focus on positive words with hot air balloons rising above desert canyons and it’s pleasant to watch. “Overcome PTSD and Look to the Future with Hope,” promises the segment teaser. Then hot air balloons with overlay words, “serenity,” “serene,” “grin,” and “kiss” start ascending. Chimes trill their way up the octave when you click the positive words. Accidentally hit a negative word like, “fear,” and “whoops” and a broken chord chimes down as the balloon sinks.

Franson cautions users against using the app in place of a mental health professional. “Happify is intended to be a complementary self-help tool and should not be used as a substitute for the advice of a licensed healthcare provider or medical professional,” she says.

A Double-Edged Damocles Sword

Rebecca Sinclair, Ph.D., Director of Psychological Services, Brooklyn Minds Psychiatry, P.C., signals caution when seeking the right apps to help those who suffer from PTSD.

“The double-edged sword is they’re not a replacement for therapy,” she said. “It’s not necessarily a one size fits all piece. The things with PTSD and trauma in general. People have the assumption that anyone who experiences trauma experiences PTSD and not everyone who experiences trauma experiences PTSD,” She adds, “there are differences in acute stress response and PTSD.

“Giving interventions after trauma before PTSD can be a problem.” Sinclair says emphatically, “everyone’s trauma is different. While we have these constellations of symptoms that come up with PTSD is so specific per person. A mental health practitioner needs to access symptoms of how they affect a person functionally,”

To monetize or Not to Monetize

PTSD Coach was created by VA’s National Center for PTSD and the National Center for Telehealth & Technology by a team of medical professionals. It provides education and coping skill tools as well as connections to resources.

Also developed by a team of mental health professionals, Happify provides evaluations and coping strategies. Unlike PTSD Coach, Happify also requires a premium purchase to unlock all five signature strengths and many other features the user might benefit from, like a detailed report of those strengths with charts tracking skills and strengths. Happify also encourages users to share on social media.

PTSD Coach isn’t encouraged to share or pay for premium services. Meanwhile, to date, Happify has raised $50 million in venture capital and says the vast majority of its business comes from “enterprise clients: self-insured employers, health plans, and pharmaceutical companies.” The company would not disclose the future return on investment plans. On the other hand, PTSD Coach was developed by the VA, subsidized by the United States military.

The Gold Standard

Sinclair describes exposure symptom reduction of PTSD as “the gold standard treatment.” It is “specific, systematic and gradual and should be guided by a trained professional who has expertise in trauma therapy.”

Furthermore, a trained therapist can also “guide the learning and use of specific coping skills, which can be idiosyncratic. For example, although mindfulness helps many folks, some individuals with a trauma that has been physical or sexual in nature or who dissociate can be triggered by some physical mindfulness exercises,” Sinclair said. This is relevant to other app features, too.

Guided Relaxation

Maybe you’re partial to the billowy white cumulus clouds hovering above a beach, or the sound of rain bouncing off leaves deep in the forest. Perhaps you prefer the autumn leaves fluttering to the ground as you wind down a quiet country road. Relaxation tools can be helpful but Sinclair also cautions that “an individual with PTSD might use guided imagery as a means to avoid in a way that impacts their functioning (e,g., using it at work to avoid any chance that they might hear about a trauma trigger and then missing an important point made at a meeting).”

Moreover, it isn’t necessarily obvious when an app impairs overall functioning. “That is why a therapist can help guide you towards functional coping skills,” Sinclair says. “The apps can absolutely help augment these treatments, particularly as a way to take the lessons of therapy with you. But they should be used in adjunct with working with a professional.”