Mobile applications in adolescent psychotherapy during the COVID-19 pandemic: a systematic review

Background: To bridge the gap in adolescent psychotherapy created by the increasing need for mental health interventions and the limited possibilities of in-person treatment during the pandemic, many health care providers opted to offer online mental health care programs. As a result, the number of mental health apps available in app stores experienced a sharp increase during the COVID-19 pandemic. Objective: The aim of the current review is to provide an overview of feasibility and effectiveness studies testing mobile applications in adolescent psychotherapy during the peak phase of the COVID-19 pandemic. Methods: We conducted a literature search in Pubmed, PsychInfo, Google Scholar, OpenSIGLE and OpenGREY for papers published from June 2020 to June 2023. Studies were included if they evaluated app-based interventions intended for psychotherapeutic treatment and targeted adolescents between 12 and 27 years of age with symptoms of psychological disorders. The quality of each study was assessed using the Systematic Assessment of Quality in Observational Research (SAQOR). Effectiveness outcomes were analyzed by vote counting and calculating a binomial probability test. Results: The search yielded 31 relevant studies that examined 27 different apps with a total of 1,578 adolescent participants. Nine articles were primary effectiveness studies and 22 focused on feasibility measures as primary outcome. There was evidence that mental health apps influenced adolescents' psychotherapy, with 83% of the studies with effectiveness outcomes favoring the intervention (p = 0.002). Sixty-one percent of the included studies were rated at low or very low quality. Conclusions: The pandemic has given apps a firm and important role in healthcare that will probably continue to expand in the future. To ensure that mental health apps are truly effective and beneficial for adolescents' psychotherapy, we need a standardized measurement of quality features of mental health apps and higher quality app evaluation studies. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=406455, PROSPERO International Prospective Register of Systematic Reviews [CRD42023406455].