At a glance
Mental health apps can help you practise and notice, yet many people find that months of faithful use leave the core feeling untouched. You keep doing the exercises and keep wondering why you still feel stuck. I set out what an app can carry for you, what it cannot, and how to tell which you need.
Clinical insights from 22 years in psychotherapy
I’m Mark Colclough, MA, psychotherapist in Copenhagen. Qualified at the Psychosynthesis Education Trust and the University of East London. 22 years of full-time, face-to-face clinical practice.
- Records without relief. Clients often show me careful logs of mood and sleep while the thing that hurts most has never been said to another person.
- Scoring as distance. I notice that rating a feeling can become a polite way of holding it away, which helps on a hard night and costs something over months.
- Knowing the exercise is the easy part. Most clients already know how to slow their breathing; what they have lacked is company while the feeling is actually there.
Clinical notes: My observations are anonymised and compounded from my session notes since 2004.
Why do I still feel stuck when I use the app every day?
Noticing a feeling and having someone with you inside it are two separate experiences, and it is usually the second that loosens something.
You can give the feeling its right name, rate it out of 10 and watch the line on the graph dip and climb over a month. None of that stops you being on your own with it. The disappointment you feel when the streak continues and the heaviness stays is a fair reaction, not proof that you are doing it badly.
The daily check-in can also quietly turn your emotional life into homework. A bad week begins to look like a failure to keep up, so you add guilt to whatever you were already carrying. When someone tells me they follow every prompt and still feel no different, I rarely think effort is the problem. More often they understand their pattern well and still find it hard to bear, and understanding was never what was missing.
Is there any evidence that these apps help?
A modest amount, and less than the app store suggests.
My reading of the evidence is cautious. One large review combined the results of 14 meta-analyses, which between them drew on 145 randomised trials and almost 48,000 people1. Against no treatment or a waiting list, phone-based programmes produced small improvements in anxiety, depression and stress. Against an active comparison the effects shrank to very small or vanished, and the authors found no convincing evidence for any single intervention. They also note that many trials leaned on self-report and seldom tracked who stopped using the app.
So an app is better than nothing, by a margin you can measure. That is worth having. It is a different claim from saying it can stand in for a therapist, and the research does not make that claim.
Where does an app pull its weight?
An app is at its best with the work that happens between conversations, and at hours when nobody else is awake.
- Repetition. Slow breathing or grounding only becomes yours through practice, and a phone is a patient coach for practice.
- Spotting a rhythm. A few weeks of entries may show that your lowest days follow particular evenings or particular phone calls, which is useful to know.
- Words for feelings. If you grew up in a home where emotions went unnamed, a list of feeling words can be a real starting point.
- Something to hold at night. When sleep will not come, a structured exercise in your hand beats scrolling.
Treated as a tool that supports the work, rather than as the work itself, an app can carry a fair share of your week.
What does a person give me that a screen of exercises cannot?
Being known while the feeling is alive in you, rather than reporting on it afterwards.
You say the thing you are most ashamed of, and the person opposite you does not pull away. Often your chest loosens or your throat tightens before you can explain what just happened. Something in you registers that it could be said and survived. That kind of learning happens between people, and a notification has no way to give it.
Much of my work is exactly this, again and again. I catch the moment your voice drops and ask what just happened. I hold what you told me months ago next to what you are telling me now. I stay with the feeling alongside you instead of helping you score it. An app can store your history, yet it cannot be surprised or moved by you, and those responses matter more than people expect. Over video this still happens, because what carries it is accurate attention rather than a shared room.
How do I choose, and when is neither enough?
Start from the place where you feel stuck, and let that decide, rather than asking which option is superior.
- An app may be enough if what you want is a new habit or skill and, on the whole, you feel understood by the people in your life.
- A person is likely to help more if the same hurt keeps repeating in your relationships, if something old is being stirred, or if the central thing still cannot be spoken.
- Combine them when sessions need practice in between. Bring what you noticed rather than the chart, and the hour becomes sharper.
- Pause the logging for two weeks if tracking has become the main way you relate to your own feelings, and see what is there without a score.
Take these as a way of thinking it through, not a test that hands you a verdict.
Sometimes neither route works on its own. If you have tried app after app, each hopeful at first and then dropped, I would treat that pattern as worth exploring rather than as evidence that you lack discipline. It often points to a need that no technique can meet. A session is a good place to work out which of these applies to you.
Questions people ask
Can I keep using my app once I start therapy?
Yes, and the combination can be useful, with the app holding the practice from one session to the next. Tell me what you noticed during the week and I will work with it.
I keep giving up on apps. Will I give up on therapy too?
Not necessarily, because what keeps people coming back to therapy is the relationship rather than willpower. Losing interest in an app often reflects not feeling met by it, which is a different thing.
Is a video session different from chatting inside an app?
Yes, because you are speaking live with one person who remembers you and responds to you in the moment. The screen is only the place where the two of you meet.
Is therapy worth it if I am coping fine on the surface?
Plenty of people who start with me are managing their lives well and feel strangely little inside them. You do not have to be at breaking point to use an hour well.
Can I have sessions with you from wherever I live?
Yes, sessions are by video, so you can join from any country with a private room and a steady connection. I confirm every appointment in Copenhagen time so the time zones stay clear.
If an app has taken you as far as it can, I offer online psychotherapy with a real person who remembers you from week to week.
Sources
How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.
