The below evaluation is an example of the types of information you may find when using our Model to assess specific apps. This sample evaluation is not intended to enable you to make a decision about choosing these specific apps for actual use, as such a decision is a personal one that you will make based on your own unique preferences, needs, and evaluation. We strongly encourage you to download these apps for yourself and use our Model to conduct your own assessment.
This evaluation was completed May 2020, and is based on publicly available information found by our Panel at that time. In July 2020, APA's contacted the app developers and offered to them an opportunity to provide feedback on these assessments. Comments from developers who responded are included here. These comments do not necessarily reflect publicy available information at the time of the original assessment or presently.
Access & Background
On which platforms/operating systems does the app work? Does it also work on desktop?
iOS and Android.
Has the app been updated in the last 180 days?
It appears to be for the Apple version. iPhone App indicates v2.5 was updated in 2018, but in the Apple App Store itself, the last update for v2.5 is 9/23/20; Google Play store current version is 1.0.4, which was updated March 16, 2020.
Does the app identify ownership?
U.S. Dept of Veterans Affairs.
Does the app identify funding sources and conflicts of interest?
No potential conflicts mentioned/identified that the reviewers could find.
Does the app come from a trusted source?
The US Department of Veterands Affairs; Project partners identified: VA National Center for PTSD; VA Sierra Pacific VISN21 MIRECC, and the DoD Center for Telehealth and Technology.
Does the app claim to be medical?
No.
Are there additional or hidden costs?
No, it is free to download and use.
Does the app work offline?
Yes.
Does the app work with accessibility features of the iPhone/Android? Is it accessible for those with impaired vision or other disabilities?
Changing the iPhone Accessibility Features does not appear to change the functionality of the app itself.
Privacy & Safety
Is there a transparent privacy policy that is clear and accessible before use?
The privacy policy is available to users upon first login to the app. Per these reviewers, the policy seems straightforward and clear.
Does the app collect, use, and/or transmit sensitive data? If yes, does it claim to do so securely?
The app collects trauma-related information as a part of its interface. Users store personal trauma-related information (including stuck point log, impact statement, etc) on the device.
Does the app declare data use and purpose?
Yes, upon logging into the app; also under license agreement on the App Store.
Does the app describe use of PHI?
In the Privacy Policy, CPT Coach indicates that it does not collect PHI, but "collects anonymous usage data and sends it to a data provider. This feature can be disabled through the app's settings screen at any time." Further, "all individually identifiable data enetered by you remains your sole property and will nto be accessed by VA...it is your responsibility to secure any information captured...on your device."
Can you opt out of data collection or delete data?
It appears to be so. "If you would like to turn off sending this anonymous usage information, go to the Settings menu, look for "Anonymous Usage Data," and flip the switch to the "off" setting."
Is data maintained in the device or on the web?
Data appear to be stored on the device.
Does the app explain security systems used?
None that these reviewers could find.
What third parties does the app share data with?
For statistical purposes, the VA collects anonymous usage data and sends it to an unidentified data provider. This feature can be disabled at any time.
If appropriate, is the app equipped to respond to potential harms or safety concerns?
The reviewers were unable to find any in-app features designed torespond to potential harms or safety concerns.
Clinical Foundation
Does the app appear to do what it claims to do?
Yes, it supports Cognitive-Processing Therapy, an evidence-based psychotherapy for PTSD.
Does the app have a clinical/recovery foundation relevant to your intended use?
Yes, CPT is established in the literature, which is relevant to those who wish to use the app as supplemental treatment for patients with PTSD.
Is the app content correct, well-written, and relevant?
The content appears to be correct. Reviewers report that the interface can be "clunky."
What are the relevant sources or references supporting the app use cases?
There is significant literature on CPT that is referenced, but the reviewers could not find anything specifically evaluating the app (e.g., the app references the CPT manual).
Was there an attempt to validate app usability and feasibility?
The reviewers searched through various literature databases and found the app mentioned, but were unable to find usability or feasibility validations, specifically.
Usability
Does the app seem easy to use?
Yes, according to these reviewers, though some interface features seem "clunky."
What are the main engagement styles of the app?
Like traditional CPT, the app has a feature similar to a work book, areas for patients to complete homework and assignments, mood tracking, etc, all of which are intended to reinforce in-person therapy.
Do the app and its features align with your needs and priorities?
It is in alignment with the population it serves (though not necessarily for these reviewers).
Is it customizable?
No.
Does the app clearly define its functional scope?
Yes, it clearly is intended as adjunctive CPT for in-person therapy, as mentioned elsewhere in this review.The app is not intended to be used for self-help and should be used under the guidance of a professional mental healthcare provider.
Therapeutic Goal
Can data be easily shared and interpreted in a way that's consistent with the stated purpose of the app?
The reviewers were unable to find any funcions of the app that allow for exporting data.
Do you own your data?
Yes.
Can the app share data with EMR and other data tools (Apple HealthKit, FitBit)?
The app does not appear to support these features.
Is the app for individual use or to be used in collaboration with a provider? If intended to be used with a provider, does the app have the ability to export or transfer data?
The app is intended to be used with a provider, but the app does not appear to be able to export data.
Does the app lead to any positive behavior change or skill acquisition?
These reviewers think that it could lead to positive behavior change, but there are no data to support this empirically.
Does the app improve therapeutic alliance between patient and provider?
App is meant to be used in conjunction with provider, so possibly; but the reviewers note that no information about patient safety within app. The app doesn't ask about suicidality (even in high risk patients) but also doesn't provide other information or resources on self-harm.