Table 2.

Recommendations for future mental health apps.

Evidence	Recommendation	Details
Demonstrably effective, but more research needed in MHapp field	1. Cognitive behavioral therapy based	Start with an evidence-based framework to maximize effectiveness
	2. Address both anxiety and low mood	Increases accessibility and addresses comorbidity between anxiety and depression. Also compatible with transdiagnostic theories of anxiety and depression
Probably effective, but more research needed in MHapp field	3. Designed for use by nonclinical populations	Avoiding diagnostic labels reduces stigma, increases accessibility, and enables preventative use
	4. Automated tailoring	Tailored interventions are more efficacious than is rigid self-help
	5. Reporting of thoughts, feelings, or behaviors	Self-monitoring and self-reflection to promote psychological growth and enable progress evaluation
	6. Recommend activities	Behavioral activation to boost self-efficacy and repertoire of coping skills
	7. Mental health information	Develop mental health literacy
	8. Real-time engagement	Allows users to use in moments in which they are experiencing distress for optimum benefits of coping behaviors and relaxation techniques
Supported by theory and indirect evidence but focused research needed	9. Activities explicitly linked to specific reported mood problems	Enhances understanding of cause-and-effect relationship between actions and emotions
	10. Encourage nontechnology-based activities	Helps to avoid potential problems with attention, increase opportunities for mindfulness, and limit time spent on devices
	11. Gamification and intrinsic motivation to engage	Encourage use of the app via rewards and internal triggers, and positive reinforcement and behavioral conditioning. Also links with flourishing
	12. Log of past app use	Encourage use of the app through personal investment. Internal triggers for repeated engagement
	13. Reminders to engage	External triggers for engagement
	14. Simple and intuitive interface and interactions	Reduce confusion and disengagement in users
	15. Links to crisis support services	Helps users who are in crisis to seek help
Necessary for validation of principles	16. Experimental trials to establish efficacy	It is important to establish the app’s own efficacy before recommending it as an effective intervention