{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:36:25Z","timestamp":1793529385477,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Mental health care has been enriched with the progressive use of technology during the last ten years, in particular after the COVID-19 pandemic. Mobile applications (apps) and smartphones have become the most widespread access point for many people who look for self-help in the psychological domain. Objective: We focused on a systematic review of mobile apps for mental health, focusing on the blending of apps with psychotherapy contexts, with a specific focus on emotional dysregulation. Methods: A comprehensive literature search (January 2017 to August 2022) in PubMed, PsycInfo, Web of Science, and the Cochrane Library was conducted. Abstracts were included if they described mental health mobile apps targeting emotional dysregulation and their use during ongoing psychological or psychotherapy treatment for adults and adolescents. Results: In total, 397 abstracts were identified; of these, 19 publications describing apps targeting borderline personality disorder, depression, anxiety, suicidal behaviors, and post-traumatic stress disorders met the inclusion criteria. Conclusions: App-enhanced psychotherapy might be a winning combination in many scenarios, but at the same time, many issues must still be faced in this yet emerging scientific field. In conclusion, we tried to put together some major guidelines for mental health mobile app development in the context of psychological treatments.<\/jats:p>","DOI":"10.3390\/ijerph20021431","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T01:30:26Z","timestamp":1673573426000},"page":"1431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["A Systematic Review of Mobile Apps as an Adjunct to Psychological Interventions for Emotion Dysregulation"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-2321","authenticated-orcid":false,"given":"Federico","family":"Diano","sequence":"first","affiliation":[{"name":"Department of Human Studies, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5587-8097","authenticated-orcid":false,"given":"Luigia Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Department of Human Studies, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2451-9539","authenticated-orcid":false,"given":"Michela","family":"Ponticorvo","sequence":"additional","affiliation":[{"name":"Department of Human Studies, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09638237.2020.1757052","article-title":"COVID-19 and its mental health consequences","volume":"30","author":"Kumar","year":"2021","journal-title":"J. Ment. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101806","DOI":"10.1016\/j.jcrimjus.2021.101806","article-title":"Domestic violence during the COVID-19 pandemic-Evidence from a systematic review and meta-analysis","volume":"74","author":"Piquero","year":"2021","journal-title":"J. Crim. Justice"},{"key":"ref_3","first-page":"137","article-title":"Mental health outcomes of the COVID-19 pandemic","volume":"55","author":"Talevi","year":"2020","journal-title":"Riv. Psichiatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S2215-0366(20)30307-2","article-title":"How mental health care should change as a consequence of the COVID-19 pandemic","volume":"7","author":"Moreno","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"523","DOI":"10.3389\/fpsyt.2020.00523","article-title":"The need for a mental health technology revolution in the COVID-19 pandemic","volume":"11","author":"Figueroa","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Phillips, E.A., Himmler, S., and Schrey\u00f6gg, J. (2022). Preferences of psychotherapists for blended care in Germany: A discrete choice experiment. BMC Psychiatry, 22.","DOI":"10.1186\/s12888-022-03765-x"},{"key":"ref_7","first-page":"97","article-title":"Towards a consensus around standards for smartphone apps and digital mental health","volume":"18","author":"Torous","year":"2019","journal-title":"World Psychiatry Off. J. World Psychiatr. Assoc. (WPA)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.copsyc.2020.04.008","article-title":"Smartphone apps for the treatment of mental health conditions: Status and considerations","volume":"36","author":"Huckvale","year":"2020","journal-title":"Curr. Opin. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1037\/pro0000122","article-title":"Evidence-based apps? A review of mental health mobile applications in a psychotherapy context","volume":"48","author":"Lui","year":"2017","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1037\/ccp0000604","article-title":"Reassessing evidence-based content in popular smartphone apps for depression and anxiety: Developing and applying user-adjusted analyses","volume":"88","author":"Wasil","year":"2020","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_11","unstructured":"Diano, F., Ferrara, F.M., and Calabretta, R. (2019, January 25\u201326). The development of a mindfulness-based mobile application to learn emotional self-regulation. Proceedings of the Psychobit, Naples, Italy."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e399","DOI":"10.2196\/jmir.8598","article-title":"Assessing the efficacy of mobile health apps using the basic principles of cognitive behavioral therapy: Systematic review","volume":"19","author":"Rathbone","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.beth.2019.10.002","article-title":"Can acceptance, mindfulness, and self-compassion be learned by smartphone apps? A systematic and meta-analytic review of randomized controlled trials","volume":"51","author":"Linardon","year":"2020","journal-title":"Behav. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.beth.2011.01.003","article-title":"A pilot study of the DBT coach: An interactive mobile phone application for individuals with borderline personality disorder and substance use disorder","volume":"42","author":"Rizvi","year":"2011","journal-title":"Behav. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.2196\/mental.7785","article-title":"Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial","volume":"4","author":"Fitzpatrick","year":"2017","journal-title":"JMIR Ment. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e14318","DOI":"10.2196\/14318","article-title":"Counseling with guided use of a mobile well-being app for students experiencing anxiety or depression: Clinical outcomes of a feasibility trial embedded in a student counseling service","volume":"7","author":"Broglia","year":"2019","journal-title":"JMIR mHealth uHealth"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.cbpra.2017.05.004","article-title":"Development and preliminary feasibility study of a brief behavioral activation mobile application (Behavioral Apptivation) to be used in conjunction with ongoing therapy","volume":"25","author":"Dahne","year":"2018","journal-title":"Cogn. Behav. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1177\/0145445517719661","article-title":"Evaluating an adjunctive mobile app to enhance psychological flexibility in acceptance and commitment therapy","volume":"41","author":"Levin","year":"2017","journal-title":"Behav. Modif."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.beth.2018.12.003","article-title":"Pilot randomized trial of a self-help behavioral activation mobile app for utilization in primary care","volume":"50","author":"Dahne","year":"2019","journal-title":"Behav. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1176\/appi.ajp.2018.17101151","article-title":"As Safe as Possible (ASAP): A brief app-supported inpatient intervention to prevent postdischarge suicidal behavior in hospitalized, suicidal adolescents","volume":"175","author":"Kennard","year":"2018","journal-title":"Am. J. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e28874","DOI":"10.2196\/28874","article-title":"Mobile Diary App Versus Paper-Based Diary Cards for Patients With Borderline Personality Disorder: Economic Evaluation","volume":"23","author":"Laursen","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e1941","DOI":"10.7205\/MILMED-D-17-00063","article-title":"Using a mobile application in the treatment of dysregulated anger among veterans","volume":"182","author":"Mackintosh","year":"2017","journal-title":"Mil. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.beth.2018.07.007","article-title":"Testing an app-assisted treatment for suicide prevention in a randomized controlled trial: Effects on suicide risk and depression","volume":"50","author":"Arendt","year":"2019","journal-title":"Behav. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jad.2021.02.007","article-title":"A therapist-guided smartphone app for major depression in young adults: A randomized clinical trial","volume":"286","author":"Raevuori","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e13479","DOI":"10.2196\/13479","article-title":"Development of an ambulatory biofeedback app to enhance emotional awareness in patients with borderline personality disorder: Multicycle usability testing study","volume":"7","author":"Derks","year":"2019","journal-title":"JMIR mHealth uHealth"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/1039856220924321","article-title":"B\u00b7 RIGHT: Usability and satisfaction with a mobile app for self-managing emotional crises in patients with borderline personality disorder","volume":"29","author":"Palma","year":"2021","journal-title":"Australas. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e18439","DOI":"10.2196\/18439","article-title":"A mobile phone\u2013based app for use during cognitive behavioral therapy for adolescents with anxiety (MindClimb): User-centered design and usability study","volume":"8","author":"Newton","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/ppc.12178","article-title":"EMOTEO: A smartphone application for monitoring and reducing aversive tension in borderline personality disorder patients, a pilot study","volume":"53","author":"Prada","year":"2017","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e14913","DOI":"10.2196\/14913","article-title":"Mobile app integration into dialectical behavior therapy for persons with borderline personality disorder: Qualitative and quantitative study","volume":"7","author":"Austin","year":"2020","journal-title":"JMIR Ment. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.beth.2020.04.013","article-title":"HabitWorks: Development of a CBM-I smartphone app to augment and extend acute treatment","volume":"52","author":"Beard","year":"2021","journal-title":"Behav. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jad.2020.12.012","article-title":"Development and Open Trial of a Technology-Enhanced Family Intervention for Adolescents at Risk for Mood Disorders","volume":"281","author":"Miklowitz","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.jad.2022.05.094","article-title":"App-enhanced transdiagnostic CBT for adolescents with mood or psychotic spectrum disorders","volume":"311","author":"Weintraub","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e14284","DOI":"10.2196\/14284","article-title":"Long-term outcomes of a therapist-supported, smartphone-based intervention for elevated symptoms of depression and anxiety: Quasiexperimental, pre-postintervention study","volume":"7","author":"Economides","year":"2019","journal-title":"JMIR mHealth uHealth"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Schiffler, T., Seiler-Ramadas, R., \u0160tefanac, S., Haider, S., M\u00fces, H.M., and Grabovac, I. (2022). Implementation of a Mobile DBT App and Its Impact on Suicidality in Transitional Age Youth with Borderline Personality Disorder: A Qualitative Study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19020701"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/wps.20442","article-title":"The third wave of cognitive behavioral therapy and the rise of process-based care","volume":"16","author":"Hayes","year":"2017","journal-title":"World Psychiatry"},{"key":"ref_36","first-page":"393","article-title":"Cognitive and cognitive-behavioral therapies","volume":"6","author":"Hollon","year":"2013","journal-title":"Bergin Garfield\u2019s Handb. Psychother. Behav. Chang."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10608-012-9476-1","article-title":"The efficacy of cognitive behavioral therapy: A review of meta-analyses","volume":"36","author":"Hofmann","year":"2012","journal-title":"Cogn. Ther. Res."},{"key":"ref_38","unstructured":"Beck, J.S. (2020). Cognitive Behavior Therapy: Basics and Beyond, Guilford Publications."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.brat.2007.12.005","article-title":"Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis","volume":"46","year":"2008","journal-title":"Behav. Res. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cpr.2005.07.003","article-title":"The empirical status of cognitive-behavioral therapy: A review of meta-analyses","volume":"26","author":"Butler","year":"2006","journal-title":"Clin. Psychol. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1001\/archpsyc.1991.01810360024003","article-title":"Cognitive-behavioral treatment of chronically parasuicidal borderline patients","volume":"48","author":"Linehan","year":"1991","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_42","unstructured":"Linehan, M. (2014). DBT Skills Training Manual, Guilford Publications."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1146\/annurev.clinpsy.2.022305.095229","article-title":"Dialectical behavior therapy for borderline personality disorder","volume":"3","author":"Lynch","year":"2007","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_44","unstructured":"Hayes, S.C., Kirk, D.S., and Kelly, G.W. (2011). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change, Guilford Press."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1002\/jclp.20237","article-title":"Mechanisms of mindfulness","volume":"62","author":"Shapiro","year":"2006","journal-title":"J. Clin. Psychol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Siegel, R.D., Germer, C.K., and Olendzki, A. (2009). Mindfulness: What is it? Where did it come from. Clinical Handbook of Mindfulness, Springer.","DOI":"10.1007\/978-0-387-09593-6_2"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.pec.2004.09.008","article-title":"Establishing the computer-patient working alliance in automated health behavior change interventions","volume":"59","author":"Bickmore","year":"2005","journal-title":"Patient Educ. Couns."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/cp.12102","article-title":"The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist\u2019s perspective","volume":"22","author":"Richards","year":"2018","journal-title":"Clin. Psychol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"180436","DOI":"10.1155\/2015\/180436","article-title":"New Technologies for the management and rehabilitation of chronic diseases and conditions","volume":"2015","author":"Castelnuovo","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_50","first-page":"1557","article-title":"Chronic care management of globesity: Promoting healthier lifestyles in traditional and mHealth based settings","volume":"6","author":"Ecastelnuovo","year":"2015","journal-title":"Front. Psychol."},{"key":"ref_51","unstructured":"Horvath, A.O., and Greenberg, L.S. (1994). The Working Alliance: Theory, Research, and Practice, John Wiley & Sons."},{"key":"ref_52","unstructured":"Muran, J.C., and Barber, J.P. (2011). The Therapeutic Alliance: An Evidence-Based Guide to Practice, Guilford Press."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1431\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:04:41Z","timestamp":1760119481000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,12]]},"references-count":52,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20021431"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20021431","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,12]]}}}