June 2022
In this installment of “Let’s Get Technical,” our panel of experts review three culturally tailored emotional and mental wellness apps: Exhale, Liberate, and Shine.
June 2022
Improving population health requires that health care professionals address the marginalization of vulnerable people. Culturally adapted health care is one solution to addressing disparities in mental health utilization by members of underserved groups. Culturally adapted health care is care that has been tailored to take into consideration patients’ norms, beliefs, values, and language. Culturally adapted interventions have been found to improve health outcomes, including mental health, and increase patient satisfaction.
In this installment of “Let’s Get Technical,” our panel of experts review three emotional/mental health wellness apps that have been tailored for traditionally marginalized or underserved groups. For each app, we provide guidance on several background factors practitioners should consider when recommending apps for their patients. Next, our panel of psychologists share their own ratings, reviews, and thoughts for how these apps can be incorporated into mental health care.
Exhale is an app focused on the emotional well-being of Black, Indigenous, and Women of Color created by women of color. The app offers several categories of resources including meditations, guided imagery, breath work, affirmations, and coach talks. Within each category, save for the Affirm section, there are at least four recorded meditations. The meditation sessions focus on topics of microaggression, stress, soul medicine, and others. Daily notifications such as reminders for self-care and affirmation statements are sent through the app.
Exhale is available on iOS and Android and is free to all users, however, the website indicates that additional premium paid content may be in the works.
The Exhale app is a supportive resource for women of color clients who are interested in developing or deepening a meditation practice or starting a healing journey. This would be a great resource for psychologists who are working with the target audience. The narrator’s voice is soothing, and the quality of the sound recordings is excellent. The content that is on the app is empowering and affirming, however, there is a limited amount of content. Additionally, the functions are very basic.
—Charmain F. Jackman, PhD
I am neutral on recommending this app to other psychologists. As a Black woman psychologist, I appreciate the visual feel of the app and the use of affirmations and breath work as a brief coping skill. The included explanation of how and why breathing exercises are helpful is important in laying the foundation of breath work and mindfulness as a practice. However, there are more robust apps that offer these skills, albeit with less focus on Black women. The creator/developer does not disclose if she has any credentials as a certified coach. I would be more likely to recommend this app if I knew more about the training of the content creator and/or the evidence supporting the resources.
—Jessica L. Jackson, PhD
Liberate is a meditation app designed for the Black community. The app provides meditation practices and recorded talks that are created by persons of color. The content is organized into 18 categories that cover topics such as anxiety, anger, mindfulness, depression, and sleep. Additionally, the app includes topics that speak to identity and experiences of racism such as race, pride, masculinity, and microaggressions. For example, within the pride category, the meditations/talks titles are “Queer Pride & Love” and “Transgender Solidarity” and within the race category, meditations/talks include “Healing from Racial Trauma” and “Racism Through a Buddhist Lens.” Liberate also offers a community aspect where users can comment on the meditation. Users can interact with each other by liking a comment.
Liberate is available on iOS and Android. Three meditations are available at no-cost. Monthly subscription for all content is $9.99 (discounts available for an annual membership).
Liberate is an app where individuals from the BIPOC and/or 2LGBTQ+ communities may find community. Psychologists can share the meditations from the app with their clients as they are led with authenticity, rawness, and vulnerability towards social justice and social change. The app provides imagery reflective of the community and teachers that are heavily involved in meditation and passionate about multiculturalism and social change. I found this app to be impactful and found myself reflecting on my own experiences, emotions, thoughts, and memories. There are specific spaces in therapy where these meditations and this app are highly helpful. I hope that others will find Liberate and that its community will continue to keep growing. It’s important not only to have spaces of safety but that these spaces are reflective of yourself.
—JoAnna Romero Cartaya, PhD
I have been recommending Liberate to clients and workshop attendees for some time and definitely recommend it to psychologists and people looking to start or deepen a mindfulness or meditation practice. It is affirming and empowering to have meditation and mindfulness resources that explicitly address race and racism within the current context, especially in an industry where White facilitators are prevalent. Liberate’s teachers, who all identify as BIPOC, have extensive experience as meditation practitioners, which increases trust in the content and teachers. The app is easy to use and the content is very relevant to our current context. In addition to the talks and meditations, Liberate offers users a community to engage with each other.
—Charmain F. Jackman, PhD
Shine is a mental health wellness app focusing on managing stress and anxiety through meditations, self-care, and community support. Shine was built with inclusion and diversity at the forefront so that those from traditionally marginalized groups have an app where they can see themselves reflected in the content, and the voices of those creating and providing the content. There are mental health playlists specifically for a variety of groups including Latinx, Black, AAPI+, and LGBTQ+.
The app offers daily meditations and texts, audio clips, self-care “courses,” and virtual workshops. It also includes pop-up daily mental health wellness checks and opportunities to personalize content based on responses to individual concerns (e.g. work, school, relationship with self, friends and family, parenting, and romantic relationships) and goals or intentions (e.g. managing stress and anxiety, prioritizing self-care, feeling more confident, loving my authentic self, and taking time to rest). There are additional resources on health and fitness, including sleep. There is a Facebook group (free) and a VIP community (behind a paywall) for user interactions and personal conversations
Shine is available on both Apple and Android devices. A 7-day free trial is available, followed by a monthly subscription fee of $14.99 or $69.99 annually to access all content. A daily meditation, daily article, and gratitude log are available free of charge.
Shine is an outstanding resource for psychologists and other mental health professionals working with individuals during therapy and as an adjunct to therapy. It does much more than address anxiety and stress, using a mindfulness and self-care focus, centering BIPOC voices and experiences while being strong for all users. It could be described as a holistic and self-reflective guidance system based on solid psychological practices and research. Though only offered in English, the conversational style of the app is particularly engaging, feeling less bot-like than many apps, often encouraging deeper thought, reflection, and strategies, rather than quick and limited solutions that I have seen on other apps.
—Mary O’Leary Wiley, PhD, ABPP
I would recommend this app to other psychologists, especially those working closely with marginalized and minority populations. Shine provides a sense of community, empowerment, and hope towards building increased resilience and management of stress, anxiety, and depression. As a woman, a person of color, and new second time mother, I teared up when I first began engaging with the app. I didn’t realize how powerful the experience could be to feel represented by people who look like me and how much I had yearned for a space, albeit virtual, to be surrounded by others who find reasons, meaning, and purposes to literally Shine and show up even when anxiety or fear is present. Each meditation that I did on Shine content was helpful and provided a reflective space to contemplate and build more space for my own self-care and self-awareness.
—JoAnna Romero Cartaya, PhD
Categories rated from 1–5, with 5 being the most positive score
Privacy/Security |
If applicable, do the creators acknowledge that providers need to be HIPAA compliant? Is there a privacy policy? Is data collected, stored, shared? Is data deidentified? Can you opt out? Is there a security policy? Data encryption? |
1 - HIPAA relevant and ignored, no privacy policy, etc.
|
Evidence Base |
Is there any research support for the product? Is it peer-reviewed? Between-group design experiments? Who provided the funding for the research? |
1 - No research evidence
|
User Feedback |
What are current user feedback/ratings? |
1 - Very negative reviews
|
Categories rated from 1–5, with 5 being the most positive score
Purpose |
What is the proposed intervention or what does it claim to do? Is it likely to do what it claims? What aspects support that it will or will not do what it claims? |
1 - Highly unlikely
|
Appropriateness of Content |
Is the content appropriate for the target population? Does the content match the description and purpose? If it claims to follow a specific psychological approach or techniques, does it? Were any clinical/psychology experts involved in the development of the material? |
1 - Very inappropriate
|
Cultural Responsiveness |
Did the app/software consider a variety/range of cultural factors (e.g., age, race, ethnicity, gender, gender identity, sexual orientation, ability levels) in the development? Is the app/software likely to appeal to people from different cultural backgrounds? Is it available in multiple languages? |
1 - Very unresponsive
|
Ease of Use |
Is it easy to navigate? Is it customizable? What was the patient experience using it? |
1 - Very difficult
|
Functionality |
Does it perform well? Does it need the internet to work? Can you export/download your data? |
1 - Very poor
|
Applications reviewed April 2022
The views expressed in this column are the views of the authors and do not reflect the views of APA or any of its divisions or subunits. All authors have no financial interests in the apps or software discussed. APA does not recommend or endorse any practitioners, products, procedures, opinions, or other information that may be mentioned in this column; those who use these applications or products do so at their own risk. Please direct updates and feedback about mental health technologies to Office of Health Care Innovation staff.