App offers mental health support for carers

An app for carers of young people with mental illness appears to enable therapeutic bonds to grow between users and the app.

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Carers of young people diagnosed with anxiety and depression benefit from online help, which includes therapy modules, social networking with other carers, peer and expert advice, and interactive problem-solving.

The carers used an app called Meridian. It was designed by Dr Simon D’Alfonso and Professor Reeva Lederman from the Melbourne School of Engineering in collaboration with carers and other researchers. Meridian uses the Moderated Online Social Therapy (MOST) web platform. MOST was developed by Orygen, a youth mental health organisation.

Carers of young people with mental illness often experience high levels of stress. They are also more likely to experience mental illness themselves. It can be difficult for them to access support because they are often time-poor.

Meridian’s design draws on the principles of self-determination theory, which outlines three basic psychological needs: control over our own lives; connection to others; and competence to manage our own environments effectively.

The researchers tested Meridian with 21 carers of young people with mental illness. The carers used the app for three months and then reported back to the researchers. The carers’ self-reported stress levels were significantly lower after using the app. The carers felt that Meridian provided a safe and trusted place to connect with other people experiencing similar challenges. They valued being able to use Meridian at their own pace, in their own time. They also developed a relationship with the app that was similar to the ‘therapeutic alliance’ that develops between psychologists and their clients. This relationship is key to delivering effective therapy.

These results suggest that technology can offer effective, low-cost and accessible mental health support.

This trial was led by Professor John Gleeson from the Australian Catholic University.

In 2019, Professor Lederman and Dr D’Alfonso hosted the #digitalta2019 symposium on the digital therapeutic alliance, with a corresponding special issue of the journal JMIR Mental Health.

Next steps

The therapist-patient relationship, known as the ‘therapeutic alliance’, plays an important role in psychological therapy. It must function well for therapy to be successful. As mental healthcare adopts digital therapies, sometimes without human counsellors, the way users relate to these technologies must be understood. The team is researching this relationship, known as the ‘digital therapeutic alliance’. Understanding it better will help build more effective digital mental healthcare technologies.


Headspace Service Improvement Project Grant

NHMRC Career Development Fellowship (APP1082934) to Professor Mario Alvarez-Jimenez

NHMRC Career Development Fellowship (APP1061998) to Professor Sue Cotton


Lederman R et al (2019) Support for carers of young people with mental illness: design and trial of a technology-mediated therapy. ACM Transactions on Computer-Human Interaction (TOCHI)26(1), pp.1-33. doi: 10.1145/3301421

Gleeson J et al (2017) Moderated online social therapy: A model for reducing stress in carers of young people diagnosed with mental health disorders. Frontiers in Psychology 8: 485. doi: 10.3389/fpsyg.2017.00485

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First published on 10 March 2022.

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