What I Wish More Mental Health Tech Companies Asked a Clinician

After years inside the therapy room — and years watching the mental health tech space from there — here are the questions I think would change everything.

I've been following the mental health technology space closely for years — from inside a therapy room, which turns out to be a useful vantage point.

I watch what tools my clients are using between sessions. I see what helps them stay regulated, track their patterns, and feel supported when I'm not available. I also see where the tools fall short — not because they're poorly made, but because the problems they're solving are genuinely hard, and some of the hardest parts aren't visible from outside a clinical context.

I've been thinking about how to bridge that gap — how the things I observe daily in clinical practice could be useful to the people building the next generation of mental health tools. And I keep coming back to the same realization: the questions that would matter most are rarely the ones being asked.

So here, offered in the spirit of genuine collaboration, are the questions I wish more mental health tech companies would bring to clinicians.

"What actually happens when insight doesn't lead to change?"

This is the question I find myself returning to most often — in sessions, in my research, and in my own clinical framework.

There's a moment that happens regularly in therapy: a client finally understands, clearly and articulately, exactly why they do the thing they keep doing. It's a real breakthrough. And then they come back the following week having done it again.

Insight arrived. Change didn't follow.

I call this the insight-action gap, and it's the central problem of my clinical work. It's also, I'd argue, one of the most underexplored problems in mental health product design.

Most mental health tools are designed to generate insight. Very few are designed for what comes after — the harder, slower, more relational work of actually changing.

The reason is structural. Insight is trackable, scalable, and satisfying to users in the short term. Change is nonlinear, often uncomfortable, and hard to attribute to any single intervention. But if the product helps someone understand their pattern more clearly without helping them shift it, something important is missing.

Clinicians think about this constantly. It's the kind of question that could reshape feature prioritization, engagement metrics, and what outcomes you choose to measure — if it were asked early enough in the process.

"What do your clients do with our tool that surprises you?"

This is a more practical question, but it gets at something important about the gap between intended use and actual use.

Clinicians who recommend digital tools to clients are, effectively, running informal field research on your product every week. We see which features clients actually engage with versus which ones they abandon. We hear what they say about the experience — what felt helpful, what felt hollow, what accidentally made things worse.

We also see the unintended consequences. The mood-tracking app that became a source of anxiety rather than self-awareness. The journaling tool that a client used to ruminate rather than reflect. The meditation app that a trauma survivor found dysregulating rather than calming.

None of that shows up in your engagement data. It shows up in therapy sessions — if you have a way to get it out.

Building formal feedback loops with practicing clinicians — not just surveying users, but actually talking to the therapists who see those users weekly — is one of the highest-leverage things a mental health tech company could do. The signal quality is extraordinary. And almost nobody is doing it systematically.

"Are we measuring the right things?"

Engagement metrics are seductive. Session length, daily active users, streak completion, self-reported mood improvement — these are measurable, they're comparable across products, and they feel like evidence that something is working.

But from a clinical standpoint, they're measuring proximity to the problem, not resolution of it. A client who is highly engaged with a mental health app and still unable to change a destructive pattern six months later is not a success story — even if their mood scores are trending positive.

The outcomes that matter clinically are harder to measure: improved relational functioning, reduced avoidance, greater capacity to tolerate distress without acting on it, increased access to the parts of oneself that have been shut down. These don't resolve neatly into a dashboard metric.

But that doesn't mean they can't be tracked. It means the measurement instruments need to be designed with clinical input, not just data science input. There's a real opportunity here for companies willing to invest in outcome measurement that actually reflects what change looks like.

"Who are we not reaching, and why?"

The people for whom the access gap is most acute — those with the most serious and complex presentations — tend to be the hardest to reach with digital tools, and the least represented in product development conversations.

Most mental health apps are well-suited to what clinicians call the worried-well: people with mild-to-moderate symptoms, reasonable insight, and the executive function to engage consistently with a self-directed tool. That's a real and meaningful population. But it's not where the crisis is.

The people who need help most urgently — those with significant trauma histories, complex PTSD, dissociative symptoms, severe depression — are often the ones for whom standard digital mental health tools are least appropriate, and sometimes actively contraindicated.

Knowing who your product isn't for is just as strategically important as knowing who it is for. Clinicians can help you draw that line accurately.

This isn't about limiting the scope of what you build. It's about building with integrity — and about not accidentally causing harm to the people who are most vulnerable to it.

The Larger Opportunity

I want to be honest about why I'm writing this.

I'm a clinician who has spent years at the intersection of psychotherapy, technology, and the question of what change actually requires. I've built a clinical framework around that question. I've been creating content about it, presenting research on it, and thinking about how to bring it into the technology space in a way that's genuinely useful.

And I believe — more than I used to — that the best mental health technology of the next decade will be built by teams that include people like me. Not as advisors who review a product after it's built, but as genuine collaborators who help shape the questions from the beginning.

The companies that will define this field are the ones curious enough to ask what they don't know — and humble enough to bring in the people who do.

If you're building in this space and these questions resonate, I'd genuinely love to connect.

About the Author

Dominic Gadoury is a Licensed Master Social Worker (LMSW) in private practice in the Hudson Valley and New York, NY, and the founder of MetaTherapy — a clinical framework and content platform at the intersection of Internal Family Systems, technology, and nature-based approaches. His poster "When Insight Isn't Enough: A MetaTherapy Framework for Addressing Stuckness" was accepted for presentation at the 2026 APA Annual Convention. He is available for clinical advisory, product consultation, and content collaboration in the behavioral health technology space.