Launch HN: Inflow (YC S21) – Self-help app for people with ADHD

> CAUTION: After the free trial period (7 days), they will charge for an annual subscription ($102.95 US). This is OPT OUT, not opt in. In other reviews they say they will offer a refund (I will update when/if I get one) but for an app for people with executive function issues, an opt out format seems shady. Either way, I won't be purchasing this for my loved one with the opt out format for payment.

> They exploit the same vulnerability of the patients, they aim to cure! They take you in confidence and then charge you after the trial ends. ADHD folks forget things all the time and it's a challenge for them. An email reminder is not going to cut it. We have thousands of emails in our inbox. This is profiteering from the mental disability of others. Stay away. A pro-rata charge is a fairer policy for ADHD folks. Any ADHD book will be more useful for what is presented in this app anyway.

> Requires payment to be set up to use free trial... Seems a bit predatory on a mental health app for ADHD brains... We tend to forget things like canceling memberships. And of course they only tell you once you have wasted time making an account. SMH

> Why do you need a credit card to do a 7 day free trial? Why don't you take my card number if I want to continue after the 7 days? What if I forget to cancel, and forget to request refund? I see what you did there

Sounds like they're all making some very relevant points about the app payment model potentially exploiting the ADHD deficit in executive functioning, and the tendency of people with ADHD to unintentionally forget things like subscriptions and bill payments. How do you respond to these critiques?

Might as well come right out and say that they understand ADHD and plan to use its drawbacks to make money from people. Considering how desperate a lot of people are for treatment, this sounds like a great monetary investment for people with no conscience.

This may be a bit harsh. I'm a bit salty as navigating the process to get treatment for ADHD is a continual reminder that most services are tilted towards providing services to already well-functioning people. I probably will try it, after all you did just remind me to cancel my free Prime membership, even though it was right there in bold on my day planner a week ago.

I will sign up for subscription services fully well intentioned and then proceed to not use the service and forget to cancel it in time. I know myself well enough now to stay away from any product offering a subscription. There is no real “managing” it, it’s just a fact of life for me and something I live around.

An app targeting ADHD minds and not offering alternative payment options is arguably more predatory than the average free-to-play mobile app, as the founders of this app presumably know about the difficulties that ADHD cause and are either willingly ignoring it or actively exploiting it.

Even if it’s a honest accident, it leaves a bad enough taste in my mouth to stay far away.

I've never logged in.

In addition to these we also send email and notification reminders before the free trial ends and refund everybody who requests one.

I cancel all my credit cards every year just to get rid of all opt-in charges on regular basis

edit: There is also a monthly subscription option, in the Apple app store at least. It's $22 a month - so over twice as much as the annual. This does not give me to think the product here is less sketchy. And the Psy.D founder, Sachs, is a pretty blatant self-promoter of the sort endemic to the ADD/ADHD "coaching" space, if unusually well qualified by that standard: https://sachscenter.com/adult-child-psychiatrist-psychologis...

Perhaps it's less of a surprise than I initially found it that the account posting this Launch HN has thus far had nothing further to say.

also edit: Sachs is a Psy.D, not an MD. Granted, this does entitle him to "Dr." as a term of address, just as would a doctorate in physics, ancient history, or underwater basket-weaving. But, just as with any of those, it doesn't qualify him as a doctor in the generally understood sense. Again, this gives one reasonably to question, and the questions thus raised are ones for which well-prepared founders may reasonably be expected to provide compelling answers.

And on my phone at least, the monthly payment option is also hidden behind a scroll down action: https://i.imgur.com/rV0bMTH.jpg, with the yearly subscription already selected by default.

It would seem they're pushing quite strongly this annual payment option.

As someone who's worked on pricing models, this speaks either to very little thought to pricing or a monumental churn issue.

A hefty discount for an annual subscription is generally something like 20%, and companies with good retention only offer ~10%.

Discounting over 50% if someone chooses annual either tells me (1) this company is low on funding and desperately needs the immediate cash flow, or (2) this company can't retain customers and is really lacking product-market fit.

Old YC would have absolutely helped the founders straighten this out, but it seems YC is now just a big cash grab and rolodex in the form of Bookface.

I'm not too proud to admit that I spent a long time not really taking ADD/ADHD all that seriously. That was before I fell in love with someone who has ADD. Seeing on a daily basis the effect it has on him, and the extent to which, even with effective treatment, it remains a serious obstacle in terms of executive function and followthrough even for things he plainly cares a lot about - to say nothing of subscription fees, which even people without these disorders find easy enough to forget that tools for managing them constitute an entire genre in their own right...

Well, I'm really looking forward to seeing what the founders have to say for themselves here, if anything, and wondering what reasons they could give me not to warn my boyfriend off their product in the strongest of terms.

(Please dont kill me for the off-the-cuff idea:)

A per-login / frequency of use model;

You agree to a MAXIMUM of $100/year as WELL AS a max per month that may be charged (== to $100/12 max) -- but the idea is that if you skip a month or some amount of time you are not charged....

The usage is based on certain amount of time-in-app or somesuch....

you get the idea.

Anyway, as someone who has debilitating ADHD I really want to use this... but whilst not working, I can't pre-commit $100 to something that I may have too bad a case of ADHD to adopt on a regular.

Granted IAP isn't that flexible, or not to my knowledge, at least. But Stripe is right there, too.

They can pry that money out of my cold dead hands. And I've yet to have anything sent to collections

1. https://privacy.com/

Right now, and in the past, "YC-backed" has consistently been a very solid selling point, both for following rounds and in recruitment. Maybe it's just a transient bobble, and I strongly hope that proves true. Still, at this rate, I'm starting to wonder a little what "YC-backed" might come to mean a few years hence, and whether it'll still be worth the same.

I think this is sort of a broader start-up problem. Some things shouldn't be monetized (period, but for the sake of the audience, I'll add: at least not as aggressively as is required for a start-up).

Close, but a slight correction here:

Every medical device is sold with the intention of maximising profit, but they can't do nothing or people wouldn't buy them.

That more accurately portrays the priority.

Getting rid of all the time waste, all the stress of AD is worth a lot.

Do you forget when a game you're looking forward to is released? I don't. Never. I remember to download it as soon as it's released, regardless of any external reminder.

Now imagine a subscription that will charge $1,000,000 if you don't cancel it. Would you remember to cancel? Would I? I am pretty sure I would, with or without any external reminder.

This suggests that we have the ability to remember. It's not that we can't remember something we've agreed to, or to remember something that we want to. It's well within our power to do so. It's more annoying than hard. It's technically easy difficulty. It's far easier and far faster to set a calendar alert and click a few buttons than learning how to parry in Dark Souls. Or to simply refuse to agree to any of these subscription dark patterns. So I find this entire victimization pose to be distasteful, inaccurate and self defeating.

We're working on extending the free trial / moving to a freemium model.

Please. You aren't spaceX "working on" your next engine, or AMD "working on" the next processor architecture. All you have to do to end the unethical behavior is flip a few bits in a database. Don't pretend it's some kind of grand technical challenge.

You're luring in people who are trying to improve their mental health and tricking them out of their money. The product isn't even technically innovative. No idea why YC is compromising its brand like this.

First, the app stores are pretty prescriptive about how you handle introductory trials on subscriptions (especially Apple), which means you are usually stuck with "start trial + opt-out" as the only viable model if you're billing through the App Store.

Second, behavioral/commitment theory often shows that for apps or really any behavior change that requires some effort, a longer time commitment/investment gets people to actually invest the effort they need to actually get value out of the product. If you let people pay for a month, they won't actually put in any effort and then at the end of the month they'll be like "I'm not getting any value here" and they'll just cancel. They won't put in the effort to build the habits. So most wellness apps/products (from meditation/fitness apps to gym memberships) end up with some sort of free trial period, followed by an annual commitment (and if there's a monthly option, it's at a steep hike from the annual one).

Finally, when you're early on in the life of your startup, you're mostly trying to get to product-market fit and see whether people are willing to use / pay for what you've built. You just choose a pricing period/plan that makes sense, focus on the product, then when you get the product where you want, you go back and experiment with finding the ideal pricing plan for you and your users.

That said, it's clear in this case that this model may not be great for the target audience (in fact, even for neurotypicals, canceling subscriptions and such is still a challenge to manage). And obviously the app creators could have put more thought into it.

We ended up with an opt-out free trial plan as per Apple's rules on iOS, with a monthly plan where the yearly plan is a 25% discount if you choose it, and several reminders before the trial converts to paid. We also allow users to do a standard opt-in plan if they're not signing up through iOS (ie only need to put credit card after trial expires). We offer refunds where we can for people who got billed but didn't intend to, but Apple has to process those refunds too.

Probably not, because your users are people who will forget to cancel and then forget to tell you about that.

> Some people also like having the subscription because it is a pay per use model

What does this mean? It sounds like users are complaining that if they download the app and don't use it it charges them $100.

> Would love any suggestions on how to improve this.

Howabout when the free trial ends, at that time the user has to approve a charge before continuing to use the app.

- Why have you chosen to make users opt out of a subscription when the free trial ends, rather than letting them opt in?

- Why is the annual payment option pushed so hard, in favour of the monthly payment option?

I'm reiterating this because promoting an opt-in, monthly payment model (thus giving more opportunities for any unintentional ongoing payments to be noticed by the payer) seems to me to be the kindest approach to subscriptions for users with ADHD, and a model that would be most empathetic to their condition.

We're actually working on several different sign-ups flows at the moment including opt-in post free trial, longer free trial, web sign-up and one-off purchase vs subscription. It is not our intention to push annual significantly over monthly - we wanted to give a significant discount to yearly subscribers but perhaps the difference between the two is too large. The previously mentioned issue with scrolling is due to to a bug with small screen sizes on Android which we're working to fix.

As you have a number of people with ADHD working on your app, I would be curious to know if any of them raised concerns about these specifics of your subscription model, during planning and development of the app?

Your current model of opt-in subscriptions makes it clear you're looking for the best model for your bank account

There's no job shortage, so don't make excuses for them

I don't want them to do it for free. I want then to not make a predatory product. I want them to make their money through a more honest business

And if they can't do that, I want them to do nothing

(As for 'quoting you', it's called paraphrasing. I'd have hoped it was rather obvious I was not suggesting that you said those exact words.)

And thats why I don't want you quoting me or paraphrasing me. You're putting words into my mouth that I never said or even implied. And once again, I find it extremely insulting.

I'm going to make it clear so you don't do it again. I want then to make an honest business model and to stop this predatory one

Not my favorite model, but also probably not intentionally predatory towards a specific group of people.

From a business point of view it makes some sense. It extracts maximum money from customers in a niche that is inherently flakey (dieting, self-help, etc.). People often start off strong for a few weeks/months and flake out. Forcing a longer up-front commitment helps their bottom line, and possibly helps some customers stick with it since they already spent the money.

I'm not trying to defend it, but I do think it's a bit much to say it's intentionally predatory. From my view it's just app economy capitalism at work.

That inner voice telling you what to do or what not to do? ADHD brains have... well, let's just say "something else".. in its place.

Pretty much every description I’ve heard from people diagnosed with ADHD features the same kind of internal voice as neurotypical people describe; the “something else” seems to be between that voice and action, not in place of it.

My natural, pre-treatment, and unmedicated sub-/semi-conscious behaviour is not at all like that of a typical person.

Cost of Install: $7.00, for something this specific Trial Start Rate: 20%, if paywalled like this app is Cost Per Trial: $35 Conversion to Trial: 40% Cost Per Subscriber: $87.50

If they charge you $10/month, they can't get into the black on a new customer for 9 months. They have to eat support costs that whole time. It just doesn't work, when you're starting out. You must charge annual.

Medical licensing cartels charge $500-800 PER MONTH. These guys are trying to charge $100 PER YEAR.

This is an order of magnitude more effective.

Said another way: if someone is too poor for this, they're fucked. They're definitely too poor for any other treatment option. On the other hand, this will open up treatment to people who can't pay the medical cartels.

That's amazing, iterative progress.

Let's give props to these guys for making epic iterative progress, not shit on them because they're not working for free.

Basically the model here is like a gym, where people buy things that they don’t use as much as the price implies or is simply ineffective.

Given that the customers are executive function impaired, seems shady.

And 7 days is really too short to notice a sustained effect.

The whole point here is to help folks who are having trouble remembering to do things. Regardless of the economics, the optics here make this seem like exploitation.

Making this opt-in avoids a dark pattern. Folks with ADHD are often impulsive and strike while the iron is hot—if this has value people will opt-in.

Generally, giving users a toggle to get reminded when a trial is about to run out will INCREASE conversion rates.

That depends on the business, and is part of a pretty standard set of experiments you run post-launch.

With your comments you're part HN is descending into a circular firing squad of virtue signaling. These guys shipped something that could help a lot of people, over time they can improve their onboarding flow, lower cost.

Is the most remarkable thing about a really cool CBT tool for ADHD really that they have a standard trial flow?

Most startups aren't offering medical care. Call it "virtue signaling" if you like that those which do come in for a likewise unusual degree of scrutiny, but do you think you're likely to convince anyone that way?

I won't quibble with your analysis of the unit economics involved, but I will say that's not on point - this isn't a question of CAC/LTV but rather one of perception and image. My impression of Launch HN posts is that they are intended in part to elicit this sort of analysis, and by that metric this one has succeeded quite well. It seems like these founders didn't know they had this problem to solve, and now - if they're paying attention, which I assume they are - they do know. In what way is that other than a win?

You can have a great business model, you can have a good product, but if you can’t operate without alienating the people you want to sell to you’re probably dead in the water.

Your comments come off as entirely unempathetic. Not everything is about bottom line capitalism.

These guys are moving the needle making improvements in a forward direction, and a big part of this thread is shitting on their launch, hyper-focusing on things they'll be able to change.

Launch HN threads used to be about asking thoughtful questions, having a back and forth where people learn about new spaces, and encouraging people launching their startups.

This whole thread is concern trolling of the worst kind, to eyes.

I'll bow out since clearly the bulk of the thread disagrees.

Also the word is "empathy" not "emphatic".

The original announcement mentioned you folks have a neuro-diverse team, which I applaud and respect. I hope you really take advantage of this to dog-food your own product and on/offboarding processes to catch stuff like this going forward.

Keep at it! I'd love to see you succeed with this product.

One thing I find very off-putting, is the rose-coloured, almost "success guaranteed"-like image your website and app store page sketches.

This product is no wishing-well that your customerpatients can simply throw money at and magically feel better. For this to ever have any meaningful and lasting effect, they will have to put in some serious effort. This requirement should be very clearly communicated I feel.

Long-term dedication and commitment to a plan with uncertain results is not exactly what ADHD brains are known to excel at ;)

Edit: I also share the others' thoughts about your billing model not being very ADHD-friendly.

All-in-all, considering your listed expertise in this field, this is very concerning and not a good look at all.

That said, while everyone is up in arms about the payment model here, I'm more concerned with the nature of the app's content.

What I was expecting to be an interactive, attention-grabbing set of modules turned out to be a whole bunch of audio recordings and generic goal-setting form fields. I almost laughed when I was creating my first goal, because in the introduction video by the cofounder he makes a point to explain that, "Like many of you, I've invested in planners and organizers hoping that they would magically help me become more productive." Can someone from the team please explain how this app's first iteration is not simply the modern & digital version of planners and organizers? Which features will be able to help users with which ADHD side-effects?

To be frank, I had high hopes when I started this free trial, only to realize that it smells a bit like a newer version of the self-help tapes people would fall asleep to in the '80s.

This is a huge red flag for any self-help app.

Therapists should never try to build a dependency upon the therapist, yet it appears this app is structured to do just that: Convince users that external tools won't work for them, then capture their activity inside of an app with an expensive annual fee.

The purpose of therapy should be to give users the tools to support themselves. For example, showing users how to use traditional organizers in ways that are more compatible with their conditions and building a system of reminders and automatic habits to support that goal.

The incentive structure of this app is inherently in conflict with the traditional goal of therapy: Self-sufficiency.

In terms of our current features, we have: - Short daily learning exercises that tackle a range of ADHD topics - Challenges to support the development and tracking of habits to help manage ADHD - A community of like-minded individuals - Live weekly events with psychologists & coaches where you can get any of your questions answered, or participate in group meditation and coworking sessions.

We are also working on some new interactive features such as accountability buddies, accountability coaching, group-based challenges and routine building tools.

Can you explain succinctly how you help with OCD?

My main concern with any app is remembering to use it. I have a dozen or so alarms, and todo lists, and I still forget to check them. Beyond some push notification, what ways can your app help me remember to use it to make it a habit?

Re: reminders, one thing I've noticed with any sort of reminder system based on alerts/notifications, is that while they work for a while, eventually my brain just starts ignoring the alerts. I honestly have no great solutions for that. This applies to any sort of organizational system I've tried, actually.

I'll definitely check out airtags, thanks!

I have the opposite issue. I'm ... what do you call it? neurodiverse (at one time, I was an "aspie"), and I can actually get locked into a fugue, so strong, that hours go by like minutes.

In the aggregate, it has worked out OK. I'm a damn good programmer (but a total nerd).

I do have family that have suffered from ADHD, and hope that your app may be helpful.

The hardest part is making the appointments, if you have someone who will help you, ask them to. If you don't just force yourself.

Though as I put on another comment I might delete, ADHD isn't really about mundane vs interesting, at least not always. Sometimes I find myself focussed on the mundane, or ignoring the interesting and enjoyable. The pills aren't magic, and there is no cure, but if you suspect it I recommend finding help. Also, intense cardio exercise, high protein low carb diet, lots of water, and vitamins. I don't stick with any of them for long periods of time, but whenever I do it makes life easier.

I hope getting treatment was that easy for you as well.

Pair programming was a massive benefit as it kept me on task all day.

Being bored was a physical pain for me. Meds took that pain away. Even after I stopped meds I was much improved as I no longer had that pain Association with boredom. Jus regular tendency to get distracted easily.

This is the norm for ADHD as far as I can tell seeing how my kid behaves.

As I see it, ADHD is not an inability to focus, but an inability to control what you focus on.

Though back to hyper focus, it is a curse and a blessing. Without it, I would never get anything done personally or professionally. Though I will also ignore family, friends, and work for entire days on things that are meaningless and I don't enjoy.

Which really brings me to the core of ADHD. What you focus on has nothing to do with what you want, or what you enjoy. It is, to various degrees, out of your control.

That said, I'm going to give the app a try, I have had some ideas for an app myself, but haven't found the focus to work on it.

As a rough analogy, ADHD is to focus as bipolar disorder is to mood.

For example I am diagnosed as ADHD. But I feel I have some issues that put me on the autism spectrum. After doing a lot more in-depth reading I’m pretty convinced I am not autistic, even though many of my symptoms do intersect with autism.

Strongly encourage you read more books about ASD and autism and then seek professional advice if you believe it would make your life better.

Is this not a normal occurrence? I thought this is just how it is for everyone when they encounter a problem that captivates them.

Issues like you describe are difficult to self-diagnose and impossible for others to diagnose over the internet. You could have an ADHD-like etiology, maladaptive daydreaming, or you could have a seizure disorder. Undiagnosed seizure disorders can be particularly draining but are often easily treated.

Be wary of internet comments pushing you to a specific diagnosis, particularly ADHD. HN commenters frequently over-diagnose ADHD from comments about vague symptoms. Leave it to professionals who can evaluate you in person.

I have no interest in the app, but I agree that folks who believe they may have any type of issues like this, should start by seeking professional help.

One of the things about HFA and ADHD, is that they can go undiagnosed for a lifetime; which is not always a bad thing. We can often be extremely productive members of society; despite challenges.

A lot of times, the behaviors and habits we develop, as mitigations of the symptoms, can cause more problems that the issue, itself.

For one thing, he gets along with other folks, much better than I ever did.

1. primarily hyperactive (cannot stay physically still),

2. primarily inattentive (”daydreamer”),

3. combined type, with features from both 1. and 2.

Can I download this directly without signing into Google? I'm not a big Google or big tech supporter.

Also why does the front page of your app not explain precisely how it works and what it does? All it promises is an awesome black box to "helps". What does it even do exactly? Writing an increasingly complex "how it works section", like Fastmail had when I signed up or that great comic on cryptography, would be appropriate.

Is that real? Or the average cost in a city like NYC? My partner has been looking for this in the UK, and the cost is under half this (so long as you're not looking for a big-name London clinic)

The $200-$300 might refer to the price they bill to insurance companies, which is not the real price anyone pays. Insurance pays the higher of the billed cost or the allowed cost, so anyone billing insurance makes sure to bill much higher than the allowed cost to avoid leaving money on the table.

In practice, people with decent insurance will be paying $15-25 copays on average, not $200-300. I suspect their marketing material is being deliberately misleading in order to dissuade people from actual therapy, which is not cool. Wish they’d just market it as an adjunctive tool instead of a therapy replacement while trying to discourage people from going to therapy.

Between this and the $110 automatic charge if people forget to cancel the trial, this app feels like they let the “growth hackers” loose on the app instead of trying to be genuinely helpful.

Context: I helped build and launch CareDash’s telehealth marketplace, which serves the large national players in mental health in the US.

> "ADHD drugs, such as Adderall and Ritalin, increase levels of the brain chemical dopamine and provide mental stimulation. This, in turn, allows users to become more focused and calm because they no longer need to engage in self-stimulating behavior."

> "The number of young people abusing ADHD medication has been steadily increasing over the last five years, with almost 9 percent of high school seniors abusing and approximately 35 percent of college students in the same category. And unfortunately, this misuse does have consequences: Over 19,000 people have suffered from complications related to ADHD drugs since 2013."

It gets less attention than opiate abuse as deadly overdoses are much less common, but amphetamine addiction has major psychological effects - whether we are talking about street meth, ritalin, adderall, desoxyn, etc., the general effect is the same.

In addition, there's no clear diagnostic test for ADD/ADHD (no way to even distinguish between the two), it's just an opinion based on the subjective judgements of psychiatrists - and yes, just as with the opiate business, there are kickbacks with the pharma outfits and reckless prescription practices.

1. https://drugabuse.com/blog/spotlight-on-adhd-meds-and-their-...

https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...

One way to think of it is to see attention/motivation control as a spectrum. There are going to be people in the bottom X% of that spectrum, where it starts to negatively affect their lives. I'm thankful we live in a society that recongizes those people and has come up with ways to help them, since I've benefitted tremendously from ADHD treatments.

Yes, ADHD drugs are abused and it leads to complications. But, to quote Alexander Scott, "drug users use a lot of drugs": https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...

Some thoughts:

- Patient intake for ADHD is genuinely awful, you're right about that. The diagnostic/treatment process for ADHD often feels like it's designed to make people with ADHD struggle.

- CBT is generally helpful, therapy is an important part of treatment. I've seen good results from it.

- in-person sessions are expensive (although if you have good insurance you shouldn't be hitting $200-300 a session).

However:

- Non-personalized CBT may not be as helpful. One thing I've learned working with my therapist is that a lot of behaviors I thought were universal aren't, even among people with ADHD. We spend a lot of time breaking down what my motivators are, what things I struggle with, and we spend a lot of time brainstorming coping mechanisms and exercises that will work specifically for me. There is no single technique to deal with all of this, and you really need to have some way of narrowing in on what type of ADHD you have and what other conditions (anxiety, autism, etc) might complicate it.

- "5 minutes a day" is not really CBT to me. CBT is work, and I'm immediately skeptical of any app that tells me I'm just going to do some quick daily exercises and it'll change my life. Therapy doesn't work that way in my experience.

- I'll also note that the reason that the average cost of a CBT session is so high is because it's a personalized, one-on-one session that can last as long as an hour. So I feel even more that the comparisons being made here to traditional therapy aren't very apt.

- A self-directed routine that isn't being done with a real person kind of misses the point that people with ADHD often have trouble forming and sticking to routines. "You just need to do X every day and be mindful" isn't good advice for someone with ADHD, the whole point of CBT is to teach you how to do that stuff. But in this case, being able to stick to a consistent routine feels like a pre-condition to using the app.

- The app can't be used for diagnosis, and I really feel like diagnosis is important. Diagnosis, insurance coverage, and medication access are the reasons why the ADHD intake process is so complicated. Of course it could be better, but I don't feel like you can brag about circumventing the intake process if the way you're circumventing it is by skipping all of the hard parts that are of significant long-term value to people with ADHD.

- Medication is often used in combination with CBT, and I feel like it's irresponsible not to get into that or even mention it. The pitch makes it seem like CBT on its own is going to solve every problem, but for many people it won't. Therapy didn't work for me at all until I got on medication, and then suddenly I had the ability to start to utilize a lot of the techniques I was learning and to be more mindful throughout the day.

- Other people have brought up the pricing model, but I just want to reinforce that this feels predatory to me, it feels designed to capitalize on behaviors that people with ADHD struggle with.

Getting more critical. From the FAQ:

> We are not trying to replace medication or in-person therapy.

This is not how you're phrasing your post on HN. If you're building a quick helper app so that people can do daily CBT exercises, then say that. I wouldn't be so critical of an app like that, I can see a lot of use for a Duolingo-style CBT exercise/reinforcement app.

But when you compare the price of your app to traditional therapy and intake, you are creating an implication that your app is a substitute for therapy or medication. And it's not, you need to be more upfront about that and you need to stop comparing your product and your product's pricing to normal medical treatment.

With all of the above in mind, (to me) $100 a year feels too expensive for a 5 minute helper app that many people with ADHD won't have the ability to keep up with or stick to unless they're already getting therapy and/or medication.

If you do have ADHD, and you are feeling overwhelmed about the intake process, the best thing you can do is find someone without ADHD (a family member, a friend) who can help you through the process and diagnosis. It's difficult and time consuming, ask people you trust to help you fill in your gaps while you're figuring things out.

If you're interested in setting up your own CBT schedule and you think you have the ability to follow a consistent schedule, then buy a CBT book[0] and read through it and see if it's right for you. I am skeptical that self-help solutions will work long-term for the majority of people with ADHD, but at the very least you'll be able to get a little bit of an overview and figure out if CBT resonates. Heck, going off of the advice above, find a friend or a family member without ADHD who will go through the book with you and do the exercises alongside you. They won't be a licensed therapist, but they can help keep you on schedule and read off the page, and it's not like you're getting personalized one-on-one advice from this app.

[0]: I personally recommend https://www.amazon.com/Cognitive-Behavioral-Therapy-Adult-AD...

Good day!

    Abou  FAQ
    t     s

Edit: added minor due to comment below in an attempt to clarify. The wierd text placement does bother me, i'm not joking. but its not that bad that i cannot get past it and read the rest of the website. thought i'd let the OP know; dont mean to poke fun at people who have been diagnosed with OCD. i'm still learning these terms via a child who was diagnosed with ADHD.

Have you looked into OCPD? (Obsessive Compulsive Personality Disorder) From my relatively uninformed knowledge on the subject, that sounds closer to OCPD. (Of course, talk to a licensed health practictoner, not a procrasting software engineer)

Therapy is actually a wonderful adjunct to medication because it helps instill lasting behavioral changes. A lot of people mistake the early motivational boost of stimulants for ADHD remission, but once the energizing effect of stimulants disappears due to tolerance, they’re left with the same bad habits they started with. Therapy can help build a better foundation for when the energizing side effect of stimulants disappears and only the attention-enhancing effects remain.

Therapy is a lot more work for the patient - more time consuming, more costly, can be emotionally taxing in the early stages, etc. So I understand the desire for a meds only solution, and in some cases that is possible. But talking about therapy more generally I would encourage anyone who can to give it a try, just as I would encourage people to put effort into their diet, exercise, etc.

Obviously make sure it is evidence-based therapy though, something like CBT that has been well-studied. There are flavors of talk therapy that are total pseudoscience.

I don't think placebo is relevant in the case of therapy because placebo itself is a psychological effect.

CBT seems to be somewhat effective but with these things people's experiences vary a lot.

CBT does perform quite well repeatedly in these sorts of experiments, particularly for depression (it is less studied in some other disorders although still promising). You're right there can be a lot of variance between people though. There can also be additional variance IRL due to therapist quality IMO.