A Theory of Change for Web-Based Therapy and Support Services for Children and Young People: Collaborative Qualitative Exploration

Hanley, Terry; Sefi, Aaron; Grauberg, Janet; Prescott, Julie; Etchebarne, Andre

doi:10.2196/23193

Cited by 20 publications

(37 citation statements)

References 42 publications

(60 reference statements)

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“…In the item, generation phase where we developed a set of statements that are responded to before the chat which represents the wants and the needs for young people an understanding of the therapeutic outcomes of single-sessions was crucial. Previous work conducted with Kooth on their Theory of Change (Hanley et al, 2021) was instrumental in determining expected wants, need and outcomes of single-sessions (Hanley et al, 2021). This then enabled an initial item generation which mapped into Kooth's Theory of Change quadrants as main domains or constructs of the measure.…”

Section: Discussionmentioning

confidence: 99%

“…From examining Kooth's Theory of Change (Hanley et al, 2020;Hanley et al, 2021), it was apparent that an I-PROM measure will be a suitable measure option. This will provide an individualised tool that explores changes in 'in-session' goals around wants and needs.…”

Section: The Framework For Creating a Single-session Measurementioning

confidence: 99%

“…Items were generated to represent the main wants and needs of young people from single-sessions or drop-in sessions. Initially, four domains of wants and needs were identified from Kooth's Theory of Change that represent the needs for mental health support in children and young people that access the web-based therapy service (Hanley et al, 2020;Hanley et al, 2021). Such domains were also previously explored investigating the goals collaboratively set by young people at the onset of their contact with the service (Hanley et al, 2017;Jacob et al, 2020).…”

Section: Phase I: Item Generationmentioning

confidence: 99%

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The Session Wants and Need Outcome Measure: The Development of a Brief Outcome Measure for Single-Sessions of Web-Based Support

Garcia¹,

Salhi

Sefi

et al. 2021

Front. Psychol.

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Single-session, brief interventions in therapy for young people make up a large proportion of service provision, including in digital mental health settings. Current nomothetic mental health measures are not specifically designed to capture the benefit or ‘change’ directly related to these brief interventions. As a consequence, we set out to design an outcome measure to concretely demonstrate the value of single-session interventions. The Session Wants and Needs Outcome Measure (SWAN-OM) aims to capture in-session goals and focuses on being user-centric, elements critical to the success of single-session and brief interventions which typically are asset-based and solution-focused. We describe the 4-stage process that was followed to develop this measure: (I) classical item generation and development, (II) content and (III) face validity pilot testing, and (IV) a user-experience approach with young people using framework analysis. This final stage was critical to ensure the integration of this outcome tool into a web-based digital therapy setting, a context which adds another layer of design complexity to item and measure development. This iterative methodology was used to overcome the challenges encountered and to place the needs of the young people and service practitioners at the centre of the design process, thus ensuring measure usability. To end, we highlight the main lessons learnt from engaging in this design process. Specifically, the needs of a measure for single-session interventions are considered, before outlining the learning associated with integrating the measure into a digital mental health platform. Both of these areas are emerging fields and, as such, this study contributes to our understanding of how an idiographic patient outcome theory driven measure can be created for use in a web-based digital mental health therapy service.

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Section: Discussionmentioning

confidence: 99%

Section: The Framework For Creating a Single-session Measurementioning

confidence: 99%

Section: Phase I: Item Generationmentioning

confidence: 99%

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The Session Wants and Need Outcome Measure: The Development of a Brief Outcome Measure for Single-Sessions of Web-Based Support

Garcia¹,

Salhi

Sefi

et al. 2021

Front. Psychol.

Self Cite

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“…These consist of brief intermittent interventions which are drop-in sessions with any practitioner who is available at the time, structured interventions in which the user engages with a series of scheduled sessions with a consistent practitioner, and on-going support for those who have more complex situations and require support either to engage on Kooth or with other services available to them. The service users whose experiences were being discussed in this study were engaged in either structured or on-going support (40).…”

Section: Participants and Recruitmentmentioning

confidence: 99%

“…Digital services such as Kooth undoubtedly have an important role to play in providing a stable source of support for young people where care otherwise is unavailable or to support existing provision. Crucially, digital or web-based services which offer anonymity and privacy are seen to provide choice for young people in the support they can seek (40,54,55). This is of particular importance for those who do not feel supported or safe within their home and may not be in a position to engage their parents for support with their mental health, or seek face-to-face support independently.…”

Section: Implications For Support Systemsmentioning

confidence: 99%

Alienated and unsafe: Life through the Covid-19 lockdown for vulnerable young people (aged 11-24 years) as revealed in web-based therapeutic sessions with mental health professionals

Oppong¹,

Salhi²,

Lockwood

2021

Preprint

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Background The Covid-19 pandemic and subsequent lockdowns have detrimentally and disproportionately affected young people, with those who are considered vulnerable due to their experiences or life circumstances disadvantaged further still. In this study, we seek to understand the experiences of vulnerable young people accessing web-based therapeutic support during the pandemic and early lockdown, as revealed through the observations of mental health professionals. Methods Four focus groups with twelve web-based mental health professionals from the service Kooth were conducted on Zoom, and data analysed using thematic analysis. Participatory workshops with young people with diverse experiences supplemented the study approach and design and involved young people in the co-design of the focus group topic guide and the interpretation and validation of analysis. Results Four main themes and additional sub-themes were identified relating to the experiences of vulnerable young people on a web-based mental health platform. These were Escalation of risk, The Experience and Consequence of Loss, Feeling Supported and Empowered, and Feeling Separate and Isolated. Conclusions Findings broadly reflect early data that suggests that those with existing vulnerability face increased risk of poor outcomes through the pandemic and the restrictions of lockdown, but evidence is also provided of positive outcomes from lockdown and its function as a catalyst for change. Results reinforce that focused support for vulnerable young people is a priority as we emerge from lockdown and points to support and protective factors of relevance to online and offline support provision. The study uniquely contributes qualitative insight from web-based mental health professionals who have provided continuity of care to vulnerable youth from pre-pandemic and during lockdown and are therefore well-positioned to understand the impact of lockdown on the lives of service users. The robust youth-based participatory design is an additional study strength.

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Helpful and unhelpful elements of synchronous text‐based therapy: A thematic analysis

Dhesi

Sefi²,

Donati

et al. 2021

Couns and Psychother Res

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published a report stating over 100,000 young people had been in contact with NHS mental health services in the UK across two months in 2016. Such figures provide a strong argument for the need for good mental health provision for young people. Young people's mental health has been at the forefront of UK government initiatives with the aim to improve access to and availability of mental health services (Care Quality Commission,

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A Theory of Change for Web-Based Therapy and Support Services for Children and Young People: Collaborative Qualitative Exploration

Cited by 20 publications

References 42 publications

The Session Wants and Need Outcome Measure: The Development of a Brief Outcome Measure for Single-Sessions of Web-Based Support

The Session Wants and Need Outcome Measure: The Development of a Brief Outcome Measure for Single-Sessions of Web-Based Support

Alienated and unsafe: Life through the Covid-19 lockdown for vulnerable young people (aged 11-24 years) as revealed in web-based therapeutic sessions with mental health professionals

Helpful and unhelpful elements of synchronous text‐based therapy: A thematic analysis

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