JMIR Publications

ABSTRACT

Background:

Many teens the United States experience challenges with symptoms of depression, but they lack adequate resources to access in-person mental health care. Involving teens and clinicians in designing technologies using evidence-based practices that reduce barriers to accessing mental health care is crucial. Interventions based on behavioral activation (BA) help teens to understand the relationship between mood and activity, practice goal-directed behaviors to improve mood, and may be particularly well-suited to delivery via online platforms.

Objective:

We aimed to understand the needs and challenges of teens and mental health clinicians with depression management and involved them in the design process using Asynchronous Remote Communities (ARCs). Our goal was to understand the benefits and challenges of adapting BA to an online platform that supports an ARC approach as a delivery tool for teen depression management.

Methods:

We enrolled mental health clinicians (n=10) and teens (n=8) in separate private online groups on Slack. They participated in 20-minute design activities for 10 weeks and were then invited to do interviews about their experience in the study.

Results:

Both teen and clinician participants wanted online support for BA as a supplement to in-person therapy. While participants perceived the asynchronous format conducive to support accessible care, teens and clinicians raised concerns with safety, privacy, and moderating the online group. Design decisions to address these concerns need to be balanced with the potential benefits of learning coping skills, increased access, and asynchronous human connection to support teens.

Conclusions:

We discuss considerations for balancing tensions in privacy and safety while designing and selecting online platforms to support remote care and integrating evidence-based support when designing digital technologies for treatment for teens with depression.