JMIR Publications

ABSTRACT

Background:

Digital tools may support early phases of trauma therapy for adolescents, yet little is known about how an app-based stabilization phase functions in routine Child and Adolescent Psychiatry clinics. No previous studies have examined a compassion-integrated app-based stabilization component within Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth.

Objective:

This formative qualitative pre-trial study explored the acceptability, feasibility, and contextual fit of an app-based stabilization phase within blended TF CBT with Compassion for adolescents with PTSD. The aim was to inform refinement of intervention content, caregiver support, and clinical workflow prior to a planned pilot RCT.

Methods:

Four adolescent girls with PTSD (aged 14–16 years), five caregivers, and four clinicians participated. Adolescents completed a five-week app-based stabilization program integrating TF-CBT coping skills and compassion-focused practices, while caregivers received a parallel version of the content delivered in a non-app format. Semi-structured post-intervention interviews with adolescents and caregivers, along with a brief open-ended clinician survey, were analyzed using reflexive thematic analysis.

Results:

One overarching theme, “Navigating digital stabilization within shifting conditions,” captured how engagement fluctuated in response to emotional capacity, cognitive load, relational dynamics, and logistical stability. Adolescents and caregivers experienced the app as grounding and meaningful but challenging to sustain amid fatigue, school pressure, neurodivergent attention patterns, and family strain. Clinicians similarly noted varying capacity, the need for scaffolding, and the importance of reminders and smooth access. Clear content could exceed users’ cognitive bandwidth; adolescents preferred autonomy, while caregivers were unsure how to support them; and technical friction sometimes disrupted momentum. Across groups, grounding and compassion-based practices appeared to enhance emotional safety, shared understanding, and readiness for trauma-focused work.

Conclusions:

Findings indicate that app-based stabilization within bTF CBT C is acceptable and potentially feasible for adolescents with PTSD, their caregivers, and clinicians. Feasibility appears to depend on flexible pacing, cognitive accessibility, caregiver guidance, and technical reliability. The study identifies essential refinements needed before the pilot RCT and provides preliminary insight into how compassion-integrated digital stabilization may support preparation for trauma-focused therapy.