Some young people come to therapy already using apps, videos or chatbots to help them through difficult moments. Asking about that support can be a useful way into the work. The answers can tell a clinician a good deal about the young person, and they open questions about the tools themselves and about how the family sees them.
Support found outside the service
Conversations about digital mental health often start with what services provide. For many young people, support arrives earlier and by another route. They find it themselves, at whatever hour they need it, with no referral involved. Some also turn to AI tools alongside the apps and platforms they already know. However, many of these resources have not been formally evaluated, even when young people report finding them helpful.
By the time a young person reaches a clinician, they may already have a small collection of tools they rely on, and some sense of which ones help them most.
The opening question
During the ACAMH workshop How to integrate AI and other digital tools into everyday clinical practice, led by Helen Pote, Gemma Rides and Lisa Summerhill, Lisa described how she begins by asking young people which digital tools they already use. She then looks into the evidence behind what they mention and thinks about how it might fit within the care pathway, adapting it where needed.
Much of what young people use will never pass through a service, which makes these conversations one of the few places where it can be thought about together. The aim is to understand what the young person is using and what they get from it, and to weigh up its benefits and risks with them, including some they may not have considered.
The tool and the young person’s context
A tool that enters therapy comes with the people and circumstances around it. A hypothetical case discussed at the workshop described an 11-year-old girl receiving online CBT for anxiety, who had found breathing and grounding exercises in short TikTok clips and wanted to share them in her sessions. She was accessing the videos through her older brother’s account, apparently without her parents’ knowledge.
Lisa noted that a young person may agree to a digital approach at the start and later find it unhelpful. Checking in again as the work goes on gives them the chance to say so.
In setting up the case, Helen asked how the young person’s own voice and choices could stay central, a question that seems to apply well beyond this one example.
The clinician’s own limits
This is new territory for many clinicians too, and some uncertainty is understandable. Frameworks such as the NHS Digital Technology Assessment Criteria (DTAC) can help shape the questions to ask about a tool, and supervision is a natural place to bring the rest. Being open with young people about what clinicians may not yet know can also help encourage a thoughtful and curious approach to technology.
Bringing digital tools into the conversation
Young people will keep finding support of their own, much of it beyond anything a service can review. Asking about it opens a conversation in which their benefits and limits can be discussed openly, with the young person and, where appropriate, with their family. For clinicians, it may begin with simple curiosity about what a young person is already doing to feel better.
Where next
ACAMH Resources
FREE CPD/CME certificates when you watch/listen to any of this content from ACAMH Learn.
Inside the CAMHS Digital Lab: Apps AI and Young People’s Mental Health, In this episode of Mind the Kids, host Dr. Clara Faria sits down with Dr. Alice Wickersham, Zoe Frith, and Professor Johnny Downs from the CAMHS Digital Lab at King’s College London to explore how digital innovation is transforming child and adolescent mental health services.
Digital Interventions and Self-harm Prevention, In this In Conversation podcast, Dr. Bethany Cliffe explores self-harm, self-harm interventions and technology.
Mind the Kids – Digital Mental Health: Persuasion, Parenting & Innovation, In this enlightening episode of Mind the Kids, our host Clara Faria, an ACAMH Young Person Ambassador, is joined by Professor Amit Baumel, Associate Professor at the University of Haifa and winner of the 2024 ACAMH Digital Innovation Award.
The Use and Potential of Artificial Intelligence for Supporting Clinical Observation of Child Behaviour, In this Video Abstract Professor Helen Minnis and Professor Alessandro Vinciarelli, discuss their co-authored CAMH journal Original Article ‘The use and potential of artificial intelligence for supporting clinical observation of child behaviour’.
