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.

Aging is thought to involve impairments to cognitive control functions that support episodic memory, for example by enabling people to strategically constrain their retrieval search towards a specific context ("source") in order to facilitate retrieval of goal-relevant memories. The "memory-for-foils" paradigm investigates source-constrained retrieval by assessing whether incidental encoding of new foils during an old/new recognition test differs depending on the type of processing that was previously used during study of the old items in the test. If it does, it suggests that people process foils differently as a result of engaging in source-constrained retrieval attempts. Young adults typically show differences in incidental encoding foils, but such differences have not been found in older adults. Here, we compared source-constrained retrieval and reward effects on incidental foil encoding between younger and older adults, to assess if age-related reductions in strategic retrieval processing are accompanied by differences in responsiveness to external rewards. The results showed only minor effects of rewards on memory processing, in younger adults only. Contrary to prior findings, older adults had equivalent overall memory performance and spontaneously constrained retrieval to the same extent as the young group, showing that aging-related impairments to strategic retrieval processes are not inevitable.

Background The COVID‐19 pandemic and subsequent lockdowns have disproportionately affected young people, and those who are vulnerable are disadvantaged further. Here, 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 12 professionals from a digital mental health service were conducted to understand the experiences of vulnerable young people during the pandemic lockdown. Workshops with young people with diverse experiences resulted in the co‐design of the focus group topic guide and the interpretation and validation of analysis. The experiential inductive–deductive framework of thematic analysis was used to analyse the workshop transcripts. Results Four main themes and subsequent subthemes were identified: escalation of risk ; the experience and consequence of loss ; feeling supported and empowered ; and feeling separate and isolated . Conclusions Findings reflect early data that suggest that those with existing vulnerability face an 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 the need for focused support for vulnerable young people as we emerge from lockdown, and point to supportive and protective factors of relevance to online and offline support provision.

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