Personalized process monitoring in youth care: A mixed method exploration of clients’ and clinicians’ perspectives

Many clients in youth care have expressed that they feel unheard in their own care process, and clinicians often lack the tools to adapt treatment to the changing needs of clients. This article explores how personalized process monitoring may provide youth with insight into their own change process and support clinicians in tailoring treatment. This approach includes three elements: 1) collaboratively developing personalized assessments, 2) monitoring on a mobile device, and 3) providing instantaneous feedback through visualizations. We implemented this approach with the iamYu app, short for “Idiographic and Adaptive Monitoring”, and examined how youth and clinicians experienced it as an add-on to treatment. Thirty-six clients used iamYu for at least one month and completed a questionnaire, of which nine were additionally interviewed. We also conducted interviews and focus groups with 15 clinicians. Overall, personalized process monitoring was rated as highly acceptable. Youths’ primary motivation for using the app was the possibility to view the timeseries graphs on their phones. This, in turn, resulted in gaining self-insight into mood, physical health, and connections between wellbeing and daily events. These insights also translated into concrete actions in their daily lives, helping clients to better deal with their problems. Clinicians emphasized that iamYu supported shared decision-making and allowed adjustments to the focus of treatment in line with clients’ needs and wishes, which gave youth a sense of agency and ownership. Our findings suggest that personalized process monitoring can strengthen person-centered and collaborative care and that successful implementation depends on actively integrating the data in treatment(sessions). We conclude by reflecting on how “small data”, i.e., collecting data that is directly meaningful for the unit that collects it, supports the primary process between client and clinician and at the same time enhances our scientific understanding of person-specific as well as general processes of change.