The session wants and needs outcome measure for adolescent Web-based therapeutic support: examining the use of personalised free-text responses

Purpose This study aims to evaluate the effectiveness of the Session Wants and Needs Outcome Measure (SWAN-OM) in capturing children and young people’s self-identified goals and outcomes in single-session web-based mental health support. Design/methodology/approach A mixed-methods design was used to analyse 1,255 SWAN-OM completions. Of these, 1,185 participants selected from pre-set items, while 70 used the personalised free-text option. Quantitative analysis compared pre- and post-session outcomes, and qualitative analysis examined the content and structure of free-text responses to explore the nature of expressed goals. Findings The results provide a useful indicator as to the way young people make use of a hybrid idiographic and nomothetic outcome measure in a real-world context. Quantitative findings highlighted consistent patterns in outcome improvement, and qualitative analysis of free-text responses revealed themes related to emotional regulation, interpersonal concerns and problem-solving. Research limitations/implications This study is limited to a single digital service provider and may not be generalisable to in-person or multi-session formats. Further research is needed to examine the use of hybrid idiographic and nomothetic outcome measures across diverse settings. Practical implications Integrating personalised outcome measures like SWAN-OM can enhance the responsiveness of digital therapeutic services, support goal alignment and empower young users in articulating their needs. Social implications This research supports the development of youth-centred, outcome-focused digital mental health services that promote agency and individualised care. Originality/value To the best of the authors’ knowledge, this is the first large-scale study to examine the use of personalised free-text responses within a session-based digital outcome framework for youth mental health.