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Sharpen Digital Therapeutic Interventions for Adolescent Mental Health

  • Writer: Robyn Hussa
    Robyn Hussa
  • Aug 20
  • 7 min read

Updated: Sep 1

A White Paper on Real-World Digital Mental Health Clinical Implementation and Engagement


August 20, 2025


  • Victoria Cosgrove, PhD, Assistant Professor of Psychiatry and Behavioral Sciences (Child and Adolescent Psychiatry and Child Development), Stanford University School of Medicine

  • Robyn Hussa Farrell, MFA, E-RYT, President & CEO, Resiliency Technologies

  • Tim Farrell, COO, Resiliency Technologies



Abstract


This white paper presents findings from two pilot implementations of Resiliency Technologies’ digital therapeutic (DTX) mental health platform across adolescent populations during July-August 2025. Analysis of 561 total participants demonstrates significant potential for DTX platforms to bridge critical gaps in adolescent mental health care delivery, with engagement rates of 59.4% in clinical populations and 83.7% completion in structured screening environments. The research provides evidence-based insights for healthcare organizations considering digital therapeutic integration and establishes benchmarks for measuring DTX effectiveness in diverse adolescent populations.


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1. Introduction


The adolescent mental health crisis has reached unprecedented levels (AAP, 2021). Up to 20% of adolescents experience mental health disorders while facing significant barriers to care access. These barriers include long waitlists and resource constraints (Sappenfield et al, 2024). Digital therapeutic (DTX) platforms represent a promising solution to bridge these care gaps (Alagarajah et al, 2024). They offer evidence-based interventions that can be deployed at scale (Liverpool et al, 2025; Linardon et al, 2019) while maintaining clinical efficacy (Chen et al, 2024).


This white paper presents a comprehensive analysis of two real-world implementations of a digital therapeutic mental health platform. It examines both clinical care integration and preventive screening applications across 537 participants.


Research Objectives


We aimed to evaluate real-world DTX effectiveness and user engagement patterns. We also sought to identify implementation success factors to establish engagement benchmarks for measuring DTX effectiveness. Additionally, we aimed to provide actionable insights for value-based healthcare providers considering DTX integration.


2. Study Overview and Methodology


Sharpen® Digital Therapeutic (Sharpen DTX) Platform


Sharpen DTX is a multi-component digital therapeutic and care management platform. It supports clinician-directed behavioral health interventions for children and adolescents ages 10 and up. The system integrates seamlessly within EHR software as a SMART-on-FHIR clinical application. Every intervention consists of modules, CBT activities, downloadable resources, and crisis response information. The system can also operate outside of EHR with a stand-alone clinician dashboard.


Patients receive interventions digitally through text messages or emails. They can manage their activities at a dashboard containing many components for additional engagement, informed through Sharpen’s proprietary AI recommendation engine.


Study 1: Clinical Waitlist Management


In July 2025, child and adolescent patients awaiting pediatric eating disorder treatment (n=37) were prescribed interventions through EHR-integrated Sharpen DTX. In some cases, clinicians prescribed one intervention. In other cases, patients received several interventions, including those for eating disorders, depression/anxiety, dietetics, and resiliency. The patients in this pilot did not have access to a dashboard.


In addition to the clinical tool for children, physicians received a 5-hour training course on effective identification, management, and treatment of eating disorders in the primary care setting. This training concluded with a comprehensive overview of how to deploy the DTX interventions through EHR. Finally, parents received a mental health literacy toolkit containing modules covering eating disorders and comorbid conditions.


Of the 37 patients assigned, the active engagement rate was 59.4%, with over 148 sessions averaging 6 minutes in length per patient. Patients aged 14-17 represented 87% of total platform time utilized, while the longest time in the interventions was 29.5 minutes per session. The pilot began on July 1, 2025, and the Director of Adolescent Medicine has since expanded the program to patients enrolled in other levels of care, including inpatient, partial hospitalization, outpatient, and intensive outpatient.


Clinical Waitlist Management Results


Engagement:

  • Total Patients Assigned: 37

  • Active Engagement Rate: 59.4% (22 of 37 patients)

  • Total Platform Visits: 148 sessions

  • Average Session Duration: 6 minutes

  • Cumulative Usage Time: 133.5 minutes across all participants


Age-Specific Patterns:

  • Ages 14-17: Highest engagement (87% of total platform time)


Most Accessed Modules:

  • Body image and self-acceptance (29.5 minutes - longest time in one session)

  • Eating disorder psycho-education through peer stories (17 minutes - in one session)

  • Stories of strength (6 minutes)

  • CBT/Cognitive restructuring (4 minutes)


Return Engagement:

  • 37.5% of users returned to modules after completion


Study 2: Preventive Mental Health Screening and Intervention


In July and August 2025, 522 Division 1 college athletes at a large public university athletic program were required to complete a computer adaptive mental health screening (CAT-MH) as part of orientation sessions. Health workers and clinicians deployed the screening to students via the Sharpen DTX stand-alone clinician portal. Students received the screening on their cell phones and could complete the CAT-MH items. Immediately after, students were assigned an intervention (“Sharpen Athlete”) containing mental health literacy, stigma reduction, and relevant programming featuring athletes, coaches, and clinicians. Students had immediate access to a dashboard containing the results of the CAT-MH and other assets. Additionally, licensed psychotherapists were available to triage cases of concern and normalize discussions around mental health.


A total of 493 athletes completed CAT-MH screenings (83.7% participation rate) with an average assessment duration of 7.8 minutes, leading to 1592 sessions on the Sharpen DTX platform. Every athlete received the first module of the Sharpen Athlete intervention after completing the CAT-MH. Twenty-two athletes (5%) were immediately flagged for enhanced support based on their screening results, and an additional 8 athletes (2%) triggered immediate protocols for suicide protection. One hundred percent of high-risk cases were successfully managed by the clinical team, who received text messages and alerts through the Sharpen DTX clinician dashboard. Clinicians could create and deploy Sharpen digital safety plans for athletes presenting with moderate to severe suicide risk.


In the weeks following the initial screenings, athletes engaged in the modules, with over 46 students spending over 309 minutes (in aggregate) in one single course. The longest time spent in one session was 31 minutes.


3. Clinical Implications and Future Research


In this study, clinical impact and safety risk management were demonstrated through the successful identification and management of 30 high-risk individuals. This included effective coordination with existing crisis response protocols.


These studies lacked randomized controlled comparison groups. Going forward, we seek funding and partnerships to measure sustained clinical impact and behavior change through RCT clinical trials. We have begun discussions with the FDA. We also intend to complete a comprehensive economic evaluation of DTX versus traditional care.


4. Value-Based Care Metrics


We asked clinicians at our recent pilot sites to complete a pilot survey (n=4). The survey focused on categories including clinical outcomes. One hundred percent of providers surveyed reported that DTX assisted with suicide risk assessment and safety planning. Seventy-five percent reported improved patient engagement with specific CBT components and patient engagement/symptom improvement.


In terms of care coordination, 100% of providers reported that EHR integration encouraged immediate intervention deployment after screening. Seventy-five percent reported that dashboard metrics improved patient connectivity and found Sharpen digital suicide safety plans effective for crisis intervention.


Regarding platform usability, 100% rated the platform as easy to use. They reported improved clinical efficiencies and found clinical interventions easy to deploy to patients. They rated the onboarding process as simple and agreed that DTX enhanced collaborative care. The clinic recommended a Net Promoter Score of 100, as all four providers rated a 9-10 likelihood to recommend. Additionally, providers reported increased comfort with suicide risk evaluation and the ability to provide immediate therapeutic support during patient distress, which increased the utilization of standardized therapeutic protocols.


5. Conclusions


Digital therapeutic platforms demonstrate significant potential for addressing critical gaps in adolescent mental health care delivery. We found high engagement rates across diverse implementation models (59.4% voluntary with no dashboard, 100% mandatory initial participation with dashboard) and successful crisis prevention and early intervention capabilities.


Resiliency Technologies focuses on population-specific content, which has proven crucial for sustained engagement. Our brief, modular intervention design (7-10 minutes) aligns with user attention spans. We also found that seamless technology integration is essential for provider and institutional adoption.


The evidence presented supports broader adoption of DTX platforms within adolescent education and mental health care systems. This is particularly important for mid-adolescent populations and implementation models that leverage existing clinical relationships and institutional infrastructure.


References


  • Alagarajah, J., Ceccolini, D., & Butler, S. (2024). Digital mental health interventions for treating mental disorders in young people based in low- and middle-income countries: A systematic review of the literature. Global Mental Health (Cambridge, England), 11, e74. https://doi.org/10.1017/gmh.2024.71


  • American Academy of Pediatrics. (2021). AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. Pediatrics, 148(5), e2021054571.


  • Lehtimaki, S., Martic, J., Wahl, B., Foster, K. T., & Schwalbe, N. (2021). Evidence on digital mental health interventions for adolescents and young people: Systematic overview. JMIR Mental Health, 8(4), e25847.


  • Liverpool, S., Mc Donagh, C., Feather, J. et al. Updates on digital mental health interventions for children and young people: systematic overview of reviews. Eur Child Adolesc Psychiatry (2025). https://doi.org/10.1007/s00787-025-02722-9


  • Chen, T., Ou, J., Li, G., Luo, H. (2024). Promoting mental health in children and adolescents through digital technology: a systematic review and meta-analysis. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1356554.


  • Liverpool, S., Mc Donagh, C., Feather, J. et al. Updates on digital mental health interventions for children and young people: systematic overview of reviews. Eur Child Adolesc Psychiatry (2025). https://doi.org/10.1007/s00787-025-02722-9


  • Linardon, J., Cuijpers, P., Carlbring, P., Messer, M., & Fuller-Tyszkiewicz, M. (2019). The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 18(3), 325–336. https://doi.org/10.1002/wps.20673


  • National Institute of Mental Health. (2023). Mental health information: Statistics. https://www.nimh.nih.gov/health/statistics/mental-illness


  • Sappenfield, O., Alberto, C., Minnaert, J., Donney, J., Lebrun-Harris, L., & Ghandour, R. (2024). Adolescent Mental and Behavioral Health, 2023. In National Survey of Children’s Health Data Briefs. (pp. 1–3). Health Resources and Services Administration.


  • Williamson, C., McLennan, L., & Robertson, C. (2024). Digital mental health interventions for adolescents in low- and middle-income countries: scoping review. Journal of Medical Internet Research, 26(1), e51376.


  • World Health Organization. (2024). Mental health of adolescents. Retrieved from https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health


This white paper is based on de-identified pilot study data collected between July 1, 2025, and August 20, 2025, across clinical and preventive care settings. All institutional identifiers have been removed to protect participant and organizational privacy.

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