Table 1.

Common themes and illustrative quotations from formative interviews with youths and providers during alpha and beta testing demonstration sessions.

Domain and common themes		Participation interview quotes
App content
	Valuable information for teens	“Having a structured activity rather than just asking a teen what they think their triggers are would be really helpful because sometimes if teens are just asked, they won’t know but with the examples, they can begin to recognize things.” [Alpha provider] “It’s good that it teaches real facts. Most therapists, the first things they will say about them is that you should not do them, but the app actually leads you to understand why. Most of the time, a therapist will tell you that this is a very bad drug, but the app actually gives you straight facts about the drug and the effects and why it is bad rather than just saying drugs are bad and don’t do it. This educates you.” [Beta teen]
	Useful embedded resources	“I felt like the menu was pretty straightforward and liked that there was a resource section, that way if a kid is having a bad day, they can easily find someone to reach out to.” [Beta provider]
	Variety of activities	“I think it’s good to have a variety of activities as there are different times when different ones are more suitable.” [Beta teen]
	Familiarity	“It helps since teens are already comfortable with smart phones, it is something familiar whereas treatment may feel less familiar. Teens work better on their phones.” [Beta provider]
	Encourages openness and honesty	“It is useful for learning more personally...it will make them feel more comfortable answering truthfully and will be easier to answer in an app than in person, especially if you were anti-social or nervous.” [Beta teen] “App could serve as a bridge in circumstances where the teen is thinking it, but just struggling to put it into words or to say out loud. The app might also help teen feel like there is less judgment or would help them answer more honestly, particularly in circumstances where there is a parent in the room.” [Beta provider]
	User-friendly	“I think it’s extremely easy to navigate, very easy. Everything is laid out, there’s a list of activities, I knew immediately what to do.” [Beta teen] “I like that it breaks things down so you can select what is most fitting to the circumstance (cravings, resources), that makes it quicker. It’s easy to navigate through.” [Beta provider]
	Privacy or restricted access	“My only concern is parents accessing things that are private. A log in would help or facial recognition. Would want therapist to have access, but parents in general should not because you go to therapy because you can’t talk to your parents about things.” [Beta teen] “An option of a password would be a really cool feature for someone who is just trying to get help in secrecy.” [Alpha teen]
App use in combination with outpatient therapy
	Improving treatment engagement	“I would like to use this in session. It would be good to start conversations with my therapist.” [Alpha teen]
	Activities outside of therapy sessions	“I think it would make a good sort of homework pre-test type thing.” [Alpha provider] “I think it would be great to give homework to clients.” [Alpha provider]
App modifications
	More detailed instructions or feedback	“I’m so used to having my assignments with clear directions. I would like to see that here. I still don’t get what to do.” [Alpha provider] “I like that it gives immediate feedback and that it gives further information about the correct answer.” [Beta provider]
	Simplified language	“I don’t talk to my kid patients like this, cognitive distortions, etc. I would probably make this more at a high school reading level, like the words.” [Alpha provider]