How Brightline and Violet are improving care outcomes for kids, teens, and families.

Since 2021, Brightline and Violet have worked together to bring a more person-centered approach into everyday care, so that clinicians understand and respond to the full context of each member's life. Our new white paper with Brightline shows what that work has meant for the families Brightline serves.

Across 37 months of real-world care, Brightline members whose clinician held a Violet Benchmark (badge) of Proficiency or above had 158% greater odds of achieving their goals than members whose clinician did not. That result stands out because of what it measures. These are personalized goals, the outcomes families themselves identify as most important.

Brightline offers virtual and in-person mental health services for kids, teens, and their caregivers. Its mission is to transform the lives of kids, teens, and families by delivering mental health care that works, led by people and amplified by technology. Clinicians are central to that care, and Brightline has invested in their person-centered care training.

How we worked together

Violet onboarded Brightline's clinicians, coaches, care team members, and staff, benchmarked 237 team members, and put targeted education in place.

A Violet Benchmark reflects a provider's ability to deliver care that responds to the lived experiences and clinical realities of different communities and patient populations. There are three levels: Awareness, Proficiency, and Excellence. A Benchmark accounts for the education, work experience, training, and lived experience a clinician already brings, strengthened by the Violet courses they complete. It also gives each provider a clear view of their skills and a roadmap for building on them. Violet’s Benchmarks include an array of communities, including: BIPOC, Disabled, LGBTQIA+, Neurodivergent, Rural, and Veteran communities. 

Brightline clinicians engaged with Violet education during onboarding and throughout their work, completing 43 courses on average. That commitment is theirs and speaks to their prioritization of delivering effective care for all. 

The study

The white paper looks at 106 licensed therapy and psychiatry clinicians at Brightline and the 6,259 members they cared for across 52,586 appointments from January 2022 through January 2025. Each clinician's whole panel of members was included, and all care in the study period was delivered virtually.

The results answer two questions. 

1. Do members have better outcomes when their clinician completes more Violet education? 
2. Do members have better outcomes when their clinician holds a Violet Benchmark of Proficiency or above with at least one community, as 52% of Brightline clinicians in the study did?

The bar for success was strict. For depression, anxiety, and psychosocial functioning, a member's score had to fall by at least 50% and end below the clinical cutoff, criteria based on those used in randomized clinical trials. For goals, a member had to reach the expected outcome or better.

Because this is a study of real-world care and not a randomized trial, the results describe associations. Violet published the white paper in collaboration with the Eidos LGBTQ+ Health Initiative at the University of Pennsylvania. Eidos provided data technical assistance reviewing and assessing the study findings.

Key findings

Brightline's care is effective. Members improved across all outcomes, on average, and 95% of members in therapy showed expected progress on their goals. Violet education and Benchmarks were associated with additional gains.

Violet education. At the average of 43 Violet courses completed per clinician, members had:

• 17.7% greater odds of remission for depression (PHQ-8)
• 15.8% greater odds of remission for anxiety (GAD-7)
• 6.0% greater odds of achieving their goals (IGARs)

Violet Benchmarks. When their clinician held a Benchmark of Proficiency or above, members had:

• 158% greater odds of achieving their goals (IGARs)
• 49.3% greater odds of remission for anxiety (GAD-7)
• 33.0% greater odds of treatment response for psychosocial functioning (PSC-17)
• 28.9% greater odds of remission for depression (PHQ-8)

Every result above was statistically significant, and both analyses found a positive association for all five outcomes measured, including caregiver strain. The white paper is candid about effect sizes. By conventional guidelines they are very small for every outcome except one, and the paper describes the education effects as still clinically meaningful. The exception is goal attainment in the Benchmark analysis, a medium effect and the largest in the study. The white paper offers a reason: personalized goals may be where personalization matters most.

What we believe

At Violet, we continue to believe that delivering person-centered care is going to improve outcomes for everyone across the country. This study adds to the evidence. Brightline's clinicians earned Benchmarks for their skills with specific communities, and the better outcomes showed up across their full panels of members.

We think the reason is simple. When the person caring for you understands your life, community, and care gaps your community most often navigates, it is easier to trust them and get better.

That belief extends beyond therapy and psychiatry. Brightline's coaches were onboarded to Violet alongside its clinicians. This study focused on therapy and psychiatry clinicians, so coaching was not part of the analysis. Our belief is that having greater access to coaching services directly will further help all of us stay healthier and get better faster.

Thank you to Brightline's clinicians and care team. The numbers in this study describe their work with families.

Together, Brightline and Violet are continuing this work so that more kids, teens, and families are cared for by people who understand their lives.

Access the full case study here.