There are many promising psychological interventions on the horizon, but there is no clear methodology for preparing them to be scaled up. Drawing on design thinking, the present research formalizes a methodology for redesigning and tailoring initial interventions. We test the methodology using the case of fixed versus growth mindsets during the transition to high school. Qualitative inquiry and rapid, iterative, randomized “A/B” experiments were conducted with ~3,000 participants to inform intervention revisions for this population. Next, two experimental evaluations showed that the revised growth mindset intervention was an improvement over previous versions in terms of short-term proxy outcomes (Study 1, N=7,501), and it improved 9th grade core-course GPA and reduced D/F GPAs for lower achieving students when delivered via the Internet under routine conditions with ~95% of students at 10 schools (Study 2, N=3,676). Although the intervention could still be improved even further, the current research provides a model for how to improve and scale interventions that begin to address pressing educational problems. It also provides insight into how to teach a growth mindset more effectively.

Adolescents face many academic and emotional challenges in middle school, but notable differences are evident in how well they adapt. What predicts adolescents' academic and emotional outcomes during this period? One important factor might be adolescents' implicit theories about whether intelligence and emotions can change. The current study examines how these theories affect academic and emotional outcomes. One hundred fifteen students completed surveys throughout middle school, and their grades and course selections were obtained from school records. Students who believed that intelligence could be developed earned higher grades and were more likely to move to advanced math courses over time. Students who believed that emotions could be controlled reported fewer depressive symptoms and, if they began middle school with lower well-being, were more likely to feel better over time. These findings illustrate the power of adolescents' implicit theories, suggesting exciting new pathways for intervention.

Objective: We sought to evaluate two approaches with varying time and complexity in engaging adolescents with an Internet-based preventive intervention for depression in primary care. We conducted a randomized controlled trial comparing primary care physician motivational interview (MI, 10–15 minutes) + Internet program versus brief advice (BA, 2–3 minutes) + Internet program. Setting: Adolescent primary care patients in the United States, ages 14–21. Participants: 83 individuals (40% non-white) at increased risk for depressive disorders (sub-threshold depressed mood > 3–4 weeks) were randomly assigned to either the MI group (n=43) or the BA group (n=40). Main Outcome Measures: Patient Health Questionnaire (PHQ-A) – Adolescent and Center for Epidemiologic Studies Depression Scale (CES-D). Results: Both groups substantially engaged the Internet site (MI, 90.7% versus BA 77.5%). For both groups, CES-D-10 scores declined (MI, 24.0 to 17.0 p < 0.001; BA, 25.2 to 15.5, p < 0.001). The percentage of those with clinically significant depression symptoms based on CES-D-10 scores declined in both groups from baseline to twelve weeks, (MI, 52% to 12%, p < 0.001; BA, 50% to 15%, p < 0.001). The MI group demonstrated declines in self-harm thoughts and hopelessness and was significantly less likely than the BA group to experience a depressive episode (4.65% versus 22.5%, p = 0.023) or to report hopelessness (MI group of 2% versus 15% for the BA group, p=0.044) by twelve weeks. Conclusions: An Internet-based prevention program in primary care is associated with declines in depressed mood and the likelihood of having clinical depression symptom levels in both groups. Motivational interviewing in combination with an Internet behavior change program may reduce the likelihood of experiencing a depressive episode and hopelessness.

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