Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health

Abstract

Background Many youths with mental health needs are unable to access care. Single-session interventions (SSIs) have helped reduce youth psychopathology across multiple trials, promising to broaden access to effective, low-intensity supports. Online, self-guided SSIs may be uniquely scalable, particularly if they are freely available for as-needed use. However, the acceptability of online SSI and their efficacy have remained unexamined outside of controlled trials, and their practical utility is poorly understood. Objective We evaluated the perceived acceptability and proximal effects of Project YES (Youth Empowerment & Support), an open-access platform offering three online SSIs for youth internalizing distress. Methods After selecting one of three SSIs to complete, participants (ages 11-17 years) reported pre- and post-SSI levels of clinically relevant outcomes that SSIs may target (eg, hopelessness, self-hate) and perceived SSI acceptability. User-pattern variables, demographics, and depressive symptoms were collected to characterize youths engaging with YES. Results From September 2019 through March 2020, 694 youths accessed YES, 539 began, and 187 completed a 30-minute, self-guided SSI. SSI completers reported clinically elevated depressive symptoms, on average, and were diverse on several dimensions (53.75% non-white; 78.10% female; 43.23% sexual minorities). Regardless of SSI selection, completers reported pre- to post-program reductions in hopelessness (dav=0.53; dz=0.71), self-hate (dav=0.32; dz=0.61), perceived control (dav=0.60; dz=0.72) and agency (dav=0.39; dz=0.50). Youths rated all SSIs as acceptable (eg, enjoyable, likely to help peers). Conclusions Results support the perceived acceptability and utility of open-access, free-of-charge SSIs for youth experiencing internalizing distress. Trial Registration Open Science Framework; osf.io/e52p3

Italia Ti Ascolto [Italy, I am listening]: an app-based group psychological intervention during the COVID-19 pandemic

“…Thus, given the lack of friends' support and stability in their daily routines, especially in a crucial developmental stage where they develop a stable and coherent sense of self, psychological support is crucial (Preti et al, 2015;Benzi, Sarno, & Di Pierro, 2018;Benzi, Preti, Di Pierro, Clarkin & Madeddu, 2019;Di Pierro, Gargiulo, Poggi, Madeddu, & Preti, 2020). The use of digital tools in preadolescent and adolescent populations has recently been tested, leading to significant improvements in their mental health (Gladstone et al, 2020;Saulsberry et al, 2013;Wahlund et al, 2020), even in the context of single-session interventions (Schleider et al, 2020). Fourth, we tailored a room for pregnant women: pregnancy is a complex experience where a need to restructure physical self-image emerges, whilst dealing with physiological and hormonal level changes, and the need to mentalize new fantasies and fears about the unborn child (De Carli et al, 2019).…”

COVID-19 Is Straining Mental Health—Could Technology Be the Answer?

“…With limited advertising on Reddit and Instagram, a few hundred teens have already completed Project Y.E.S, and the team has completed a study describing the outcomes for the first 190 teens who completed the interventions [15]. Interestingly, the early results suggest that even though the different SSIs teach different skills or strategies, they have similar results.…”

Retiring, Rethinking, and Reconstructing the Norm of Once-Weekly Psychotherapy

“…This concern is misguided for at least two reasons. First, many brief treatments are “problem-agnostic” by necessity (e.g., walk-in single session therapy): They are inherently designed to adapt to the patient’s presenting problem as they understand it —not to a particular clinical diagnosis, which many therapy protocols are designed to target (Harper-Jaques and Foucault 2014 ; Schleider et al 2020a , b ). Thus, many brief treatments may be easier to personalize than traditional, manualized treatments centering diagnostic-criteria.…”

“…Most traditional RCTs have too few participants to reliably identify precision treatment rules (Kessler et al 2019 ), but online SSI research may overcome this obstacle. In the previous year, our group has recruited over 900 youths for an open-label trial of SSIs (Schleider et al 2020 ); 302 participants for an online RCT testing an SSI targeting parents experiencing anxiety (NLM, NCT04453865); and >500 adolescents for another online SSI RCT (NLM, NCT04498143). Large datasets aggregated across affordable, online SSI trials could be leveraged to develop precision-treatment “rules” with great statistical precision, and at a long-impossible rate, thus rapidly forwarding efforts to reduce psychopathology’s public health burden (Kazdin 2019 ).…”