Online interventions reduce teens’ depression symptoms

Two free, brief, single-session online interventions reduced teenagers’ depressive symptoms and hopelessness and increased their ability to create and work towards goals, data showed.

Depression was the world’s leading cause of disability among adolescents before the COVID-19 pandemic, Jessica Schleider, PhD, an assistant professor of the department of psychology at Stony Brook University in New York, and colleagues wrote. The risk for adolescent depression likely increased following school closures, isolation, interruptions of support mechanisms and the economic downturn spurred by the pandemic. The researchers noted that financial strain, which already kept some teenagers with depression from seeking treatment before the pandemic, may have worsened access to services.

“A generation of youth exposed to unprecedented psychosocial adversity is thus poised to fall through the cracks of the mental health care system,” they wrote in Nature Human Behavior. “It is critical to identify effective, scalable strategies to reduce adolescent depression, both during and beyond COVID-19.”

Schleider and colleagues evaluated the interventions during a randomized clinical trial of more than 2,000 teenagers, most of them girls, aged 13 to 16 years who had been recruited from across the U.S. via social media and reported elevated symptoms of depression. The participants were randomly assigned to one of three single-session interventions (SSIs) that lasted approximately 20 to 30 minutes.

For the first online intervention, which the researchers called Project ABC, 729 participants engaged in values-based activities that explained how pleasure and accomplishment can diminish sadness and low self-esteem; discussed how behavior may form feelings and thoughts; asked the participants to identify areas such as family relationships, friendships, school or hobbies that bring enjoyment and meaning; created a personalized action plan to improve their depressive symptoms; and asked participants to write about the potential benefits of the intervention and how they can overcome barriers to follow through on the plan.

For the second online intervention, a self-administered program called Project Personality, 653 participants engaged in lessons on the brain and its plasticity; received testimonials from older youths about how the brain’s plasticity makes traits adaptable to situations; heard other stories from older youths about how “growth mindsets” helped them persevere during social or emotional ordeals; reviewed studies that explained how personality can change and why; and completed an exercise in which the participants used scientific information to write to younger students about people’s “capacity for change.”

The remaining online intervention, called Supportive Therapy Single Session Intervention, also included peer narratives and writing activities; however, it was “designed to control for non-specific aspects of completing a generally supportive online activity,” the researchers wrote. As such, its 630 participants served as the control cohort.

All the participants were invited to complete three questionnaires: one before the intervention, one immediately after the intervention and another 3 months later. The participants also received a list of additional mental health resources and were told that they could reach out to the research team with questions or help accessing mental health support beyond the intervention.

“Notably, the trial took place approximately 8 months after school closures and social distancing mandates were first imposed in the United States but before the COVID-19 vaccine was publicly available,” Schleider and colleagues wrote. “The trial thus took place at a time when pandemic-related conditions were still evolving and unpredictable in many U.S. regions and when some adolescents might have begun to adjust to lifestyle changes and norms.”

The researchers reported that after 3 months, and compared with the control group, teenagers in Project ABC and Project Personality reported decreases in depression symptoms and restrictive eating and an increased ability to create goals and work toward them. These adolescents also reported fewer feelings of hopelessness immediately after the invention and 3 months later.

“On average, the effects on depression were moderate,” Schleider said in a press release. “In some teens, the SSIs helped reduce their symptoms a lot. For others, only a small amount. But on a public health scale, since the programs are so easily accessible, and free, this type of intervention could help reduce the overall burden of depression in this vulnerable population of youth.”

The study results validate the use of the SSIs for “high-symptom adolescents, even in the high-stress COVID-19 context,” the researchers wrote. However, Schleider also noted in the release that the interventions “are not meant to replace other in-person counseling specific treatments.”

“They are more designed to be a safety net and an evidence-based support service for many teens who may otherwise have limited access to intervention or have not sought care,” she said.

References

Schleider JL, et al. Nature Human Behavior. 2021;doi:10.1038/s41562-021-01235-0.

Study reveals brief online interventions help reduce teen depression. https://www.newswise.com/coronavirus/study-reveals-brief-online-interventions-help-reduce-teen-depression/?article_id=762002. Published Dec. 14, 2021. Accessed Dec. 14, 2021.