The COVID-19 pandemic caused financial hardship, social isolation, and distress, increasing risk for adolescent depression. Even before the pandemic, <50% of youth with depression accessed care, and not all benefited from existing treatments. Accordingly, this randomized-controlled trial tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression (N=2,452, ages 13-16). Adolescents recruited via social media were randomized to 1 of 3 SSIs: a behavioral activation SSI, an SSI teaching that personal traits are malleable, or a supportive control. We tested each SSI’s effects on post-intervention (hopelessness, agency) and 3-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-related trauma). Compared to the control, both active SSIs reduced 3-month depressive symptoms; decreased post-intervention and 3-month hopelessness; and increased post-intervention agency. Several differences between active SSIs emerged. Results confirm the effectiveness of two free-of-charge, online SSIs for adolescents with elevated depression, even in the high-stress context of COVID-19.
Background. The demand for psychological services outpaces the number of available providers. Waitlists at mental health clinics range from weeks to months in length, and longer wait-times predict less favorable outcomes once treatment begins. There is a need for efficient, sustainable service models that provide faster access to care. Offering interim, low-intensity supports to treatment-seekers may both strengthen clinically-relevant proximal outcomes and prevent clinical deterioration while waiting for longer-term treatment. Thus, we tested the acceptability and short-term effects of a solution-focused single-session consultation (SSC), offered to individuals waiting for therapy at two outpatient mental health clinics. Method. Clients wait-listed for outpatient therapy at either clinic were offered an SSC. Participants self-reported overall psychological distress at baseline and two-week follow-up, along with levels of hopelessness and perceived agency at baseline and post-intervention. Participants also rated the SSC’s acceptability. Results. Of 90 treatment-seeking individuals offered an SSC, 46 (51.11%) scheduled an appointment, and 30 (65.21%) attended the session (M age = 31.2, 72.67% female). SSC recipients reported significant pre- to post-intervention improvements in perceived agency (d_z = 1.11, p < .001) and hopelessness (d_z = 1.43, p < .001). Psychological distress significantly decreased from baseline to follow-up (d_z = .73, p = .002). Participants rated SSC sessions as highly acceptable, useful, and worth recommending to others. Conclusions. A solution-focused single-session consultation was associated with improvements in hopelessness, agency, and psychological distress in treatment-seeking adults. Pending larger-scale controlled trials, the SSC may help prevent clinical deterioration among individuals on therapy wait-lists.
Background: A majority of youth with depression and related difficulties never access treatment. Barriers such as stigma, financial costs, and provider shortages contribute to this problem. Single session interventions (SSIs) have been found to benefit youth and help reduce depression symptoms. Since many SSIs are brief and can be accessed online, they may circumvent traditional barriers to accessing treatment, thus supporting wellbeing in individuals otherwise unable to access care. SSIs may be particularly beneficial for LGBTQ+ youth, for whom barriers to treatment are often exacerbated. There is a need to determine whether LGBTQ+ youth respond as positively to SSIs as non-LGBTQ+ youth, or if adaptations are needed prior to widespread dissemination. Methods: We investigated whether changes in helplessness, agency, and self-hate from before to after completing online SSIs differed as a function of LGBTQ+ identity in a sample of 258 youths (N=258, 81.4% female assigned sex, 60.5% LGBTQ+, 47.3% BIPOC). We also quantitatively and qualitatively compared intervention acceptability ratings and feedback across LGBTQ+ and non-LGBTQ+ youths. Results: Analyses revealed no significant differences between cisgender LGBQ+, trans and gender diverse, and cisgender heterosexual youths for any intervention outcomes. Likewise, no group differences emerged in intervention acceptability ratings or written program feedback. Limitations: Self-selection bias and underrepresentation of certain populations, such as American Indian and Alaskan Native youths, may limit generalizability of results.Conclusions: Results suggest that online mental health SSIs are equally acceptable and useful to LGBTQ+ and non-LGBTQ+ youth alike, even without culturally specific tailoring.
Rates of self-injurious thoughts and behaviors (SITBs) increase sharply across adolescence and remain high in young adulthood. Across 50 years of research, existing interventions for SITBs remain ineffective and inaccessible for many young people in particular need of mental health care. Briefer intervention options may increase access to care. However, many traditional interventions for SITBs take 6 months or more to complete-making it difficult for providers to target SITBs under real-world time constraints. The present study is a systematic review project that aims to (1) identify and (2) evaluate brief psychosocial interventions for SITBs in young people, ages 10 -24 years. We will conduct searches for randomized and quasi-experimental trials conducted in the past 50 years that evaluate effects of "brief interventions" (i.e. not exceeding 240 minutes, or four 60-minute sessions in total length) on SITBs in young people.
Objective: Many youth with mental health needs cannot access treatment, with multiply-marginalized youth, such as sexual minority youth of Color (SMYoC), experiencing both structural and identity-related barriers to care. The COVID-19 pandemic threatens to exacerbate multi-level treatment access barriers facing SMYoC youth nationwide. However, little large-scale research has examined access to mental health care among SMYoC across the United States, either during or prior to the pandemic. Such work is critical to understanding and ameliorating barriers in this domain. Methods: Using data from adolescents who self-identified as SMYoC and who endorsed a desire for mental health support during the COVID-19 pandemic (N=470, ages 13-16, from 43 U.S. states), we examined associations between state-level, structural factors (income inequality; mental healthcare provider shortage; anti-Black racism; homophobia; and the interaction between anti-Black racism and homophobia) and SMYoC mental health treatment access. Results: Multinomial logistic regressions revealed state-level mental healthcare provider shortage as the only significant predictor of SMYoC reporting they never (versus always) accessed mental health support during the COVID-19 pandemic. SMYoC living in areas with both lower homophobia and lower anti-Black racism were more likely to report always (versus sometimes) accessing mental health treatment. Conclusions: Results highlight the critical importance of considering diverse structural factors and applying an intersectional lens when exploring barriers to mental health treatment among multiply-marginalized youth. In locations where provider shortages are less severe, cultural stigma—including anti-Black racism and homophobia—may still pose challenges for SMYoC in need of mental health care.
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