Leveraging the social network for treatment of social anxiety: Pilot study of a youth-specific digital intervention with a focus on engagement of young men

Rice, Simon; O’Bree, Bridget; Wilson, Michael J.; McEnery, Carla; Lim, Michelle H.; Hamilton, Matthew; Gleeson, John; Bendall, Sarah; D’Alfonso, Simon; Russon, Penni; Valentine, Lee; Cagliarini, Daniela; Howell, Simmone; Miles, Christopher; Pearson, Marc; Nicholls, Laura; Garland, Nicola; Mullen, Edward J.; McGorry, Patrick D.; Álvarez‐Jiménez, Mario

doi:10.1016/j.invent.2020.100323

Cited by 50 publications

(108 citation statements)

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“…The MOST model merges (1) interactive web therapy, (2) peer-to-peer web-based social networking, (3) peer, and (4) clinical moderation. Successive iterations and evolutions of MOST have been successfully adapted for, and trialed with, young people with psychosis [ 42 , 50 ], at clinical risk of psychosis [ 43 ], suicidal risk [ 51 ], depression [ 44 , 52 ], and social anxiety [ 53 ], as well as relatives of young people with psychosis [ 54 ] and depression [ 55 ]. To respond to the crisis in access to care by young people who experience mental ill-health, our group has developed a new model of web-based clinical support entitled Enhanced Moderated Online Social Therapy (MOST+).…”

Section: Introductionmentioning

confidence: 99%

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service

Álvarez‐Jiménez¹,

Rice²,

D’Alfonso³

et al. 2020

J Med Internet Res

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Background Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidence-based support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking. Objective The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables. Methods Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled single-group study. Results Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8). Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=−0.39; P<.001), perceived stress (d=−0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=−0.29; P<.001), loneliness (d=−0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables. Conclusions MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental ill-health. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.

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Section: Introductionmentioning

confidence: 99%

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service

Álvarez‐Jiménez¹,

Rice²,

D’Alfonso³

et al. 2020

J Med Internet Res

Self Cite

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“…Participants of the 12-week Entourage project pilot study, described in detail elsewhere [ 30 , 37 ] were invited to share and reflect on their experiences of using the platform in semi-structured interviews. All participants interviewed had previously participated in the Entourage pilot study (Australian New Zealand Clinical Trials Registry: ACTRN12619000923167).…”

Section: Methodsmentioning

confidence: 99%

“…All participants interviewed had previously participated in the Entourage pilot study (Australian New Zealand Clinical Trials Registry: ACTRN12619000923167). Comprehensive analysis of outcomes for this trial are explored elsewhere [ 30 ]. Data reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (CORE-Q) guidelines [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

“…Entourage uses the Moderated Online Social Therapy (MOST) model of intervention that has been piloted in previous studies with young people, and their carers, experiencing a range of diagnoses [ 25 , 26 , 27 , 28 , 29 ]. The Entourage intervention is described in detail elsewhere, [ 30 ], however in brief, the MOST model uniquely integrates a social-networking aspect within the online platform in which participants are able to engage in peer-to-peer interactions and support [ 25 , 31 ]. This involves participants having access to evidence based psychosocial therapy content that is delivered via bespoke therapy comics (see Figure 1 ), as well as mindfulness and self-compassion audio tracks, opportunities for moderated group problem solving, interacting with peers in a safe online environment and access to support from trained mental health clinicians via chat functions.…”

Section: Introductionmentioning

confidence: 99%

“…User experience and co-design with consumers of mental health interventions is recognised as an important component, with particular regard for program acceptability [ 32 ]. Clinical outcomes of the pilot study indicated significant and clinically meaningful improvements on a number of symptoms such as social anxiety, loneliness, social disconnectedness and wellbeing, with no gender differences found [ 30 ]. Similarly, usage data showed no differences in usage patterns between genders.…”

Section: Introductionmentioning

confidence: 99%

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Perceived Helpfulness of a Moderated Online Social Therapy Network for Young People Experiencing Social Anxiety

O’Bree

Walton

Bendall

et al. 2021

IJERPH

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There is a growing need for more effective delivery of digital mental health interventions, particularly for individuals experiencing difficulty accessing or engaging with traditional face-to-face therapy. Young people with social anxiety, and young males with social anxiety in particular need interventions sensitized to their needs. While digital interventions for mental health have proliferated, increasing their accessibility and utility, the data on acceptability and effectiveness of these interventions, however, indicates a need for improvement. The current study sought to utilise qualitative data from semi-structured interviews with 70 participants (male n = 33; age range = 14–25 years, mean age = 19.8) from a single-group pilot study of a novel intervention for young people with social anxiety (Entourage), using a content analysis approach. Results indicated that participants spoke about five main categories: connection, anxiety management, appeal, disengagement and system improvement. No overt gender differences were found in the appeal or perceived helpfulness of the Entourage platform. The current study provides valuable information and suggestions to guide future improvement of digital interventions for young people, particularly those experiencing social anxiety.

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Designing and scaling up integrated youth mental health care

et al. 2022

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Mental ill‐health represents the main threat to the health, survival and future potential of young people around the world. There are indications that this is a rising tide of vulnerability and need for care, a trend that has been augmented by the COVID‐19 pandemic. It represents a global public health crisis, which not only demands a deep and sophisticated understanding of possible targets for prevention, but also urgent reform and investment in the provision of developmentally appropriate clinical care. Despite having the greatest level of need, and potential to benefit, adolescents and emerging adults have the worst access to timely and quality mental health care. How is this global crisis to be addressed? Since the start of the century, a range of co‐designed youth mental health strategies and innovations have emerged. These range from digital platforms, through to new models of primary care to new services for potentially severe mental illness, which must be locally adapted according to the availability of resources, workforce, cultural factors and health financing patterns. The fulcrum of this progress is the advent of broad‐spectrum, integrated primary youth mental health care services. They represent a blueprint and beach‐head for an overdue global system reform. While resources will vary across settings, the mental health needs of young people are largely universal, and underpin a set of fundamental principles and design features. These include establishing an accessible, “soft entry” youth primary care platform with digital support, where young people are valued and essential partners in the design, operation, management and evaluation of the service. Global progress achieved to date in implementing integrated youth mental health care has highlighted that these services are being accessed by young people with genuine and substantial mental health needs, that they are benefiting from them, and that both these young people and their families are highly satisfied with the services they receive. However, we are still at base camp and these primary care platforms need to be scaled up across the globe, complemented by prevention, digital platforms and, crucially, more specialized care for complex and persistent conditions, aligned to this transitional age range (from approximately 12 to 25 years). The rising tide of mental ill‐health in young people globally demands that this focus be elevated to a top priority in global health.

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Leveraging the social network for treatment of social anxiety: Pilot study of a youth-specific digital intervention with a focus on engagement of young men

Cited by 50 publications

References 82 publications

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service

Perceived Helpfulness of a Moderated Online Social Therapy Network for Young People Experiencing Social Anxiety

Designing and scaling up integrated youth mental health care

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