'A Support Net': Evaluating a novel mental health-related online educational tool

Context: Mental ill-health affects an estimated one-in-four people over a lifetime, but members of the public can struggle to know how to help someone in need. We therefore felt it was important to create an interactive educational tool focused on mental health literacy. We developed a bespoke educational tool, called A Support Net, and evaluated its uptake in a real-world context. Methods: We captured data including: total learners; completion rates; learner country; and time spent using A Support Net. Intervention: A Support Net uses immersive video-based vignettes demonstrating realistic case studies of someone struggling with mental health problems, and learners are encouraged to reflect on how to support that person. Learners are introduced to four different scenarios and are tasked with making decisions around supporting that person, with the aim of making a positive difference (visually displayed with a ‘your impact’ scale). Results: To date there have been 8,814 users. The most frequently used vignette (‘Lily’) was accessed by 2,848 learners and had a completion rate of 62%. Most learners are from the UK, and 86% used the tool on their PC (average amount of time spent = 11 minutes). Conclusions: Overall engagement, evidenced by total learner numbers, has been encouraging which could indicate that the use of video vignettes was an engaging intervention strategy. However the completion rates for all four scenarios are low. For future interactive tools of this kind we plan to include a small number of evaluation items to measure possible improvements in mental health literacy

A Randomized Controlled Trial Comparing two Cognitive-Behavioral Programs for Adolescent Girls with Subclinical Depression: A School-Based Program (Op Volle Kracht) and a Computerized Program (SPARX)

Limited research has indicated the effectiveness of the school-based Cognitive Behavioral Therapy (CBT) prevention program ‘Op Volle Kracht (OVK)’ and the computerized CBT program ‘SPARX’ in decreasing depressive symptoms. Therefore, a randomized controlled trial of the effectiveness of OVK and SPARX was conducted among Dutch female adolescents (n = 208, mean age = 13.35) with elevated depressive symptoms. Participants were randomly assigned to one of four conditions: OVK only (n = 50), SPARX only (n = 51), OVK and SPARX combined (n = 56) and a monitoring control condition (n = 51). Participants in the first three conditions received OVK lessons and/or the SPARX game. Depressive symptoms were assessed before interventions started, weekly during the interventions, and immediately after the interventions ended, with follow-up assessments at 3, 6 and 12 months. Intention to treat results showed that depressive symptoms decreased in all conditions (F(12, 1853.03) = 14.62, p < .001), with no difference in depressive symptoms between conditions. Thus, all conditions, including the monitoring control condition, were equally effective in reducing depressive symptoms. Possible explanations for the decrease of depressive symptoms in all conditions are discussed and suggestions for future research are provided. Dutch Trial Register: NTR3737

Computer-Based and Online Therapy for Depression and Anxiety in Children and Adolescents

Objective: The purpose of this study was to provide an overview of computer-based and online therapies (e-therapy) to treat children and adolescents with depression and/or anxiety, and to outline programs that are evidence based or currently being researched. Methods: We began by defining the topic and highlighting the issues at the forefront of the field. We identified computer and Internet-based interventions designed to prevent or treat depression or anxiety that were tested with children and young people <18 years of age (or inclusive of this age range together with emerging adults). We included randomized controlled trials (RCTs). We summarized available relevant systematic reviews. Results: There is an increasing body of evidence that supports the use of computers and the Internet in the provision of interventions for depression and anxiety in children and adolescents. A number of programs have been shown to be effective in well-designed RCTs. Replication and long-term follow-up studies are needed to confirm results. Conclusions: There are now a range of effective computerized interventions for young people with depression and anxiety. This is likely to impact positively on attempts to make psychological therapies widely available to children and young people. We expect to see increased program sophistication and a proliferation of programs in the coming years. Research efforts, when developing programs, need to align with technological advances to maximize appeal. Implementation research is needed to determine the optimal modes of delivery and effectiveness of e-therapies in clinical practice. Given the large number of unproven program on the Internet, ensuring that there is clear information for patients about evidence for individual programs is likely to present a challenge

The health and well-being of transgender high school students: results from the New Zealand adolescent health survey (Youth’12).

Purpose To report the prevalence of students according to four gender groups (i.e., those who reported being non-transgender, transgender, or not sure about their gender, and those who did not understand the transgender question), and to describe their health and well-being. Methods Logistic regressions were used to examine the associations between gender groups and selected outcomes in a nationally representative high school health and well-being survey, undertaken in 2012. Results Of the students (n = 8,166), 94.7% reported being non-transgender, 1.2% reported being transgender, 2.5% reported being not sure about their gender, and 1.7% did not understand the question. Students who reported being transgender or not sure about their gender or did not understand the question had compromised health and well-being relative to their nontransgender peers; in particular, for transgender students perceiving that a parent cared about them (odds ratio [OR], .3; 95% confidence interval[CI], .2 -.4), depressive symptoms (OR, 5.7; 95% CI, 3.6-9.2), suicide attempts (OR, 5.0; 95% CI, 2.9-8.8), and school bullying (OR, 4.5; 95% CI, 2.4-8.2). Conclusions This is the first nationally representative survey to report the health and well-being of students who report being transgender. We found that transgender students and those reporting not being sure are a numerically small but important group. Transgender students are diverse and are represented across demographic variables, including their sexual attractions. Transgender youth face considerable health and well-being disparities. It is important to address the challenging environments these students face and to increase access to responsive services for transgender youth

A Web-Based Intervention to Support the Mental Well-Being of Sexual and Gender Minority Young People: Mixed Methods Co-Design of Oneself

© 2024 The Author(s). Originally published in JMIR Formative Research (https://formative.jmir.org), 21.05.2024. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background: Sexual and gender minority youth are at greater risk of compromised mental health than their heterosexual and cisgender peers. This is considered to be due to an increased burden of stigma, discrimination, or bullying resulting in a heightened experience of daily stress. Given the increasing digital accessibility and a strong preference for web-based support among sexual and gender minority youth, digital interventions are a key means to provide support to maintain their well-being. Objective: This paper aims to explicate the co-design processes and underpinning logic of Oneself, a bespoke web-based intervention for sexual and gender minority youth. Methods: This study followed a 6-stage process set out by Hagen et al (identify, define, position, concept, create, and use), incorporating a systematic scoping review of existing evidence, focus groups with 4 stakeholder groups (ie, sexual and gender minority youth, professionals who directly support them, parents, and UK public health service commissioners), a series of co-design workshops and web-based consultations with sexual and gender minority youth, the appointment of a digital development company, and young adult sexual and gender minority contributors to create content grounded in authentic experiences. Results: Oneself features a welcome and home page, including a free accessible to all animation explaining the importance of using appropriate pronouns and the opportunity to create a user account and log-in to access further free content. Creating an account provides an opportunity (for the user and the research team) to record engagement, assess users’ well-being, and track progress through the available content. There are three sections of content in Oneself focused on the priority topics identified through co-design: (1) coming out and doing so safely; (2) managing school, including homophobic, biphobic, or transphobic bullying or similar; and (3) dealing with parents and families, especially unsupportive family members, including parents or caregivers. Oneself’s content focuses on identifying these as topic areas and providing potential resources to assist sexual and gender minority youth in coping with these areas. For instance, Oneself drew on therapeutic concepts such as cognitive reframing, stress reduction, and problem-solving techniques. There is also a section containing relaxation exercises, a section with links to other recommended support and resources, and a downloads section with more detailed techniques and strategies for improving well-being. Conclusions: This study contributes to research by opening up the black box of intervention development. It shows how Oneself is underpinned by a logic that can support future development and evaluation and includes diverse co-designers. More interactive techniques to support well-being would be beneficial for further development. Additional content specific to a wider range of intersecting identities (such as care-experienced Asian sexual and gender minority youth from a minority faith background) would also be beneficial in future Oneself developments.Peer reviewe

A randomized controlled trial comparing two cognitive-behavioral programs for adolescent girls with subclinical depression: A school-based program (Op Volle Kracht) and a computerized program (SPARX).

Limited research has indicated the effectiveness of the school-based Cognitive Behavioral Therapy (CBT) prevention program ‘Op Volle Kracht (OVK)’ and the computerized CBT program ‘SPARX’ in decreasing depressive symptoms. Therefore, a randomized controlled trial of the effectiveness of OVK and SPARX was conducted among Dutch female adolescents (n = 208, mean age = 13.35) with elevated depressive symptoms. Participants were randomly assigned to one of four conditions: OVK only (n = 50), SPARX only (n = 51), OVK and SPARX combined (n = 56) and a monitoring control condition (n = 51). Participants in the first three conditions received OVK lessons and/or the SPARX game. Depressive symptoms were assessed before interventions started, weekly during the interventions, and immediately after the interventions ended, with follow-up assessments at 3, 6 and 12 months. Intention to treat results showed that depressive symptoms decreased in all conditions (F(12, 1853.03) = 14.62, p < .001), with no difference in depressive symptoms between conditions. Thus, all conditions, including the monitoring control condition, were equally effective in reducing depressive symptoms. Possible explanations for the decrease of depressive symptoms in all conditions are discussed and suggestions for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Rainbow SPARX: a novel approach to addressing depression in sexual minority youth.

A seven-module computerized cognitive behavioral therapy (CCBT) program (Rainbow SPARX) was developed for adolescents with depressive symptoms who are also sexually attracted to the same sex, both sexes, or who are questioning their sexuality (i.e., sexual minority youth). In this paper a rationale for the use of CCBT amongst sexual minority youth with depression and a brief overview of the intervention are provided. Acceptability, feasibility, and preliminary data on Rainbow SPARX’s effectiveness, based on a pilot feasibility trial, are provided. Twenty-one sexual minority youth (male 52.4%) aged 13–19 years old with significant depressive symptomatology were enrolled in the study. Almost all the participants (n = 19, 90.5%) completed at least four out of seven modules of Rainbow SPARX and the program received favorable usefulness and likeability ratings. Depressive symptoms decreased significantly post-intervention (p < 0.0001, pre- to post-effect size d = 1.01) and this was maintained at 3-month follow-up. Rainbow SPARX is an acceptable, feasible, and promising intervention, which can be offered as a self-help resource that can be used in privacy and without stigma or can be used as an adjunct to face-to-face therapy