Is There a Place for Cognitive Restructuring in Brief, Self-Guided Interventions? Randomized Controlled Trial of a Single-Session, Digital Program for Adolescents.

IF 4.2 1区 心理学 Q1 PSYCHOLOGY, CLINICAL
Joshua S Steinberg, Olivia M Fitzpatrick, Sakshi Khurana, Melody Y Kim, Patrick Mair, Jessica L Schleider, Mark L Hatzenbuehler, John R Weisz
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Abstract

Objective: Self-guided digital mental health interventions (DMHIs) teaching empirically supported skills (e.g. behavioral activation) have demonstrated efficacy for improving youth mental health, but we lack evidence for the complex skill of cognitive restructuring (CR).

Method: We conducted the first-ever RCT testing a CR DMHI ("Project Think") against an active control (supportive therapy; "Project Share") in collaboration with public schools. Pre-registered outcomes were DMHI acceptability and helpfulness post-intervention, as well as internalizing symptoms and CR skills use from baseline to seven-month follow-up, in the full sample and the subsample with elevated symptoms.

Results: Participants (N = 597; MAge = 11.99; 48% female; 68% White) rated both programs highly on acceptability and helpfulness. Both conditions were associated with significant internalizing symptom reductions across time in both samples, with no significant condition differences. CR skills use declined significantly across time for Project Share youths but held steady across time for Project Think youths in both samples; this pattern produced a significant condition difference favoring Project Think within the elevated sample at seven-month follow-up.

Conclusion: Internalizing symptoms declined comparably for Think and Share participants. Consequently, future research should examine whether encouraging youths to share their feelings produces symptom improvements, and whether a single-session, self-guided CR DMHI produces beneficial effects relative to more inert control conditions. Further, the decline in CR skills use for Project Share youths versus sustained CR use by Project Think youths raises questions about the natural time course of youths' CR use and the impact of these DMHIs on that course. ClinicalTrials.gov Registration: NCT04806321.

认知重组在简短的自我指导干预中占有一席之地吗?针对青少年的单课时数字程序随机对照试验》。
目的:自助式数字心理健康干预(DMHIs)教授经验支持的技能(如行为激活),在改善青少年心理健康方面已被证明有效,但我们缺乏认知重组(CR)这一复杂技能的证据:方法:我们与公立学校合作,首次开展了一项 RCT 研究,测试认知重组 DMHI("思考项目")与积极对照组(支持疗法;"分享项目")的效果。预先登记的结果是干预后的 DMHI 可接受性和有用性,以及从基线到七个月随访期间的内化症状和 CR 技能使用情况,包括全部样本和症状升高的子样本:参与者(N = 597;平均年龄 = 11.99;48% 为女性;68% 为白人)对两个项目的可接受性和有用性都给予了高度评价。在两个样本中,在不同时期,两种方案都能显著减少内化症状,且没有明显的条件差异。在两个样本中,"分享项目 "的青少年在不同时期使用 CR 技能的情况明显减少,而 "思考项目 "的青少年在不同时期使用 CR 技能的情况则保持稳定;在七个月的随访中,这种模式产生了明显的条件差异,即在高分样本中,"思考项目 "更胜一筹:结论:"思考 "项目和 "分享 "项目参与者的内化症状下降幅度相当。因此,未来的研究应考察鼓励青少年分享自己的感受是否会改善症状,以及单次自我指导的 CR DMHI 是否会产生相对于惰性对照条件的有益效果。此外,"分享项目 "青少年使用 CR 技能的减少与 "思考项目 "青少年持续使用 CR 的对比,也引发了关于青少年使用 CR 的自然时间过程以及这些 DMHI 对这一过程的影响的问题。ClinicalTrials.gov 注册:NCT04806321。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.70
自引率
4.80%
发文量
58
期刊介绍: The Journal of Clinical Child and Adolescent Psychology (JCCAP) is the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association. It publishes original contributions on the following topics: (a) the development and evaluation of assessment and intervention techniques for use with clinical child and adolescent populations; (b) the development and maintenance of clinical child and adolescent problems; (c) cross-cultural and sociodemographic issues that have a clear bearing on clinical child and adolescent psychology in terms of theory, research, or practice; and (d) training and professional practice in clinical child and adolescent psychology, as well as child advocacy.
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