Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children.

Joshua S Steinberg, Jingxuan Sun, Katherine E Venturo-Conerly, Gauri Sood, Patrick Mair, Oksana Davydenko, Robert Porzak, Dennis Ougrin, John R Weisz
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Abstract

Ukraine's war-exposed youth face a myriad of barriers to receiving mental health services, perhaps most notably a dearth of mental health professionals. Experts recommend evaluating digital mental health interventions (DMHIs), which require minimal clinician support. Based on the content of empirically supported treatments for war-exposed youth (e.g., Teaching Recovery Techniques), one strategy that might be useful is self-calming (e.g., paced breathing, progressive muscle relaxation). In this pre-registered randomized controlled trial (ClinicalTrials.gov Record: NCT06217705 ; first submitted January 12, 2024), we assessed the acceptability, utility, and clinical efficacy of one such DMHI (Project Calm) relative to a usual schoolwork control among a sample of Ukrainian students in grades 4-11. We analyzed outcomes for the full sample and subsamples with elevated symptoms at baseline. Although Calm was perceived favorably, there were no significant between-group differences in the full sample (N = 626); differences in subsample analyses demonstrated that while internalizing, externalizing, and trauma symptoms held steady for the Calm group, control participants' symptoms reduced. We generated potential explanations for these results (e.g., interference with youths' natural coping skills or fear extinction) through a focus group with school staff. Given that we found no evidence that calming skills taught via DMHI are effective for Ukrainian youth, we suggest that researchers test other strategies delivered by DMHI and that calming skills continue to be taught in provider-guided formats.

随机试验测试一种自我引导的数字心理健康干预,为乌克兰儿童教授镇静技巧。
暴露在战争中的乌克兰青年在接受心理健康服务方面面临着无数障碍,最明显的可能是缺乏心理健康专业人员。专家建议评估数字心理健康干预措施(DMHIs),这需要最少的临床医生支持。根据经验支持的针对暴露于战争中的年轻人的治疗方法(例如,教学恢复技术)的内容,一种可能有用的策略是自我镇静(例如,有节奏的呼吸,渐进式肌肉放松)。在这项预先注册的随机对照试验中(ClinicalTrials.gov记录:NCT06217705;首次提交于2024年1月12日),我们在乌克兰4-11年级的学生样本中评估了一种这样的DMHI(平静项目)相对于常规学业控制的可接受性、效用和临床疗效。我们分析了在基线时症状升高的全样本和亚样本的结果。虽然Calm被认为是有利的,但在整个样本中没有显著的组间差异(N = 626);子样本分析的差异表明,虽然平静组的内化、外化和创伤症状保持稳定,但对照组的症状减轻了。我们通过与学校工作人员的焦点小组,对这些结果产生了潜在的解释(例如,干扰青少年的自然应对技能或恐惧消退)。鉴于我们没有发现证据表明通过DMHI教授的镇静技巧对乌克兰青年有效,我们建议研究人员测试DMHI提供的其他策略,并继续以提供者指导的形式教授镇静技巧。
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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