Abstract
BackgroundDigital interventions offer new avenues for low-threshold prevention and treatment in young people. Ecological momentary interventions (EMIs) represent a powerful approach that allows for adaptive, real-time, and real-world delivery of intervention components in daily life by real-time processing of ecological momentary assessment (EMA) data. Compassion-focused interventions (CFIs) may be particularly amenable to translation into an EMI to strengthen emotional resilience and modify putative risk mechanisms, such as stress sensitivity, in the daily lives of young help-seeking individuals.ObjectiveThis study aims to investigate the feasibility, safety, and initial therapeutic effects of a novel, accessible, transdiagnostic, ecological momentary CFI for improving emotional resilience to stress (EMIcompass).MethodsIn this uncontrolled pilot study, help-seeking youth with psychotic, depressive, or anxiety symptoms were offered the EMIcompass intervention in addition to treatment as usual. The EMIcompass intervention consisted of a 3-week EMI (including enhancing, consolidating, and EMA-informed interactive tasks) administered through a mobile health app and three face-to-face sessions with a trained psychologist intended to provide guidance and training on the CFI exercises presented in the app (ie, training session, follow-up booster session, and review session).ResultsIn total, 10 individuals (mean age 20.3 years, SD 3.8; range 14-25) were included in the study. Most (8/10, 80%) participants were satisfied and reported a low burden of app usage. No adverse events were observed. In approximately one-third of all EMAs, individuals scored high on stress, negative affect, or threat anticipation during the intervention period, resulting in real-time, interactive delivery of the CFI intervention components in addition to weekly enhancing and daily consolidating tasks. Although the findings should be interpreted with caution because of the small sample size, reduced stress sensitivity, momentary negative affect, and psychotic experiences, along with increased positive affect, were found at postintervention and the 4-week follow-up. Furthermore, reductions in psychotic, anxiety, and depressive symptoms were found (r=0.30-0.65).ConclusionsOur findings provide evidence on the feasibility and safety of the EMIcompass intervention for help-seeking youth and lend initial support to beneficial effects on stress sensitivity and mental health outcomes. An exploratory randomized controlled trial is warranted to establish the feasibility and preliminary evidence of its efficacy.
Highlights
BackgroundMost mental disorders first emerge in adolescence and young adulthood, with an estimated lifetime prevalence of approximately 50% of any mental disorder in young age groups [1,2,3,4,5]
The EMIcompass intervention consisted of a 3-week ecological momentary intervention ESM (EMI) administered through a mobile health app and three face-to-face sessions with a trained psychologist intended to provide guidance and training on the compassion-focused intervention ecological momentary assessment (EMA) (CFI) exercises presented in the app
Our findings provide evidence on the feasibility and safety of the EMIcompass intervention for help-seeking youth and lend initial support to beneficial effects on stress sensitivity and mental health outcomes
Summary
BackgroundMost mental disorders first emerge in adolescence and young adulthood (three-fourths by the age of 24 years [1]), with an estimated lifetime prevalence of approximately 50% of any mental disorder in young age groups [1,2,3,4,5]. Clinical staging models as an adjunct to formal diagnoses have been introduced [17,18,19], highlighting the importance of transdiagnostic (indicated) prevention and early intervention [20,21,22,23,24]. Conventional mental health services offer a range of therapeutic options, it has been widely documented that psychological help remains difficult to access, especially for young individuals in the early stages of mental health problems [21,22,32,33]. Tailoring therapeutic options to specific needs and preferences of youth remains a challenge [32,33,34,35,36] and likely contributes to the problem that only a fraction of young people in need of help access any mental health service. Compassion-focused interventions (CFIs) may be amenable to translation into an EMI to strengthen emotional resilience and modify putative risk mechanisms, such as stress sensitivity, in the daily lives of young help-seeking individuals
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