Abstract
BackgroundEven though depression and anxiety are highly prevalent in adolescence, youngsters are not inclined to seek help in regular healthcare. Therapy through the Internet, however, has been found to appeal strongly to young people. The main aim of the present study is to examine the efficacy of preventive Internet-based guided self-help problem-solving therapy with adolescents reporting depressive and anxiety symptoms. A secondary objective is to test potential mediating and moderating variables in order to gain insight into how the intervention works and for whom it works best.Methods/designThis study is a randomized controlled trial with an intervention condition group and a wait-list control group. The intervention condition group receives Internet-based self-help problem-solving therapy. Support is provided by a professional and delivered through email. Participants in the wait-list control group receive the intervention four months later. The study population consists of adolescents (12-18-year-olds) from the general population who report mild to moderate depressive and/or anxiety symptoms and are willing to complete a self-help course. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are quality of life, social anxiety, and cost-effectiveness. The following variables are examined for their moderating role: demographics, motivation, treatment credibility and expectancy, externalizing behaviour, perceived social support from parents and friends, substance use, the experience of important life events, physical activity, the quality of the therapeutic alliance, and satisfaction. Mediator variables include problem-solving skills, worrying, mastery, and self-esteem. Data are collected at baseline and at 3 weeks, 5 weeks, 4 months, 8 months, and 12 months after baseline. Both intention-to-treat and completer analyses will be conducted.DiscussionThis study evaluates the efficacy and mechanisms of Internet-based problem-solving therapy for adolescents. If Internet-based problem-solving therapy is shown to reduce depressive and anxiety symptoms in adolescents, the implication is to implement the intervention in clinical practice. Strengths and limitations of the study are discussed.Trial registrationNetherlands Trial Register NTR1322
Highlights
Even though depression and anxiety are highly prevalent in adolescence, youngsters are not inclined to seek help in regular healthcare
If Internet-based problem-solving therapy is shown to reduce depressive and anxiety symptoms in adolescents, the implication is to implement the intervention in clinical practice
We examine the effects of an Internetbased guided self-help intervention (PST) for adolescents reporting mild to moderate symptoms of depression and/ or anxiety compared to a wait-list control group
Summary
Even though depression and anxiety are highly prevalent in adolescence, youngsters are not inclined to seek help in regular healthcare. The main aim of the present study is to examine the efficacy of preventive Internet-based guided self-help problem-solving therapy with adolescents reporting depressive and anxiety symptoms. Depression and anxiety disorders tend to have their first onset in adolescence and often show a chronic course with a high risk of relapse, which makes it important to prevent or postpone the onset of these mental health problems [14,15]. Despite the high incidence of common mental health problems in adolescence, teenagers rarely seek professional help for their emotional problems through regular healthcare services. A recent study among a community sample of adolescents, found the Internet to be an acceptable medium through which they tend to seek help [17]
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