Online for a Healthy Mind

Project Team

Principle Investigator: Prof Stephen Houghton (stephen.houghton@uwa.edu.au)

GCU Co-investigators: Prof Simon Hunter.

External Co-investigators: Prof Colin MacLeod, Dr David Lawrence, Dr Ben Grafton, Prof Andrew Page, Dr Michael Rosenberg, Prof Annemaree Carroll, Chris Gostelow.

Researcher: Corinne Zadow

Funder: WA Health Promotion Foundation Healthway

Dates: Ongoing

Background

Mental health difficulties that persist into adulthood (see Dray et al., 2017; Patton et al., Lancet Commission, 2016). World Health Organisation data in 2012 revealed that approximately 20% of adolescents had experienced a mental health problem in any given year, while Mission Australia’s latest annual analysis in 2016 found 22.8% of Australian 15-19 year olds exhibited symptoms of a serious psychological issue; up from 18.7% in 2011. Although there are evidence based mental health practices available that seek to address the mental health needs of young people, it is also clear that many adolescents do not seek treatment (Eisenberg et al., 2011). There is considerable evidence that adolescents reporting high levels of emotional vulnerability, such as anxiety or depression, display an increased tendency to impose negative resolutions on ambiguous information (Grafton & MacLeod, 2014). Moreover, such an interpretive bias can lead to worry (see Hirsch, Hayes, & Matthews, 2009) and there is increasing evidence that training benign interpretations via Cognitive Bias Modification over differing lengths of time (from a single session to six weeks) reduces negative thought intrusions and anxiety. However, existing paradigms for delivering Cognitive Bias Modification are not engaging for young people.

Aims and Objectives

The study aims to develop a highly engaging, 3-D gamified format proposed to expose adolescents to scenarios that challenge their mental health at different times along the high school trajectory.

The specific objectives are to:

• Identify the specific scenarios that clearly describe the types of ambiguous situations that pose challenges to adolescents’ mental health at different points in the developmental transition trajectory across high school (10-17 years);
• Delineate the subtypes of scenarios that pose challenges to mental health in adolescent cohorts differing in sex (male/female), and rural/remote/metropolitan locations;
• Develop age-appropriate animation and content commensurate with the different challenges (and protective factors) that impact upon mental health along the transition trajectory
• Translate the scenarios into CBM-I format;
• Develop a technologically innovative, brief, rapidly-delivered, fully-animated, interactive adolescent self-paced program which incorporates the scenarios;
• Evaluate the efficacy of the new program for promoting positive mental health and reducing adverse mental health by training benign interpretations of the challenges to mental health using different delivery formats: (i) At school only and (ii) At school supplemented by home access;
• Examine whether there are differences in the efficacy of the program among adolescents in rural and metropolitan locations.

Study Design

The study has three phases. Phase 1 involves identification of the types of ambiguous situations that pose challenges to adolescents’ mental health and to achieve this, a range of relevant stakeholders will be interviewed (adolescents, school psychologists, teachers, parents). In Phase 2 we will develop an online digital environment for the “MindsOnline” mental health promotion program. There will be formative research with adolescents in Year 1 and a small scale pilot in Year 2 of the project relating to content and style of materials and program delivery. This recognises that credibility, delivery style and visual presentation are critical when engaging young people. Finally, in Phase 3, a wait-list RCT design will be used to evaluate “MindsOnline” and Intervention feasibility, fidelity and acceptability will be assessed during this phase.