Mental health apps for mild psychological distress amongst adolescents
Research type
Research Study
Full title
Mental Health Mobile Application Self-Help for Adolescents Exhibiting Mild Psychological Distress: A Single Case Experimental Design
IRAS ID
269736
Contact name
David Dawson
Contact email
Sponsor organisation
University of Lincoln
ISRCTN Number
ISRCTN00000000
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 3 days
Research summary
SUMMARY OF RESEARCH
Previous research shows that self-help can improve psychological well-being (Cuijpers et al., 2011, Hirai & Clum, 2006); with advancements in technology, there is an increasing potential for self-help to be accessed via mobile apps. Despite wide availability of mental health apps, there is insufficient evidence to suggest they promote psychological well-being amongst adolescents (Grist, Porter & Stallard, 2017); this is problematic considering the quantity of healthcare providers recommending apps (Bennion, Hardy, Moore & Millings, 2017).
The purpose of the study is to understand:
1. whether there is evidence of psychological change after the introduction of a mental health mobile app amongst young people experiencing mild psychological distress.
2. the processes in which change may occur at an individual level, and how these processes cohere with existing psychological understanding of therapeutic change.
3. the acceptability of utilising a mental health mobile app as a psychological intervention from the perspective of adolescents, after using the app.In this research, 10 young people aged 13-18 years will be provided with mobile application for daily use over five weeks, to enable them to access guided self-help based on cognitive behavioural therapy (CBT) and mindfulness. Young people will be recruited via the Lincolnshire Healthy Minds service; the app will be offered to those on the waiting list for the service and will not affect their access to the service as usual. To understand the impact of assisted self-guidance, five of the young people will receive weekly phone calls from the researcher and the remaining five will not. Young people will be able to use the app and complete measures online from any location of their choice. Following app-use, young people will be invited to a face-to-face interview on an NHS site. This research is being funded and completed as part of the Trent DClinPsy programme.
SUMMARY OF RESULTS
This study sought to investigate whether use of a mental health app, underpinned by cognitive behaviour therapy (CBT) led to change amongst adolescents. Mechanisms of change were also examined, specifically whether changes may be attributable to cognitive strategies. This study utilised a multiple-baseline single case experimental design. Five participants experiencing psychological distress engaged with a mental health app over a five-week period. Participants were recruited from both a wellbeing service and from the general population. App-use was supplemented by weekly calls to offer a rationale or clarification of app content. Only one participant recruited from the NHS wellbeing service completed the study, with a further four from the community also completing the intervention. An overall attrition rate of 55% was noted within this investigation. A small overall effect of the intervention of psychological distress was evident; however, participant outcomes were dependent on the analysis conducted and method of recruitment. The intervention appeared to promote an increase in use of adaptive cognitive strategies, but not negative thinking styles. The CBT app did not promote changes in participant wellbeing. The clinical benefits of app-based CBT may be small, and given the study design recruiting five self-selecting participants, overall conclusions regarding the effectiveness of apps cannot be drawn. A range of barriers exist to the effective implementation of apps, such as large attrition rates. While further research is required, caution should be exercised in the interpretation of studies reporting on app effectiveness.
REC name
Wales REC 6
REC reference
20/WA/0150
Date of REC Opinion
26 May 2020
REC opinion
Favourable Opinion