JMIR Publications

ABSTRACT

Background:

Adolescents and young adults are a target population for early intervention and prevention. Whereas evidence for early intervention is promising, availability and use of youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed.

Objective:

The current paper aims to 1) present a manual for a hybrid intervention, combining an ecological momentary intervention (EMI) and face-to-face sessions aimed for enhancing resilience in help-seeking youth based on compassion-focused interventions (CFIs) and 2) explore whether participants’ baseline characteristics are associated with putative mechanisms, processes and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether a) participants’ sociodemographic, clinical and functional characteristics at baseline are associated with putative mechanisms and processes (i.e., change in self-compassion, change in emotion regulation, working alliance, training frequency); b) participants’ sociodemographic, clinical and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (i.e., psychological distress and general psychopathology at post-intervention and four-week follow-up) in the experimental condition and obtain first parameter estimates for main effects and time-specific contrasts for post-intervention and follow-up.

Methods:

We recruited youth aged 14 to 25 with psychological distress, clinical high-at-risk mental states or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline, post-intervention and at four-week follow-up. The current analysis focuses on the experimental condition receiving the EMIcompass intervention.

Results:

A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with CFIs and the principles of EMIs. Forty-six young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B = 0.11, 95% CI = 0.00 – 0.22), general psychopathology (B = 0.08, 95% CI = -0.01 – 0.16) and clinical stage (B = 1.50, 95% CI = 0.06 – 2.93) on change in momentary self-compassion and change in emotion regulation from baseline to post-intervention assessments. There was no evidence for associations of other baseline characteristics (e.g., gender, minority status, level of functioning) and putative mechanisms and processes (e.g., overall self-compassion, working alliance, training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B = -2.83, 95% CI = -5.66 – 0.00), we found no evidence that baseline characteristics related to clinical outcomes.

Conclusions:

Findings indicated reach of participants by the intervention largely independently from sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial.

Conclusions:

Findings indicated reach of participants by the intervention largely independently from sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. Clinical Trial: German Clinical Trials Register DRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265