Lab Projects

Read about some of our ongoing projects! 

Project S.A.F.E.
Service Access for Families Everywhere

PI: Jessica Schleider, PhD
Co-I: Susmita Pati, MD

In collaboration with Stony Brook University's Division of Pediatric Primary Care
Supported by the Klingenstein Third Generation Foundation

PROJECT SUMMARY: Major depression (MD) in youth is a serious psychiatric illness with extensive morbidity and mortality. The American Academy of Pediatrics recently released practice guidelines promoting primary care (PC)-based youth MD screening; however, even when diagnosed by PC providers, <50% of youth with MD access treatment. Thus, a need exists for interventions that are feasible for youths and parents to access and complete—and that may strengthen parents’ likelihood of pursuing longer-term services. Single-session interventions (SSIs) may help forward these goals. SSIs include elements of comprehensive treatments, but their brevity makes them easier to disseminate at scale. Meta-analytic evidence suggests SSIs can reduce youth psychopathology, including self-administered (e.g., online) SSIs. One computer-based SSI, teaching growth mindset (GM; viewing personal traits as malleable), has reduced adolescent depressive symptoms in multiple RCTs; GM-SSIs have also improved parents’ expectancies that psychotherapy could benefit their children’s mental health. This project will test whether these online, youth- and parent-directed GM-SSIs—designed to reduce youth depressive symptoms and improve parents’ mental health treatment expectancies, respectively—may increase mental health service access, reduce youth depressive symptoms, and relieve parental stress following PC-based youth MD screening. Youths reporting elevated MD symptoms at PC visits (N = 200) will receive either Information/Psychoeducation/Referral (IPR) or IPR plus parent- and youth-directed GM-SSIs (IPR+SSI). We will examine whether IPR+SSI, versus IPR alone, increases MD service access; reduces parental stress; and reduces youth depressive symptoms across three months. Results may yield a disseminable model for promoting youth treatment access after PC-based depression screening.

Trial preregistration: ClinicalTrials.gov NCT 04030897; Study Protocol
Project TRACK to TREAT:
​Harnessing Network Science to Personalize Scalable Interventions for Adolescent Depression

PI: Jessica Schleider, PhD
Consultants: Nicholas Eaton, PhD; Laura Bringmann, PhD

Supported by the National Institutes of Health (Office of the Director) & the American Psychological Foundation

.PROJECT SUMMARY: Efforts to reduce major depression (MD) in youth have advanced greatly, yet 30-65% of youth who receive treatment fail to respond. The multifarious nature of MD contributes to this problem. An MD diagnosis reflects >1400 possible symptom combinations, highlighting the need for treatments matched to personal clinical need. Compounding the problem of potency, existing treatments are not uniformly accessible: up to 70% of youth with MD do not access services. This project aims to address the need for accessible, potent youth depression interventions by integrating methods and findings from previously separate areas: single-session intervention (SSI) research and network science. In a meta-analysis of 50 randomized trials, SSIs have reduced diverse youth psychiatric problems, including MD. Further, a web-based SSI teaching growth mindset (the belief that personal traits are malleable) reduced depression and anxiety in high-symptom youth across 9 months. Thus, well-targeted SSIs can yield lasting benefits—but given MD’s heterogeneity, there is a need for tools that can match youth to SSIs optimized for personal symptom structures. This project harnesses computational advances from the network approach to psychopathology, which views psychiatric disorders as causal interactions between symptoms, to evaluate such a tool. Aim 1 is to establish guidelines for computing personalized symptom networks using experience sampling method (ESM) data from youth with MD across several weeks. This will include a comparison of two leading approaches for computing network parameters, such as outward centrality (the degree to which a symptom prospectively predicts other symptoms). Aim 2 is to test network parameters as SSI outcome predictors among youth with MD. Youth will be randomized to a behavioral activation (BA) SSI (adapted from evidence-based BA SSIs); the mindset SSI noted above; or a control SSI. Network parameters will be tested as predictors of SSI response. For instance, youth with stronger centrality on a behavioral symptom (e.g. withdrawal from pleasurable activities) may respond more favorably to the BA SSI, and youth with stronger centrality on a cognitive symptom (e.g. hopelessness) to the mindset SSI. Results may identify a novel means of matching youth to targeted MD SSIs by personal need. The project will also include the first RCT comparing two youth MD SSIs, with the longest follow-up of any SSI trial to date (2 years), gauging their relative promise to reduce youth MD.

Read about TRACK to TREAT via NIH RePORTER.

Testing the Single-Session Consultation (SSC) Program
​for Emotional and Behavioral Distress

PI: Jessica Schleider, PhD
Co-PI: Jenna Sung, BA
Co-Is: Dina Vivian, PhD; Adam Gonzales, PhD; Wilfred  Farquharson IV, PhD;
Amanda Bianco, MA; Michael Mullarkey, PhD

PROJECT SUMMARY: The Krasner Psychological Center (KPC), the Mind Body Clinical Research Center (MBCRC), and Child and Adolescent Outpatient Services (CAOS) are outpatient mental health clinics affiliated with Stony Brook University (SBU). All three clinics faces a challenge common to virtually all mental health clinics across the United States: the demand for psychotherapy far outpaces the number of available providers. As such, wait-lists at clinics like the KPC, MBCRC, and CAOS are increasingly long, and longer wait-times for psychotherapy have predicted worse clinical outcomes once treatment is accessed. Thus, there is a need for effective, sustainable service delivery models that facilitate rapid access to care—for instance, providing a low-intensity service shortly after an individual decides to seek treatment, capitalizing on client motivation. Such a service might have the added benefit of reducing overall waitlist lengths: If some subset of clients find a low-intensity service to be sufficient,  a single session might be able (in some cases) to spur positive behavioral and emotional change. Therefore, the objective of our initial pilot study was to examine the feasibility, acceptability, and short-term effects of the new Single-Session Consultation (SSC) service, for clients 13 and older on the psychotherapy waitlists at the KPC, MBCRC, and CAOS. The SSC offers clients the opportunity to participate in a single, goal-directed consultation session within two weeks of inquiring about psychotherapy services, based on Solution-Focused Brief Therapy (SFBT): an evidence-based therapy approach that guides services offered by single-session and walk-in clinics internationally. Results suggested acceptability and positive effects of the SSC; we are now continuing to evaluate the intervention within and beyond SBU in diverse settings and populations, including via telehealth.

Trial preregistration: ClinicalTrials.gov NCT04069832
Pilot Trial Results: Schleider et al., 2020
Project YES
Youth Empowerment & Support

PI: Jessica Schleider, PhD
Co-​PIs: Jenna Sung, BA; Mallory Dobias, BS
Co-Is: Emma Mumper, MA; Michael Mullarkey, PhD

PROJECT SUMMARY: Project YES (Youth Empowerment & Support; www.schleiderlab.org/YES) is the first large-scale program evaluation of web-based SSIs for adolescent mental health. Project YES aims to evaluate the acceptability and effects of three free-of-charge, publicly available web-based SSIs for adolescent internalizing distress developed by our team: Project Personality, the Teen Goals Project, and the ABC Project, (designed to improve youth agency, self-compassion, and hope, respectively). Each program follows an evidence-based framework SSI construction, developed by our research team and informed by basic social-psychological research. First, youths (1) learn brain science that normalizes each program’s core concept; (2) are treated as “experts” and invited to help researchers learn about youths’ perspectives and challenges; (3) synthesize the program’s ideas using their own words, while offering advice to peers facing difficulties; (4) hear stories from peers who used the program’s content to overcome setbacks. Within Project YES, youths are invited to complete pre- and post-program assessments of proximal SSI targets and feedback on the SSI(s) they complete. Data from these assessments will allow us to investigate (1) the acceptability and feasibility of our SSIs in their current forms, and (2) the immediate effects of our SSIs on proximal, clinically-relevant outcomes (agency; hope; self-compassion). Towards the first question, use-pattern variables (e.g., SSI selection; SSI completion rates; reasons for taking part in Project YES), user characteristics (age-range; sex; gender identity; race/ethnicity; depressive symptoms), and feedback variables (program feedback scale) will be evaluated. Key variables for our second question include pre-and post-SSI levels of hopelessness, self-hate, and agency in participating youths.

Project YES was recently covered in Vox. 

Study preregistration: Open Science Framework
Interm results: Schleider et al., 2020
Empowering Anxious Parents to Manage Child Avoidance Behaviors
Project BRAVE

PIs: Jenna Sung, BA; Emma Mumper, PhD
Co-PI: Jessica Schleider, PhD

Supported by Psi Chi International Honor Society​
PROJECT SUMMARY: Efforts to develop and disseminate evidence-based practices (EBPs) for youth anxiety have made great strides. Still, up to 82.2% of youth who need mental health treatment for anxiety never access care or drop-out from treatment prematurely. Commonly barriers to treatment include provider shortages, transportation limitations, financial burdens, and gatekeeping behaviors by caretakers, creating a need for accessible, scalable interventions that can ameliorate the global burden of youth anxiety—including those that help prevent the onset of anxiety disorders in at-risk children. Single session interventions (SSIs), which have prevented and reduced child anxiety across numerous trials to date, may offer a promising solution, given their potential disseminability and cost-effectiveness. This randomized trial will evaluate the acceptability and short-term effects of a novel, web-based, self-guided SSI for parents (N=300), designed to systematically reduce parent accommodation—a parenting behavior identified as a strong risk factor for anxiety in offspring. Study aims are three-fold: (1) to examine the SSI’s short-term effects on parental accommodation, relative to an information-only control; (2) to assess the SSI’s short-term effects on parents’ perceived ability to help their children manage distressing situations; and (3) to evaluate the SSI’s feasibility and acceptability. We will recruit parents reporting elevated anxiety levels, as children of anxious parents are at particular risk for developing anxiety symptoms themselves. Results may suggest a promising approach to preventing anxiety in at-risk children.

Randomized Trial preregistration:  ClinicalTrials.gov NCT04453865 

Pre-registration for open-access program evaluation of Project BRAVE: https://osf.io/maqw5
Project S.A.V.E
Stop Adolescent Violence Everywhere

PI: Mallory Dobias, BS
Co-PIs: Jessica Schleider, PhD; Kathryn Fox, PhD

Supported by Psi Chi International Honor Society​
PROJECT SUMMARY: Lifetime prevalence for self-injurious thoughts and behaviors (SITBs) increases sharply across adolescent development. However, effects of interventions targeting SITBs are small and inconsistent. Further, existing treatments are often inaccessible—even among adolescents in urgent need of mental health care. For those who do initially seek help, treatment uptake is low and attrition is high. More than 25% of adolescents do not attend scheduled, post-discharge outpatient appointments following a suicide attempt, and ~11% attend only one appointment. Suicidal thoughts fluctuate dramatically within a daily, and even hourly, basis—making it less likely that adolescents will have access to care when they most need it. Single-session interventions (SSIs), well-targeted, accessible interventions designed to last one session, may be a low-cost and timely resource for vulnerable adolescents who may not otherwise receive treatment in their time of need. A novel, web-based SSI specifically addresses two commonly reported functions of self-injury in youth: emotion regulation and self-punishment. This project will test whether this novel, online intervention reduces 3-month frequency of non-suicidal self-injury and suicidal ideation, relative to an active control group program, in a large sample of adolescents (N ~ 500). Results may identify a low-cost, easy-to-disseminate intervention for SITBs within a high-risk sample.

Trial preregistration:  Open Science Framework; ClinicalTrials.gov NCT 04498143
The BEST-TECH Project
Building Evidence-based Supports for Teens via Technology

PI: Jessica Schleider, PhD
Co-I: Michael Mullarkey, MA, PhD Candidate
Co-I: John Weisz, PhD

Supported by Limbix Health, Inc.

PROJECT SUMMARY: Depression is the leading cause of disability in youth, with a global economic burden of US >$210 billion annually. However, up to 70% of youth with depression do not receive services. Even among those who do access treatment, 30% to 65% fail to respond and many dropout prematurely, demonstrating a need for more potent, accessible interventions. In a previous trial, a single-session Web-based growth mindset (GM) intervention significantly reduced depressive symptoms in high-symptom adolescents; however, this intervention did not benefit adolescents uniformly. For instance, the intervention reduced depression in adolescents who reported post intervention increases in perceived control, but it did not lead to significant depression reductions in adolescents who reported no significant post intervention increases in perceived control. Accordingly, the goal of this project is to test the acceptability and efficacy of a novel, single-session, virtual reality (VR) depression intervention—the VR Personality Project—teaching GM, the belief that personal attributes are malleable rather than fixed. The VR Personality Project was designed to systematically target and increase adolescents’ perceived control by offering a more immersive, engaging, user-directed intervention experience than the Web-based intervention can provide. By targeting an identified predictor of intervention response, the VR Personality Project may lead to larger reductions in depressive symptoms than existing Web-based mindset interventions. Adolescents with elevated depressive symptoms or a recent history of depression (N=159; ages 12 to 16 years) will be randomized to one of 3 intervention conditions: the VR Personality Project; the Web-based GM intervention tested previously; or an active, Web-based control. Adolescents and their parents will report on the adolescents’ depression symptoms, perceived control, and related domains of functioning at preintervention, postintervention, and at 3- and 9-month follow-up assessments. Results may suggest an efficient strategy for reducing adolescent depressive symptoms: One that is mechanism-targeted, relatively affordable (less than US $200 for a commercially available VR headset, a fraction of the cost of long-term psychotherapy) and potentially engaging to adolescents experiencing mood-related distress.
​
​Trial preregistration: ClinicalTrials.gov NCT03858881
International Registered Report Identifier (IRRID): DERR1-10.2196/13368
The College Goals Project

PIs: Michael Mullarkey, PhD; Jessica Schleider, PhD
Co-I: Nicole Leavey, PhD

In collaboration with Stony Brook University's Alan Alda Center for Communicating Science
​
PROJECT SUMMARY: Up to 31% of current college students currently meet criteria for Major Depression (MD). Even students experiencing subclinical depression symptoms have more alcohol related problems, earn worse grades, and are more likely to drop out of college compared to less depressed students. However, up to 80% of students with depression do not receive treatment, and increasing demand for treatment cannot be effectively met by brick and mortar clinics alone. This project aims to address some of this increasing demand by implementing a single session intervention for depression on a college campus. This intervention was developed by synthesizing knowledge from symptom level depression research and best practices for brief interventions. Our previous research indicates self-dislike is the most central symptom in college student depression – it best predicts whether students will be experiencing other depression symptoms. This project will test whether our intervention can reduce self-dislike and depression symptoms in college students. We will also examine the intervention's effects on theoretically related constructs such as empathy and hopelessness. College students on Stony Brook’s campus will be universally invited to participate in the intervention, and we will test whether our intervention reduces self-dislike and other depression symptoms compared to a placebo control across one month. Results may provide a scalable, low-burden option to reduce depression in college students. 

Trial preregistration:  ClinicalTrials.gov NCT04082052
The BETR Project
Brief Experiences for Teen Resilience

PIs: Mallory Dobias, BS; Jessica Schleider, PhD
Co-I: Michael Mullarkey, PhD

In collaboration with the Child Mind Institute's Healthy Brain Network 
​
PROJECT SUMMARY: Despite increasing rates of depressive disorders in recent years, a majority of adolescents experiencing depression never access treatment. Additionally, substantial limitations in our capacity to predict whether and where high-symptom adolescents access mental health treatment underscores the need for more accessible, scalable adolescent depression treatments. One computer-based SSI, teaching growth mindset (GM; viewing personal traits as malleable), has reduced adolescent depressive symptoms in multiple RCTs. A second computer-based SSI was recently developed to reduce youth depressive symptoms via targeting reductions in self-hate--a symptom identified as potentially important for the maintenance of other depressive symptoms in adolescents. This BETR Project will test whether either a growth mindset SSI (GM-SSI), a self-kindness SSI (SK-SSI), or both SSIs reduce symptoms of depression in a community sample of adolescents, relative to an active “supportive therapy” SSI, which teaches adolescents to share their emotions with trusted others. Our second goal is to evaluate whether the GM-SSI and SK-SSI target and specifically improve proximal targets, unique to each SSI, immediately after SSI administration, relative to the comparison intervention (e.g., whether the GM-SSI improves perceived control relative to the comparison intervention, and whether the SK-SSI mitigates fear of self-compassion relative to the comparison intervention).Youths participating in existing research through the Healthy Brain Network (N=501) will receive either the growth mindset SSI (GM-SSI), the self-kindness SSI (SK-SSI), or the supportive therapy SSI (ST-SSI). The investigators will examine whether the GM-SSI and/or the SK-SSI, versus the ST-SSI will reduce youth depressive symptoms across three months. Results may identify two novel, potent, and brief interventions for adolescent depressive symptoms.  

Trial preregistration: ClinicalTrials.gov NCT04066985
Single-Session Intervention for Comorbid Internalizing Symptoms in Autism Spectrum Disorder

PI: Matthew Lerner, PhD
Co-PI: Jessica Schleider, PhD

In collaboration with the Social Competence and Treatment Lab, directed by Matthew Lerner, Ph.D.
Supported by the Society of Clinical Child and Adolescent Psychology, APA Div. 53, & the Autism Research Institute
​
PROJECT SUMMARY: Internalizing symptoms (anxiety and depression) are highly prevalent among adolescents with autism spectrum disorder (ASD) and are among the leading risk factors for functional impairment, self-injury, and suicide in this population. Existing interventions for these symptoms are resource-intensive, with variable effects; it is thus often intractably hard to scale and disseminate them. This pilot randomized-controlled trial will test whether a single-session growth mindset intervention (GM SSI), which emphasizes cognitive flexibility, may help reduce depression and anxiety among teens with ASD, providing the first-ever test of a GM SSI in this high-risk population. ​

Trial preregistration: Open Science Framework; ClinicalTrials.gov NCT04208425