Lab Projects

Read about some of our ongoing projects! 

Project COPE: Testing Scalable, Single-Session Interventions for Adolescent Depression in the Context of COVID-19

PI: Jessica Schleider, PhD
Co-Is: Kathryn Fox, PhD; Michael Mullarkey, PhD

Supported by the National Institutes of Health (Office of the Director, NIMH)

PROJECT SUMMARY: States and localities nationwide are taking unprecedented steps to reduce public health threats posed by COVID-19, including school closures affecting >50 million youth. The pandemic has also caused families extreme financial hardship and distress. This combination of collective trauma, social isolation, and economic recession drastically increases risk for adolescent major depression (MD): already the lead cause of disability in youth. However, youth MD treatments face problems of potency and accessibility. Up to 65% of youth receiving MD treatment fail to respond, partly due to MD’s heterogeneity: an MD diagnosis reflects >1400 possible symptom combinations, highlighting the need for treatments matched to personal need. Treatment accessibility issues are similarly severe. Before the pandemic, <50% of youth with MD accessed any treatment at all; newfound financial strain may further preclude families’ capacity to afford care for their children. It is thus critical to identify effective, scalable strategies to buffer against youth MD in the context of COVID-19, along with strategies to match such interventions with youth most likely to benefit. Project COPE will integrate machine learning approaches and large-scale SSI research to rapidly test potent, accessible strategies for reducing adolescent depressive symptoms during COVID-19. Via the largest-ever SSI trial (N=2,452 adolescents), Project COPE will test whether: (1) evidence-based SSIs improve proximal targets (e.g., hopelessness and perceived agency/hope, which has predicted longer-term SSI response) and 3-month clinical outcomes (depressive symptom severity), and (2) whether SSIs targeting cognitive depressive symptoms versus behavioral depressive symptoms differentially affect depression symptoms across 3 months. In this fully-online trial, youths ages 13-16 recruited from across the U.S. via social media-based strategies will be randomized to 1 of 3 self-administered SSIs: a behavioral activation SSI (“Activate Action”), targeting behavioral MD symptoms (anhedonia; activity withdrawal); an SSI teaching growth mindset (“Project Personality”), the belief that personal traits are malleable, targeting cognitive MD symptoms (e.g. hopelessness); or a control SSI (“Sharing Feelings Project”). Per baseline, post-SSI, and 3-month follow-up data, we will test each SSI’s relative benefits, versus the control, for depressive symptoms (at 3 months) and proximal outcomes (hopelessness, agency/hope). Results may identify immediately actionable strategies to matching adolescents to targeted SSIs based on personal needs during the COVID-19 pandemic.

Paper reporting Project COPE Main Outcomes: Preprint (Schleider et al., 2021; invited for revision)
Trial preregistrations: ClinicalTrials.gov NCT04634903; Study Protocol
Leveraging Social Media to Enhance Access to Brief, Evidence-Based, and Low-Cost Mental Health Treatment for LGBTQ+ Adolescents

Co-PIs: Jessica Schleider, PhD; Kathryn Fox, PhD
Co-Is: Jill Ehrenreich-May, PhD; Michael Mullarkey, PhD

Supported by the Upswing Fund for Adolescent Mental Health
In collaboration with the Fox Lab at University of Denver
PROJECT SUMMARY: The COVID-19 pandemic has dramatically increased youth risk for anxiety and depression, while simultaneously undermining youths’ access to mental healthcare. COVID-19-related challenges are disproportionately harming LGBTQ+ and youth of Color, who have experienced disproportionate financial difficulties, discrimination, illness, and death due to the pandemic. These unequal impacts threaten to exacerbate already high risk for mental illness among LGBTQ+ youth of Color, creating a critical need for barrier-free interventions tailored to this population’s needs. The goal of this project is to partner with LGBTQ+ youth of Color to adapt and improve the Lab's evidence-based, single-session, online interventions for LGBTQ+ youth of Color seeking anonymous online mental health support. Via focus groups and partnerships with LGBTQ+ youth of Color with lived experience of mental illness, we will integrate their stories, perspectives, and experiences as we update the language and personalize SSI content to be maximally affirming and acceptable. We will then use social media-based recruitment to disseminate and evaluate these adapted SSIs to ~5,000 LGBTQ+ youth of Color across the United States.

​As of April 2021, preparations for focus groups are underway.
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 (target N = 246) 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 3 months. Results may yield a disseminable model for promoting treatment access after PC-based depression screening.

​As of April 2021, participant recruitment for Project SAFE is underway.

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.

As of April 2021, recruitment for Phase/Aim 1 of TRACK to TREAT (N = 110) is complete; follow-up assessments are underway. Recruitment for Phase 2/Aim 2 (N = 216) begun in March 2021, and follow-ups will span through 2024.

Read about TRACK to TREAT via NIH RePORTER. Clinicaltrials.gov Registration, Phase 2. 

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.

Following promising pilot trial results, ​we are continuing to test the SSC in diverse settings and populations, such as through tele-health and via delivery by lay providers (e.g., college students).

Trial preregistration 1 (initial trial, face-to-face SSC): ClinicalTrials.gov NCT04069832
Trial preregistration 2 (Telehealth SSC): ClinicalTrials.gov NCT04725578
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, PhD; Michael Mullarkey, PhD
Culturally Adapting & Evaluating Project YES in San Antonio

Co-PIs: Jessica Schleider, PhD; Kristin Plastino, MD
Co-​Is: Jenna Sung, BA; Mallory Dobias, BS; Michael Mullarkey, PhD
In Collaboration with UT Teen Health - San Antonio
Supported by a Service Grant from the City of San Antonio, Texas Health Department
PROJECT SUMMARY: Project YES (Youth Empowerment & Support; www.schleiderlab.org/YES) is the first large-scale program evaluation of anonymous, web-based SSIs for adolescent mental health. Project YES aims to evaluate the acceptability and effects of three free, web-based SSIs for adolescent internalizing distress developed by our team: Project Personality, the Teen Goals Project, and the ABC Project, (designed to improve hope, self-compassion, and agency, respectively). Each SSI follows an evidence-based framework SSI construction, developed by our 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 this ongoing program evaluation allows to (1) test the acceptability and feasibility of our SSIs in their current forms, and (2) gauge immediate effects of our SSIs on proximal, clinically-relevant outcomes (agency; hope; self-compassion), and (3) iteratively improve our SSIs per feedback from anonymous teen users.

In December 2020, we partnered with the City of San Antonio, Texas Health Department to adapt Project YES to serve a broader youth population. This partnership has four primary goals:

  1. Culturally adapt Project YES for use with ethnic and racial minority youth, via focus groups with teens living in San Antonio;
  2. Translate Project YES into Spanish, to enable use by Spanish-speaking youth
  3. Disseminate Project YES to 8,000 youth across San Antonio, TX;
  4. Assess the feasibility and acceptability of the culturally-adapted Project YES 
 
Our work on Project YES may produce—and help us iteratively improve—a free-of-charge, acceptable means of providing youth evidence-based, culturally competent, and anonymous mental health support.

Project YES was recently covered in Vox. 

Study preregistration: Open Science Framework
Interim results (published in Journal of Medical Internet Research): Schleider et al., 2020
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.

​As of January 2021, data collection for for Project SAVE is complete. The manuscript reporting intervention outcomes is under peer review.

Trial preregistration:  Open Science Framework; ClinicalTrials.gov NCT 04498143
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.  

​As of April 2021, participant recruitment for The BETR Project is underway.

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. ​

​As of April 2021, participant recruitment for is complete. Data analyses are underway.
​
Trial preregistration: Open Science Framework; ClinicalTrials.gov NCT04208425