Lab Mission

Despite progress in the identification of effective youth mental health interventions,
​rates of youth mental illness remain stable and high.

Low access to treatment contributes to this problem:
In the U.S.,  up to 80% of youths in need of psychological services never receive them.
​
The goals of our research are:

(1) Develop brief, accessible interventions to help reduce youth mental health problems at scale

(2) Identify mechanisms of change and treatment-matching strategies to build potent, personalized interventions

(3) Test novel approaches to dissemination in non-traditional settings (beyond brick-and-mortar clinics)

BRIEF & SINGLE-SESSION INTERVENTIONS (SSIs) FOR YOUTH MENTAL HEALTH 

Due to logistical, financial, and many other barriers, up to 80% of youths discontinue mental health treatment prematurely, with a sizable number dropping out after just one session. As a result, it is important to understand what it is possible to accomplish through a single "dose" of intervention. In a recent meta-analysis, we evaluated the effects of single-session interventions (SSIs) for youth mental health problems. Across 50 RCTs representing 10,508 youths, SSIs demonstrated a significant beneficial effect--even for self-administered interventions (i.e., those that did not involve a therapist). Separately, in a recent systematic review of brief (<4-session) social-psychological interventions, we identified several programs (including SSIs) that have significantly reduced youth mental health problems, especially adolescent depression. Practical and public health implications of these results may be considerable: in some cases, SSIs may present a cost-effective alternative or adjunct to traditional youth psychiatric services.
​Ongoing projects are exploring the promise of SSIs and other scalable intervention strategies—particularly novel, theoretically-precise approaches harnessing family processes and youth cognitions, using low-cost delivery systems--to help lessen the burden of depression and related difficulties youth. We are currently launching projects testing new strategies of matching youths to mechanism-targeted SSIs based on their personal symptom profiles using an idiographic network analysis approach, along with projects testing deployment of SSIs in nontraditional settings (e.g., pediatric primary care).

MALLEABILITY BELIEFS & YOUTH MENTAL HEALTH

​Compared to youths who believe personal traits are malleable, those who believe personal traits are fixed experience more academic and self-regulatory distress. Recently, studies have begun to explore relations between beliefs about the malleability of personal traits, or 'mindsets', and youth mental health problems. In a  meta-analysis on this topic, we observed that youths who view personal traits and abilities as fixed and unchangeable are more likely to experience a wide variety of mental health problems, and that youth psychopathology predicts increases in maladaptive, fixed mindsets over time. In a randomized-controlled trial supported by the NIMH, the APF, and the Harvard Center on the Developing Child, we found that an intervention teaching that emotions, behavior, and symptoms are malleable may show promise: compared to a control program, a 30-minute growth mindset intervention improved physiological stress recovery and perceived control, as well as longer-term anxiety and depressive symptoms, in high-symptom early adolescents.  In a separate study of 222 adolescent girls, a single-session, self-administered program teaching that personal traits (including emotions) can change reduced depression symptoms across a 4-month period, relative to an active comparison program.

Current and future studies are evaluating predictors of this intervention's effects; alternative delivery systems that may enhance potency (e.g., via virtual reality technology, through a collaboration with Limbix VR; details on this clinical trial are available here); mechanisms underlying the intervention's effects (e.g. improved perceived control or reduced hopelessness); and whether the program may help reduce youth depression at scale, either independently or in combination with longer-term evidence-based therapies.

FAMILY PROCESSES, YOUTH MENTAL HEALTH, & INTERVENTION DESIGN

Familial stressors correlate with and predict mental health problems in offspring and unfavorable youth treatment responses. My research has explored how various family stressors—including parental mental illness, low family functioning, parental stress, and family structure—singly and jointly affect youth psychiatric problems and intervention outcomes. Together, this work has led us to develop a new theoretical model, the triadic model of family process, to help guide systematic identification of family-focused intervention strategies. This model outlines networks of parent-level (e.g. parental psychopathology), dyad-level (e.g. sibling conflict), and family-level risk factors (e.g. family stability) that may jointly shape youth processes underlying internalizing dysfunction (e.g., low perceived control).

In several ongoing studies, we are applying this model in developing and evaluating brief, novel strategies for reducing youth internalizing distress and improving treatment retention and outcomes, targeting both youth- and parent-level factors.