Submission
| Title: |
Lessons learned and future directions from a remote trial of guided self-help for internalizing distress |
| Co-Authors: |
Peipert, Allison, Indiana University Bloomington; John Buss, BA, Indiana University Bloomington; Isabella Starvaggi, BA, Indiana University Bloomington; Colton Lind, BA, Indiana University Bloomington; Jacqueline Howard, BA, Indiana University Bloomington; Lorenzo Lorenzo-Luaces, Ph.D., Indiana University Bloomington |
Abstract
Background/Significance/Rationale: Internalizing disorders are leading causes of disability with evidence suggesting that the burden of internalizing disorders is being concentrated among younger people. While effective interventions exist, they are very difficult to access, particularly in rural areas. Doing What Matters in Times of Stress (DWM) is a 6-week transdiagnostic guided self-help intervention originally developed by the World Health Organization.
Methods: We conducted a remote trial with adults recruited via social media and assessed engagement and effectiveness of DWM. We measured internalizing symptoms, well-being, intervention usability, and emotion regulation over the intervention period.
Results/Findings: Of the individuals who completed our screening (N=263), 75% (n= 198) were eligible for participation. We reached most eligible participants (71%, n= 141) via phone or email to schedule an initial session, and most attended at least one session (84%, n = 119). Of those who attended one session, most completed more than half the treatment (84%, n = 100). Over the course of the intervention, there was statistically significant (i.e., p < 0.05) improvements in: internalizing distress (d=-1.22, 95% CI: -1.38, -1.06), psychological well-being (d=0.83, 95% CI: 0.69, 0.97), work and social functioning (d=-1.06, 95% CI: -1.21, -0.91), and emotion regulation (reappraisal: d=.68, 95% CI: 0.55, 0.82; suppression: d= -0.35, 95% CI: -0.48, -0.23).
Conclusions/Discussion: As in other trials of internet-based interventions, attrition was high and concentrated to the early part of the intervention. These data support adapting the 6-week guided self-help format into an unguided single-session intervention (DWM-SSI) to allow automatic delivery of the material. Additionally, the material is written at a 4th-grade reading level, suggesting the intervention could be appropriate for those under 18. DWM may have implementation potential for individuals waiting for appointments.
Translational/Human Health Impact: These future directions may push an evidence-based intervention into clinical practice settings to address the public health burden of untreated mental illness.
