Current status and ongoing work
Recruitment is underway at SiO mental health. Students who seek help at SiO are continuously offered the opportunity to participate in the study.
Qualitative interviews are being conducted.
Expansion and planning of the project at Modum Bad and SiT mental health.
Summary
The project explores modern and innovative ways to address the challenge of long waiting times in mental health services. To do this, we plan to develop, implement, and test digital therapy programs that patients complete before receiving regular mental health care.
Development of interventions is inspired by research indicating that Single-session digital interventions can have strong short-term impact on mental health, while being easier to complete than longer, modular digital courses and apps. Although several single-session interventions exist for young people, there are few studies evaluating their effectiveness among clinical adult populations, and none inspired from metacognitive therapy and network theory.
The project uses an innovative study design by both randomizing participants to different groups and measuring symptoms in their everyday lives via smartphones using Ecological momentary assessments. This allows us to explore participants’ symptoms on a more granular level and the mechanisms involved in potential improvement or deterioration. In addition, it enables us to offer tailored feedback to participants depending on their symptom levels.
Objectives
The project aims to develop, implement, and test a Single-session intervention and Ecological momentary intervention scheme tailored to reduce the negative effects of long waiting times in mental health services and be used across a variety of mental health providers in Norway.
The program will be formally tested in a randomized controlled trial at several treatment institutions. The testing will use a combination of pre-post panel measures and ecological momentary assessments.
Due to the scope of the project, an extended pilot phase with two pilot studies is planned. The aim of these pilot projects is to examine the feasibility of the randomized controlled trial and the interventions, as well as further develop the digital therapy programs.
Thtrough the utilization of ecological momentary assessments, the project aims to model symptom variation over time, both within individual participants and across groups. This allows us to identify key mechanisms involved in symptom improvement or deterioration.
Detailed background
Long waiting times for mental health care can make an already vulnerable phase even more difficult. Many experience increased symptoms and stress, higher absence from work or school, and challenges in close relationships. The risk of dropping out of treatment and responding poorly to therapy appears to increase the longer patients have to wait before receiving help.
Digital single-session interventions (SSIs) are an effective and accessible alternative and supplement to traditional therapy. These are brief digital programs that nonetheless function as complete support offers. Several studies have documented positive effects of such programs, but the effects are usually short-lived. This makes this type of intervention particularly suitable for the waiting period before other treatment begins.
Although the research on SSIs is extensive, there are fewer studies examining purely clinical populations, participants on waiting lists, and none that are based on metacognitive therapy and network theory. There are also no studies that combine single-session interventions with Ecological Momentary Assessment (EMA) to examine treatment response in daily life. EMA involves participants responding to short, frequent questionnaires via an app several times a day, which can improve the quality of responses, since they are completed in the moment rather than retrospectively, as with traditional questionnaires.
This study takes EMA one step further by also including Ecological Momentary Interventions (EMI). EMI provides participants with brief, immediate messages and tasks in their everyday lives to help them practice managing their difficulties at the moments when they need it. One challenge in psychological treatment is the gap between therapy sessions and patients’ everyday lives. EMI is one way of reducing this gap. Combined with the digital program, participants will receive a complete and time-limited support plan during the waiting period.
The project combines several forms of scalability:
Digital interventions are often cost-effective and can be offered to many people at the same time – including those without good access to mental health care.
Single-session interventions are brief and reduce costs related to dropout.
Ecological Momentary Interventions can be delivered automatically via mobile phone and may enhance the effect of single-session treatment.
To investigate whether such an offer is effective for patients on a waiting list, a comprehensive research project is planned with an extended development and implementation phase. Both the digital intervention and the momentary interventions are designed and developed specifically for this project. The project will be tested both at Modum Bad, in a sample with longer waiting times and more severe mental health problems, and at SiO and SiT mental Health, both primary healthcare providers for students with mild to moderate difficulties around Norway. The final main study will include four intervention groups – both with and without EMI – in addition to two control groups.
