Online Skills Training for Emotional Distress

Overseen By Douglas S Mennin, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Teachers College, Columbia University

Must not be taking: Psychotropic medication

Disqualifiers: Suicidal ideation, Substance dependence, Schizophrenia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 7

Duration: 6 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine which of three online skills training programs best helps people manage emotional distress. Participants will try one of three approaches: attention skills, attention with reflective thought, or health and wellness education. The study targets individuals in New York City who frequently feel worried, ruminate on negative thoughts, or are self-critical, and who have been diagnosed with a psychological disorder. Participants will engage in a 6-week program featuring short video modules and weekly coaching calls. As an unphased trial, this study provides a unique opportunity to explore innovative approaches to managing emotional distress.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it requires that any psychotropic medication you are taking has been stable for at least 3 months.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that online skills training programs are generally safe for people. For example, studies on online attention training have found it can help people focus better and feel less bored, indicating that users usually receive these programs well. Additionally, mindfulness training, similar to attention skills training, helps people relax and manage stress more effectively.

The attention and reflective thought skills training builds on these concepts. Reflective training teaches mental skills like focusing and controlling thoughts. This method, used in counseling, appears safe for enhancing mental well-being.

Health and wellness education training also appears safe. It follows coaching methods that support healthy lifestyle changes and teaches practical skills for reducing stress and improving overall wellness.

Overall, these online training programs are low-risk, using proven techniques to help people manage stress and enhance their mental health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these online skills training programs for emotional distress because they offer a flexible, self-directed approach that can be accessed from anywhere, making mental health support more accessible. Unlike traditional face-to-face therapy sessions, these programs use short, engaging video modules that participants can complete at their own pace, each accompanied by suggested activities and skills practice. Additionally, all programs include weekly coaching calls, providing personalized support and accountability. This combination of self-paced learning and one-on-one coaching makes these treatments distinct from other current options, which often require in-person visits and rigid scheduling.

What evidence suggests that this trial's treatments could be effective for coping with emotional distress?

This trial will compare different online skills training methods for emotional distress. Participants in the Attention Skills Training arm will receive online training to improve attention. Research shows this can help people focus better and feel less emotional distress. Studies have found that this type of training can increase attention and reduce boredom.

Participants in the Attention and Reflective Thought Skills Training arm will receive training that early results suggest can improve mindfulness and self-control, making stress management easier.

Participants in the Health and Wellness Education Training arm will receive training linked to less health-related distress and better stress management. Research indicates that digital health coaching can help people set and reach health goals, leading to improved emotional well-being. Together, these training methods offer promising ways to handle emotional distress. ^{1 2 5 6 7}

Who Is on the Research Team?

Douglas S Mennin, PhD

Principal Investigator

Teachers College, Columbia University

Are You a Good Fit for This Trial?

This trial is for adults aged 18-65 in New York City who are fluent in English and experiencing high levels of worry, rumination, or self-criticism. Participants must have a psychological disorder as per DSM-5 criteria and access to a smartphone with internet. It's not for those currently receiving other treatments, college students at Teachers College, on unstable psychotropic meds, with suicidal thoughts, certain medical conditions or severe psychiatric disorders.

Inclusion Criteria

Fluent in English (and therefore able to provide consent)

Currently living in New York City

Access to a smartphone and the internet

Exclusion Criteria

Active suicidal ideation or intent

Current students at Teachers College, Columbia University

My mental health medication has been stable for less than 3 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (online)

Treatment

Participants complete 6 weeks of self-directed, online skills training for coping with distress

6 weeks

6 weekly online modules, weekly 5-10 minute calls

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Online, Self-Directed Attention & Reflective Thought Skills Training with Coaching Support
• Online, Self-Directed Attention Skills Training with Coaching Support
• Online, Self-Directed Health & Wellness Education Training with Coaching Support

Trial Overview The study compares three online skills trainings aimed at coping with distress: one focuses on attention skills; another combines attention with reflective thought; the third offers health and wellness education. Each participant receives coaching support throughout the training process.

How Is the Trial Designed?

Group I: Health and Wellness Education Training Experimental Treatment 1 Intervention

Participants assigned to Health and Wellness Education Training will receive 6-weeks of self-directed, online skills training on stress-reduction psychoeducation. Six weekly modules will include 10-15 minutes of narrated videos, as well as suggestions for activities and skills practices between modules. Participants will also schedule weekly, 5-10 minute calls with an assigned skills training coach to discuss the participant's experience with the skills training.

Group II: Attention and Reflective Thought Skills Training Experimental Treatment 1 Intervention

Participants assigned to Attention and Reflective Thought Skills Training will receive 6-weeks of self-directed, online skills training on attention and metacognitive regulation skills for coping with distress. Six weekly modules will include 10-15 minutes of narrated videos, as well as suggestions for activities and skills practices between modules. Participants will also schedule weekly, 5-10 minute calls with an assigned skills training coach to discuss the participant's experience with the skills training.

Group III: Attention Skills Training Experimental Treatment 1 Intervention

Participants assigned to Attention Skills Training will receive 6-weeks of self-directed, online skills training on attention regulation skills for coping with distress. Six weekly modules will include 10-15 minutes of narrated videos, as well as suggestions for activities and skills practices between modules. Participants will also schedule weekly, 5-10 minute calls with an assigned skills training coach to discuss the participant's experience with the skills training.

Who Is Running the Clinical Trial?

Teachers College, Columbia University

Lead Sponsor

Trials

27

Recruited

6,100+

Published Research Related to This Trial

In a study involving 241 participants who underwent 8 weeks of internet-delivered Cognitive Behavior Therapy (iCBT), a direct relationship was found between the frequency of using CBT skills and current levels of anxiety, depression, and functional impairment.

However, the study did not find consistent long-term effects of CBT skills usage on clinical outcomes, suggesting that while using these skills is beneficial in the moment, their role in maintaining improvements after therapy is still unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relationship between posttherapeutic Cognitive Behavior Therapy skills usage and follow-up outcomes of internet-delivered Cognitive Behavior Therapy. Eilert, N., Wogan, R., Adegoke, A., et al.[2023]

A pilot study showed that a Virtual Mindfulness Coach is more effective than self-administered training in helping students establish a regular mindfulness practice, indicating its potential for enhancing patient education and behavior change.

Participants using the virtual coach reported higher self-efficacy and were in more advanced stages of change according to the transtheoretical model, suggesting that the interactive and adaptive features of the coach contribute significantly to its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual training and coaching of health behavior: example from mindfulness meditation training. Hudlicka, E.[2022]

Clinicians who participated in a didactic seminar followed by supervised casework demonstrated significantly better adherence and skill in implementing cognitive-behavioral therapy (CBT) compared to those who only reviewed a CBT manual.

The addition of a CBT training website provided intermediate results, suggesting that more interactive and supportive training methods enhance the effectiveness of clinicians in applying CBT techniques.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Sholomskas, DE., Syracuse-Siewert, G., Rounsaville, BJ., et al.[2019]

A study involving 225 patients using therapist-assisted internet-delivered cognitive behaviour therapy (T-ICBT) for depression and anxiety revealed that 64% of participants highlighted the strengths of the course, such as downloadable content and the sharing of patient experiences.

Patient feedback indicated areas for improvement, including a desire for more diverse patient stories and better alignment of therapist availability with patient needs, which can enhance the effectiveness and personalization of T-ICBT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient Perspectives on Strengths and Challenges of Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy: Using the Patient Voice to Improve Care. Hadjistavropoulos, HD., Faller, YN., Klatt, A., et al.[2020]

A study involving 43 postgraduate health professionals showed that online training for Cognitive Behavior Therapy (CBT) was as effective as traditional in-person training in terms of content satisfaction and didactic quality.

While online training was generally well-received, there was a slight preference for in-person training regarding professional benefit and active participation, suggesting that online methods can be effectively integrated into CBT education even after social distancing measures are lifted.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching Cognitive Behavior Therapy to Postgraduate Health Care Professionals in Times of COVID 19 - An Asynchronous Blended Learning Environment Proved to Be Non-inferior to In-Person Training. Soll, D., Fuchs, R., Mehl, S.[2021]

The automated e-Coach helped employees gain insights into their stress levels and resilience strategies, but participants struggled to integrate these strategies into their daily lives, indicating a need for more practical guidance.

While participants reported some benefits from the e-Coach in understanding their stress and resilience, the lack of recurring events in their lives made it difficult to practice and evaluate the strategies effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How Reflective Automated e-Coaching Can Help Employees Improve Their Capacity for Resilience: Mixed Methods Study. Lentferink, A., Oldenhuis, H., Velthuijsen, H., et al.[2023]

A study analyzing responses from 301 clients undergoing Internet-delivered cognitive behaviour therapy (ICBT) revealed that clients often face specific challenges with skill practice and maintenance, which can lead to decreased engagement over time.

Clients reported various difficulties, with thought challenging and graded exposure techniques being associated with the most significant challenges, highlighting the need for therapists to proactively address these issues to improve client retention and success in ICBT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding Client Difficulties in Transdiagnostic Internet-Delivered Cognitive Behaviour Therapy: A Qualitative Analysis of Homework Reflections. Peynenburg, V., Wilhelms, A., Sapkota, R., et al.[2022]

A study involving 191 patients who completed the Alcohol Change Course (ACC) showed that 69.6% were satisfied with the program, indicating its efficacy as an Internet-delivered cognitive behavior therapy for alcohol misuse.

Patients found skills like coping with cravings and managing risky situations particularly helpful, but many suggested increasing personal interaction and providing more information to enhance the course experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion. Hadjistavropoulos, HD., Chadwick, C., Beck, CD., et al.[2021]

In a study involving 8341 employees participating in a 30-day online mindfulness program, those who engaged in live mindfulness sessions experienced a significant reduction in perceived stress, while those who only used recorded sessions did not show similar benefits.

The results suggest that live mindfulness training is more effective for lowering stress compared to recorded sessions, highlighting the importance of interactive, real-time participation in mindfulness programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Relative Contributions of Live and Recorded Online Mindfulness Training Programs to Lower Stress in the Workplace: Longitudinal Observational Study. Wolever, RQ., Finn, MTM., Shields, D.[2022]

A self-directed Stress Management and Resiliency Training (SMART) program using only written materials was effective in improving stress, resilience, mindfulness, anxiety, and quality of life among 37 employees over a 12-week period.

Out of the 37 participants, 34 completed the study, showing that the program can be successfully implemented without in-person training, making it accessible for wider use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bibliotherapy to decrease stress and anxiety and increase resilience and mindfulness: a pilot trial. Sharma, V., Sood, A., Prasad, K., et al.[2014]

A pilot study involving 16 patients with anxiety disorders tested a 4-week eHealth protocol for attention training technique (ATT), showing no dropouts and over 80% of participants meeting practice benchmarks.

Improvements were observed in clinician-rated, patient-rated, and performance-based outcomes, suggesting that ATT could be a promising eHealth treatment for anxiety disorders that warrants further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pilot Study of a 4-Week eHealth-Based Protocol of the Attention Training Technique Component of Metacognitive Therapy Among Patients With Anxiety Disorders. Fergus, TA., Hiraoka, R.[2020]

Guided Internet-based cognitive behavior therapy (iCBT) was found to be more effective than online psychoeducation (OPE) in reducing depressive symptoms, especially in individuals without prior psychotherapy, with a significant effect size of Cohen's d = 1.09 for iCBT compared to d = 0.60 for OPE.

While both treatments were effective, 26.2% of participants in the iCBT group reported side effects, highlighting the need to consider potential negative effects when implementing this therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The more I got, the less I need? Efficacy of Internet-based guided self-help compared to online psychoeducation for major depressive disorder. Reins, JA., Boß, L., Lehr, D., et al.[2019]

An online training program significantly improved socioemotional skills in 448 adults, enhancing their emotional awareness, mindfulness, and emotion regulation strategies compared to a placebo control.

Sustained improvements in emotional skills were observed at a 6-month follow-up for participants who completed the training, suggesting the program may offer protective benefits against emotional challenges, particularly during stressful times like the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in mindfulness, interoceptive and emotional awareness, emotion regulation, and interpersonal emotion management following completion of an online emotional skills training program. Smith, R., Persich, MR., Chuning, AE., et al.[2023]

Citations

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Online Skills Training for Emotional Distress This trial is testing three types of online lessons to help adults in NYC manage stress and negative thoughts. The lessons focus on improving attention, ...

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Well-Being Technologies and Positive Psychology ... Metacognition meta-skills refer to a set of consciousness-raising skills, that allow one to intentionally observe, regulate, and adapt cognitive and emotional ...