Music and Visual Arts for Teen Mental Health

(SMART Trial)

Recruiting at 1 trial location

Overseen By Pablo Ripolles, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: New York University

Disqualifiers: Age not 13-16, MEG/MRI contraindications, others

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

Compensation: Varies

Number of Visits: 24

90 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Music and Visual Arts Digital Intervention, SMART, Arts-Based Digital Intervention for teen mental health?

Digital interventions, including those using social media, show promise in reaching young people who prefer online support and may not engage with traditional mental health services. These interventions can help address mental health issues by promoting engagement and social connectedness, which are important for improving mental health outcomes. ^{1 2 3 4 5}

Is the Music and Visual Arts Digital Intervention safe for teens?

The eSMART-MH study assessed safety as one of the critical parameters of an avatar-based digital intervention for reducing depressive symptoms in young adults, suggesting that digital interventions like Music and Visual Arts Digital Intervention are generally considered safe. ^{1 2 4 6 7}

How is the Music and Visual Arts Digital Intervention treatment different from other treatments for teen mental health?

The Music and Visual Arts Digital Intervention is unique because it combines music and visual arts in a digital format to engage teens, making it more accessible and appealing to young people who are familiar with digital platforms. This approach is different from traditional therapies as it leverages creative expression and online access to support mental health, which can enhance engagement and rapport with adolescents. ^{8 9 10 11 12}

What is the purpose of this trial?

The primary goal of this interventional study is to explore whether 3 months of arts-based digital interventions can change the way in which teenagers (13-16 years of age) use social media and are affected by them. The main questions it aims to answer are: * Can we give teenagers new, stimulating, and more goal-oriented ways of using social media through arts-based digital trainings and active discussions around social media? * Can these arts-based digital interventions also help teenagers to overcome the negative consequences of social media overuse (such as depression, anxiety, and reduced attention and cognitive performance)? Secondarily, this study also aims to explore the brain and behavioral traits associated with these arts-based interventions to better understand how they work. Researchers will compare a music composition intervention with two other interventions: an active control intervention based on visual-arts instead of music (i.e., photography), and a passive approach to control for the mere pass of time. Participants will: * Complete a baseline and a post-intervention evaluation where researchers will obtain measures of cognitive performance (attention and executive functions, mainly), mood, mental health, brain structure and function, and social media usage and attitudes towards these platforms. * Complete weekly measures regarding their use of social media platforms and their mood. * Complete 3-month arts-based composition / edition intervention (based on music or visual-arts/photography), or the equivalent time with no intervention (passive control group). The motivation of this study was driven by the observation that, in recent years, there has been an increasing use of social media and digital devices in teenagers, while the scientific community still does not fully understand the effects of the overuse of these digital means and platforms. Moreover, some of the negative effects described to be associated with the passive overuse of social media tap on the same brain structures that are benefited by musical and artistic trainings. Hence, we thought it could be worth trying to use arts-based training to help teenagers compensate for or overcome the negative effects of social media at the neural, cognitive, mood and mental health levels. This study introduces novelty through three main aspects. Firstly, it employs a digital art creation approach that requires no classical art training, making it more accessible and less intimidating. Secondly, it incorporates commonly used digital devices (e.g., phones/tablets) and motivating environments into the learning process, integrating the development of new digital skills and the practice of critical thinking around the use of SM into normal classroom activities. Finally, the study employs a multi-methodological approach to explore the brain mechanisms underlying mental-health and cognitive changes resulting from arts-based interventions. Finally, we believe that conclusions from SMART will: * set the basis for developing preventive and therapeutic interventions for depression and anxiety in teenagers, * promote educational programs that provide optimal tools for adolescents to navigate social media in a healthy manner, and * inspire educational policy.

Eligibility Criteria

This trial is for healthy teenagers aged 13-16 who may experience the impact of social media on their mental health. It's designed to see if creative digital activities like making music or photography can lead to healthier social media habits and improve mood, attention, and overall mental well-being.

Inclusion Criteria

I am between 13 and 16 years old.

Parents of child participants willing to answer questions about their child

Participants must not have any contraindications for completing MEG or MRI scans

Exclusion Criteria

I am not between the ages of 13 and 16.

Participants with contraindications for MEG or MRI scans for optional neuroimaging measures

Parents who are not parents of a child enrolled in the study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants engage in a 3-month arts-based digital intervention, either in music composition or photography, with weekly self-reporting on mood and social media usage.

12 weeks

24 sessions (in-person, twice a week)

Follow-up

Participants complete a post-intervention evaluation to assess changes in cognitive performance, mental health, and social media usage.

2 weeks

Optional Control Group Intervention

Control group participants are offered the opportunity to complete the intervention of their choice after the study.

Treatment Details

Interventions

• Music and Visual Arts Digital Intervention

Trial Overview The study tests if a 3-month program of digital art creation (music composition or photography editing) can positively influence teens' social media use and mental health. Participants will also be part of discussions about social media, with evaluations before and after the intervention.

Participant Groups

Group I: Music Composition / Edition Experimental Treatment 1 Intervention

Teenage participants assigned to the 'Music Composition / Edition' (MUS) intervention will receive the 3-month Music Composition Intervention, completing self-reporting weekly measures of mood and social media usage, as well as a pre- and a post-intervention evaluation in which cognitive, mental-health, mood, social media usage and neuroimaging measures will be obtained.

Group II: Photography Composition / Edition Active Control 1 Intervention

Teenage participants assigned to the 'Photography Composition / Edition' or Visual-Arts (VIS) intervention will receive the 3-month Photography Composition/Edition Intervention, completing self-reporting weekly measures of mood and social media usage, as well as a pre- and a post-intervention evaluation in which cognitive, mental-health, mood, social media usage and neuroimaging measures will be obtained.

Group III: Control Active Control 1 Intervention

Teenage participants assigned to the 'Passive Control' (CON) arm will complete self-reporting weekly measures of mood and social media usage during 3 months, as well as a pre- and a post-intervention evaluation in which cognitive, mental-health, mood, social media usage and neuroimaging measures will be obtained. Once their participation in the study is complete, controls will be offered to complete the intervention of their choosing, according to the availability of teaching artists and locations to perform this.

Who Is Running the Clinical Trial?

New York University

Lead Sponsor

Trials

249

Recruited

229,000+

American Composers Orchestra

Collaborator

Trials

1

Recruited

90+

Findings from Research

POD Adventures is a blended problem-solving game-based intervention designed for adolescents in India, developed through extensive stakeholder engagement and user-testing with 126 participants, including students and service providers.

The intervention aims to provide accessible mental health support through a gamified app, emphasizing relatability and interactivity, and will be evaluated in a randomized controlled trial to assess its effectiveness in low-resource school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Design and Development of the "POD Adventures" Smartphone Game: A Blended Problem-Solving Intervention for Adolescent Mental Health in India. Gonsalves, PP., Hodgson, ES., Kumar, A., et al.[2023]

Approximately 22.2% of children and adolescents with mental disorders in the study met the DSM-5 criteria for internet gaming disorder, indicating a significant prevalence of screen media addiction among this population.

The study found that over two-thirds of participants exceeded the recommended screen time of 2 hours per day, with an average usage of 3.14 hours, highlighting concerns about excessive screen media use in children and adolescents with mental health issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Problematic screen media use in children and adolescents attending child and adolescent psychiatric services in a tertiary care center in North India. Raju, V., Sharma, A., Shah, R., et al.[2023]

Digital interventions delivered through social media show promise in improving mental health outcomes for adolescents and young adults, with preliminary evidence from 15 studies published between 2017 and 2021.

The review emphasizes the need for further research to explore the effectiveness of these interventions, particularly in leveraging existing peer networks and scaling them to reach more young people in need of mental health support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social media-based interventions for adolescent and young adult mental health: A scoping review. Kruzan, KP., Williams, KDA., Meyerhoff, J., et al.[2023]

This systematic review analyzed 25 studies on digital health interventions (DHIs) for mental disorders in youth, identifying cognitive and affective mediators as key factors influencing intervention outcomes, with 100% of affective mediators showing significant effects.

Despite the promising findings, most studies lacked the ability to draw causal conclusions, highlighting the need for improved research designs to better understand how DHIs work and enhance their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mechanisms of Change in Digital Health Interventions for Mental Disorders in Youth: Systematic Review. Domhardt, M., Engler, S., Nowak, H., et al.[2021]

The study found that the social media-based intervention Horyzons effectively fostered social connections and a sense of belonging among young people with first-episode psychosis, enhancing their social functioning over the long term.

Despite the positive experiences reported, participants faced barriers such as social anxiety and internalized stigma that hindered their engagement with the platform, suggesting the need for customizable features in digital interventions to better support users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Young People's Experience of a Long-Term Social Media-Based Intervention for First-Episode Psychosis: Qualitative Analysis. Valentine, L., McEnery, C., O'Sullivan, S., et al.[2020]

Adolescents with nonsuicidal self-injury (NSSI) expressed a strong interest in smartphone-based mental health interventions, provided they are perceived as helpful, relevant, and user-friendly, highlighting the importance of tailoring these tools to their specific needs.

The study developed a framework emphasizing that effective digital mental health interventions should consider the individual user, their mental health condition, and technology-related factors, necessitating collaboration among adolescents, mental health professionals, and technology experts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Smartphone Apps Are Cool, But Do They Help Me?": A Qualitative Interview Study of Adolescents' Perspectives on Using Smartphone Interventions to Manage Nonsuicidal Self-Injury. Čuš, A., Edbrooke-Childs, J., Ohmann, S., et al.[2021]

The avatar-based intervention eSMART-MH was found to be necessary, acceptable, and safe for young adults, showing promise in reducing depressive symptoms over a 12-week period with 60 participants.

Compared to usual care, eSMART-MH demonstrated greater feasibility, suggesting that improving access through mobile devices could enhance its effectiveness as a digital therapeutic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing the Critical Parameters of eSMART-MH: A Promising Avatar-Based Digital Therapeutic Intervention to Reduce Depressive Symptoms. Pinto, MD., Greenblatt, AM., Hickman, RL., et al.[2018]

A pilot study involving five young people in a CAMHS setting showed that a weekly music group over 2 months was enjoyable and helped improve mood, self-confidence, and social skills.

The music group also led to good attendance at clinic appointments, indicating it may enhance engagement in mental health services for young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot music group for young people attending a community Child and Adolescent Mental Health Service. McDonald, J., Codrea, A., Gavin, B.[2019]

In a study of 66 adolescent patients with anorexia, those receiving music and art therapy combined with cognitive behavioral therapy (CBT) showed significantly greater improvements in body weight, BMI, and emotional well-being compared to a control group.

The treatment group also experienced a lower dropout rate and higher overall treatment satisfaction, indicating that this combined therapy approach is not only effective but also more engaging for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Music and art therapy combined with cognitive behavioral therapy to treat adolescent anorexia patients. Wang, C., Xiao, R.[2023]

Young people aged 18-24 perceive online arts and culture (OAC) as beneficial for mental health, particularly valuing human connection and the ability to engage regularly, which enhances their experience.

Participants reported that OAC can disrupt negative thought patterns and improve mood through mechanisms like reflection, creativity, and escapism, highlighting the potential of OAC to support mental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online arts and culture for mental health in young people: a qualitative interview study. Syed Sheriff, R., Bergin, L., Bonsaver, L., et al.[2023]

A systematic review of eight studies on visual art and music interventions for eating disorders found limited and inconclusive evidence regarding their effectiveness.

While these interventions may help reduce negative emotional states in patients, more research is needed to determine their clinical relevance and effectiveness in treating eating disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model. Pedra Cruz Bettin, B., Urquiza Nogueira, L., Bertasso de Araujo, PA., et al.[2023]

A scoping review of 23 studies involving youth aged 4 to 25 with various mental health conditions found that music therapy is the most commonly researched intervention, primarily aimed at improving social skills.

While participants generally appreciate music interventions, the effectiveness is hard to determine due to varied research designs, highlighting the need for more standardized studies to better understand their therapeutic benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Music interventions with children, adolescents and emerging adults in mental health settings: a scoping review. Romano, M., Archambault, K., Garel, P., et al.[2023]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Design and Development of the "POD Adventures" Smartphone Game: A Blended Problem-Solving Intervention for Adolescent Mental Health in India. [2023]

2. India pubmed.ncbi.nlm.nih.gov

Problematic screen media use in children and adolescents attending child and adolescent psychiatric services in a tertiary care center in North India. [2023]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Social media-based interventions for adolescent and young adult mental health: A scoping review. [2023]

4. Canada pubmed.ncbi.nlm.nih.gov

Mechanisms of Change in Digital Health Interventions for Mental Disorders in Youth: Systematic Review. [2021]

5. Canada pubmed.ncbi.nlm.nih.gov

Young People's Experience of a Long-Term Social Media-Based Intervention for First-Episode Psychosis: Qualitative Analysis. [2020]

6. Switzerland pubmed.ncbi.nlm.nih.gov

"Smartphone Apps Are Cool, But Do They Help Me?": A Qualitative Interview Study of Adolescents' Perspectives on Using Smartphone Interventions to Manage Nonsuicidal Self-Injury. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Assessing the Critical Parameters of eSMART-MH: A Promising Avatar-Based Digital Therapeutic Intervention to Reduce Depressive Symptoms. [2018]

8. England pubmed.ncbi.nlm.nih.gov

A pilot music group for young people attending a community Child and Adolescent Mental Health Service. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Music and art therapy combined with cognitive behavioral therapy to treat adolescent anorexia patients. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Online arts and culture for mental health in young people: a qualitative interview study. [2023]

11. England pubmed.ncbi.nlm.nih.gov

Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model. [2023]

12. England pubmed.ncbi.nlm.nih.gov

Music interventions with children, adolescents and emerging adults in mental health settings: a scoping review. [2023]