Resilience Training for Mental Illness Prevention

Overseen By Nicole R DeTore, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Must not be taking: Psychotropic medications

Disqualifiers: Psychotherapy

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

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

70 Participants Needed

Trial Summary

What is the purpose of this trial?

This research study aims to develop a brief group-based treatment called Resilience Training for Teens, then to test how well it protects high school students with mild symptoms of depression, anxiety, or having unusual feelings from developing mental illnesses.

Will I have to stop taking my current medications?

If you are currently taking psychotropic medications (drugs that affect your mind, emotions, or behavior), you cannot participate in this trial. However, medications for attention deficit/hyperactivity disorder are allowed.

What data supports the effectiveness of the treatment Resilience Training for Teens, Transdiagnostic Intervention for Adolescents?

Research suggests that resilience-focused interventions can help reduce mental health problems in children and adolescents by strengthening protective factors, especially during times of increased risk or adversity. Additionally, transdiagnostic prevention programs, which address multiple mental health issues rather than focusing on a single disorder, have been shown to be cost-effective and beneficial in reducing psychopathology in young adults. ^{1 2 3 4 5}

Is Resilience Training for Mental Illness Prevention safe for humans?

The interventions, including PROCARE and PROCARE+, were found to be acceptable with good satisfaction rates, suggesting they are generally safe for adolescents. ^{6 7 8 9 10}

How is the Resilience Training for Teens treatment different from other treatments for mental illness prevention?

Resilience Training for Teens is unique because it focuses on building resilience by training adolescents to recall and anticipate specific positive events, enhancing their ability to handle stress and adversity. This approach is distinct from traditional treatments as it emphasizes positive memory recall and future event anticipation to boost mental well-being. ^{11 12 13 14 15}

Eligibility Criteria

This trial is for high school students aged 14-19 who can communicate in English and have had at least one psychotic experience. They must be willing to give consent (or assent if under 18) and have a parent or guardian who can also consent and participate in a session.

Inclusion Criteria

Able to communicate in English

I am a high school student aged between 14 and 19.

Endorsed at least one psychotic experience

Exclusion Criteria

I am prescribed medication for a mental health condition.

I am currently receiving therapy for my mental health.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Waitlist

A one year waitlist period where participants will not participate in Resilience Training for Teens

1 year

Treatment

Participants receive a brief 6-session group-based behavioral intervention called Resilience Training for Teens

6 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 year

Treatment Details

Interventions

• Resilience Training for Teens

Trial Overview The study is testing 'Resilience Training for Teens,' a group-based program designed to help prevent the development of serious mental illnesses in adolescents showing early signs of depression, anxiety, or unusual experiences.

Participant Groups

Group I: Resilience Training for Teens Experimental Treatment 1 Intervention

A brief 6-session group-based behavioral intervention for teens at risk of a mental illness.

Group II: Waitlist Active Control 1 Intervention

A one year waitlist period where participants will not participate in Resilience Training for Teens. Following that one year waitlist period, they can participate in Resilience Training for Teens.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Findings from Research

Higher levels of resilience in children and adolescents are consistently linked to fewer mental health problems, based on a review of 25 studies, highlighting the importance of resilience in promoting mental well-being.

Resilience is influenced by a variety of factors, including social, cultural, and family contexts, suggesting that interventions aimed at enhancing resilience should consider these multisystem influences for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resilience and mental health in children and adolescents: an update of the recent literature and future directions. Mesman, E., Vreeker, A., Hillegers, M.[2023]

The Transition_psy study aims to evaluate changes in mental health care needs and quality of life for 300 emerging adults transitioning from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) over a 24-month period.

This study is significant as it is the first national cohort study on Transition Psychiatry in French-speaking Belgium, focusing on understanding the relationship between genetic, environmental, and clinical factors in developing mental health issues during this critical transition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study Protocol: Transition_psy a Multicenter Prospective Longitudinal Cohort Study Assessing Risk and Protective Factors to Develop Psychopathology in Transitional Age Youth in Belgium. Reis, J., Marchini, S., De Leeuw, A., et al.[2021]

A systematic review of 9,562 articles on adolescent mental health identified 105 studies that helped develop a framework categorizing resilience into three dimensions: enduring adversity versus overcoming distress, resilience as a trait versus a process, and individual versus group resilience.

This framework can enhance understanding and comparison of resilience concepts in mental health research, policy, and clinical practice, promoting better strategies for strengthening adolescent resilience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Concepts of Resilience in Adolescent Mental Health Research. Anderson, K., Priebe, S.[2021]

Mental disorders in children and adolescents are a major global health concern, accounting for 15-30% of disability-adjusted life years, highlighting the urgent need for effective prevention and intervention strategies.

Resilience-focused interventions that strengthen protective factors may help reduce mental health problems during challenging times, but future research should improve the measurement and reporting of these interventions to better understand their impact and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child and Adolescent Mental Health and Resilience-Focussed Interventions: A Conceptual Analysis to Inform Future Research. Dray, J.[2021]

The Resilience Training (RT) program, involving 107 college students with mild depressive or subclinical psychotic symptoms, led to significant reductions in psychotic experiences, distress, depression, and anxiety after just four sessions, compared to a waitlist control group.

Improvements in resilience, mindfulness, and self-compassion were correlated with symptom reductions, and these benefits were maintained even 12 months after the intervention, suggesting RT's long-term efficacy in enhancing mental health among at-risk young adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a transdiagnostic, prevention-focused program for at-risk young adults: a waitlist-controlled trial. DeTore, NR., Luther, L., Deng, W., et al.[2023]

This study is the first randomized controlled trial evaluating a selective transdiagnostic prevention program for emotional problems in adolescents, involving 286 participants, which showed that tailored interventions like PROCARE+ were more effective than standard emotional psychoeducation.

Both PROCARE and PROCARE+ interventions were well-received by participants, indicating high acceptability and satisfaction, suggesting that these programs could be beneficial in reducing the risk of anxiety and depression in at-risk adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. Vivas-Fernandez, M., Garcia-Lopez, LJ., Piqueras, JA., et al.[2023]

This study is the first randomized controlled trial evaluating a selective transdiagnostic prevention program for emotional problems in adolescents, involving 208 participants, and found that tailored interventions significantly improved emotional outcomes compared to an active control group.

The PROCARE+ intervention, which included personalized modules addressing individual risk factors, showed superior effectiveness in both the short and long term, indicating that targeted approaches can be beneficial for at-risk adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. Vivas-Fernandez, M., Garcia-Lopez, LJ., Piqueras, JA., et al.[2023]

A systematic review of 57 randomized controlled trials involving school-based resilience-focused interventions showed effectiveness in reducing depressive symptoms, internalizing problems, externalizing problems, and general psychological distress in children and adolescents.

These interventions were particularly effective for short-term reductions in anxiety and depressive symptoms, especially when using cognitive-behavioral therapy approaches, highlighting their potential in school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting. Dray, J., Bowman, J., Campbell, E., et al.[2018]

The FIRST intervention, a flexible transdiagnostic psychotherapy designed for youth with various mental health issues, is being rigorously tested in a randomized controlled trial involving 212 participants aged 7-15, comparing its effectiveness to usual care in community clinics.

This study aims to determine if FIRST improves mental health outcomes by regulating negative emotions and to identify factors that influence how clinicians implement this treatment, potentially making it a practical option for addressing the diverse needs of youths in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Principle-Guided Psychotherapy for Children and Adolescents (FIRST): study protocol for a randomized controlled effectiveness trial in outpatient clinics. Bailin, A., Cho, E., Sternberg, A., et al.[2023]

The FIRST intervention, a flexible transdiagnostic psychotherapy designed for youth with various mental health issues, is being rigorously tested in a randomized controlled trial involving 212 participants aged 7-15, comparing its effectiveness to usual care in community clinics.

This study aims to determine if improvements in mental health outcomes from FIRST are mediated by the regulation of negative emotions, potentially offering a practical approach to enhance treatment for youths with comorbid conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Principle-Guided Psychotherapy for Children and Adolescents (FIRST): Study Protocol for a Randomized Controlled Effectiveness Trial in Outpatient Clinics. Bailin, A., Cho, E., Sternberg, A., et al.[2023]

The Tutor of Resilience model trains service providers to focus on the strengths and healing capacities of individuals who have faced adversity, which can enhance the effectiveness of interventions.

This model has been successfully applied in humanitarian settings to support children and youth under stress, emphasizing the importance of culturally and contextually relevant interventions in building resilience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tutor of Resilience: A Model for Psychosocial Care Following Experiences of Adversity. Giordano, F., Cipolla, A., Ungar, M.[2023]

A cluster randomized controlled trial was conducted with adolescents to evaluate the effectiveness of Positive Events Training (PET) in enhancing resilience and mental wellbeing, comparing it to a creative writing program over four weekly sessions.

The study aims to provide evidence for the PET program's effectiveness, potentially leading to a free online protocol for teachers to help students improve their mental health without needing external trainers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study protocol for a randomized controlled trial of the RASPERA project: recalling and anticipating specific positive events to boost resilience in adolescents. Loyen, E., Bogaert, L., Hallford, DJ., et al.[2023]

A culturally adapted resilience curriculum for low-income, predominantly racial and ethnic minority students significantly improved overall internal resilience scores, particularly in problem-solving and empathy skills.

The curriculum not only enhanced connections among students and between students and teachers but also helped destigmatize mental health issues, indicating its potential as a valuable resource in schools lacking mental health services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting and Implementing a School-Based Resilience-Building Curriculum Among Low-Income Racial and Ethnic Minority Students. Ijadi-Maghsoodi, R., Marlotte, L., Garcia, E., et al.[2020]

The Summer Institute in Global Mental Health and Psychosocial Support provides essential training for professionals working with communities affected by severe adversities, focusing on enhancing social connectedness and resilience.

The program emphasizes the importance of supportive organizational contexts, understanding complex systems, and fostering healing, using a mix of teaching methods including interactive exercises and case studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Building Resilience in Families, Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support. Saul, J., Simon, W.[2017]

Adolescence is a critical period for intervening in the effects of early-life adversity (ELA), as it is marked by significant brain development and increased sensitivity to social influences, which can enhance resilience.

Key intrapersonal factors such as reward processing, affective learning, and self-regulation become more important during adolescence, and understanding how these factors interact with puberty may provide new opportunities for effective interventions against the negative impacts of ELA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurobiological Markers of Resilience to Early-Life Adversity During Adolescence. Méndez Leal, AS., Silvers, JA.[2021]

References

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

Resilience and mental health in children and adolescents: an update of the recent literature and future directions. [2023]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Study Protocol: Transition_psy a Multicenter Prospective Longitudinal Cohort Study Assessing Risk and Protective Factors to Develop Psychopathology in Transitional Age Youth in Belgium. [2021]

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

Concepts of Resilience in Adolescent Mental Health Research. [2021]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Child and Adolescent Mental Health and Resilience-Focussed Interventions: A Conceptual Analysis to Inform Future Research. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Efficacy of a transdiagnostic, prevention-focused program for at-risk young adults: a waitlist-controlled trial. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. [2023]

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

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting. [2018]

9. England pubmed.ncbi.nlm.nih.gov

Principle-Guided Psychotherapy for Children and Adolescents (FIRST): study protocol for a randomized controlled effectiveness trial in outpatient clinics. [2023]

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

Principle-Guided Psychotherapy for Children and Adolescents (FIRST): Study Protocol for a Randomized Controlled Effectiveness Trial in Outpatient Clinics. [2023]

11. Switzerland pubmed.ncbi.nlm.nih.gov

Tutor of Resilience: A Model for Psychosocial Care Following Experiences of Adversity. [2023]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Study protocol for a randomized controlled trial of the RASPERA project: recalling and anticipating specific positive events to boost resilience in adolescents. [2023]

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

Adapting and Implementing a School-Based Resilience-Building Curriculum Among Low-Income Racial and Ethnic Minority Students. [2020]

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

Building Resilience in Families, Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support. [2017]

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

Neurobiological Markers of Resilience to Early-Life Adversity During Adolescence. [2021]