The Impact of Text Engagement in a Brief, Technology-Enhanced Adjunctive Intervention for Youth Suicide Risk and Depression

Abstract

OBJECTIVE: Brief, technology-enhanced interventions can increase treatment access while effectively addressing widespread clinical problems, such as major depression and suicidal thoughts and behavior, among young adults. Understanding the extent to which the digital components of these innovative interventions contribute to outcomes is key to realizing their potential. This study investigated whether text engagement enhances the effectiveness of a brief, adjunctive intervention, Skills to Enhance Positivity (STEP). METHODS: Thirty-five young adults in outpatient treatment received the STEP intervention, which was hypothesized to reduce depression and suicidal ideation by engaging the transdiagnostic mechanism of positive affect. Text engagement was examined as a predictor of positive affect, depressive symptoms, and suicidal ideation at posttest and follow-up, with baseline scores controlled. The authors also examined associations of text engagement with baseline clinical and demographic variables. RESULTS: A significant effect was found for text engagement on positive affect, and a trend toward a significant effect was found for text engagement on depressive symptoms. No significant effect was found for suicidal ideation. CONCLUSIONS: Findings add to a growing body of literature suggesting that light-touch, low-cost technology enhancements, such as text messaging, may enhance the impact of therapeutic interventions. Future research with larger sample sizes is essential to better understand when, how, and for whom such light-touch enhancements may increase intervention effectiveness.

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