A Randomized Trial of Online Single Session Interventions for Adolescent Depression during COVID-19

The COVID-19 pandemic has potentially increased the risk for adolescent depression. Even pre-pandemic, <50% of youth with depression accessed care, highlighting needs for accessible interventions. Accordingly, this randomized-controlled trial (ClinicalTrials.gov: NCT04634903) tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression symptoms (N=2,452, ages 13-16). Adolescents from all 50 U.S. states, recruited via social media, were randomized to 1 of 3 SSIs: a behavioural activation SSI, an SSI teaching that traits are malleable, or a supportive control. We tested each SSI’s effects on post-intervention (hopelessness, agency) and 3-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-related trauma, restrictive eating). Versus control, both active SSIs reduced 3-month depressive symptoms (ds=0.18); decreased post-intervention and 3-month hopelessness (ds=0.16-0.28); increased post-intervention agency (ds=0.15-0.31); and reduced 3-month restrictive eating (ds=0.12-17). Several differences between active SSIs emerged. Results confirm the utility of free-of-charge, online SSIs for high-symptom adolescents, even in the high-stress COVID-19 context.