A recent study published in the Journal of Medical Internet Research has found evidence that a self-guided digital mental health program, tailored specifically for adolescents, can significantly reduce stress, rumination, and feelings of loneliness.
Nearly 20% of adolescents globally suffer from mental health disorders, a number that has been climbing more steeply compared to adults. Traditional access to mental health services for adolescents remains limited, especially for those with less severe symptoms, despite an overall increase in the utilization of these services. This paradox highlights a clear need for alternative, accessible interventions that can alleviate the strain on existing mental health services and address the burgeoning mental health needs of the younger population.
“I am a mom of two boys – when we started along this line of research, my oldest was a preteen – he’s now a freshly minted teenager, and my younger son is following closely behind. So mental health concerns in adolescents is personal for me – it’s something that impacts my own kids and their friends,” said study author Eliane Boucher, a senior director of behavioral science at Twill.
“And all the data is telling us that this generation of youth are struggling – for several years, APA’s Stress in America survey has shown that stress levels among Gen Z are particularly high, and often these young people are reporting that they’re not really doing much to manage their stress. This year, Gallup’s World Happiness Report showed that for the first time ever, levels of well-being were lower among youth than among adults – and this pattern was unique to countries like the United States.”
“So this is a pressing issue – and clearly our traditional systems for supporting youth mental health are not sufficient and we need new solutions that are effective, and that teens will actually use,” Boucher explained.
The research was structured as a 12-week, randomized controlled trial involving U.S. adolescents aged 13 to 17 years exhibiting elevated levels of stress and brooding. Participants were recruited through various channels including social media and direct emails, and were randomly assigned to either the intervention group, which received access to the digital program “Happify for Teens,” or a waitlist control group.
“Happify for Teens” includes gamified activities derived from cognitive behavioral therapy, mindfulness, and positive psychology, aiming to teach skills to manage stress and negative thoughts. Participants were not guided on how often to engage with the program but were encouraged via notifications and weekly emails. The effectiveness of the program was assessed at multiple points during the trial, using validated scales to measure perceived stress, brooding, sleep disturbances, loneliness, and optimism.
Results indicated a substantial decrease in stress levels among participants using the “Happify for Teens” program. The intervention group experienced a significant reduction in perceived stress, with statistical analysis showing more pronounced decreases than those observed in the control group. Similar to the findings on stress, participants in the intervention group reported significant reductions in brooding.
“I would say that the primary takeaway is that digital tools for stress management can be effective in an adolescent population,” Boucher told PsyPost. “A follow-up survey we did with these teens to solicit feedback on the product also suggests they had positive impressions of the digital intervention.”
“Given the complexities and costs associated with implementing stress management programs in school – and the increasing levels of stress among young people – having a tool they can access anytime, anywhere to help manage their mental health is an important step to addressing the mental health crisis in youth.”
Loneliness was another key area where the intervention group saw significant improvement. Adolescents engaging with the “Happify for Teens” program reported feeling less lonely over the course of the study. This reduction was more significant than in the control group, highlighting the potential of digital interventions to not only reduce negative mental states but also enhance feelings of social connectedness and emotional well-being among users.
“I was relatively surprised to see that teens who engaged with our digital intervention also reported lower levels of loneliness over the 12 week study period,” Boucher said. “We do have programs that are focused on friendships and loneliness, but we didn’t target a sample of teens who had elevated levels of loneliness.
“It’s a self-guided program after all, so the idea that engaging with this tool and completing activities doesn’t just help with stress or brooding, but might actually help teens feel less lonely was a happy surprise.”
However, the study found that the intervention did not significantly impact all areas. For instance, measures of sleep disturbance and optimism did not show significant changes attributable to the digital intervention. This could indicate the need for more targeted approaches within the digital platform to address these specific areas or possibly longer intervention durations to observe measurable changes.
“Like any research, there are definitely caveats,” Boucher noted. “As is often the case, our sample was relatively homogeneous – the majority of our participants identified as women (though less than you see in some other digital health studies) and identified as White, and they were all required to reside in the United States. Additionally, because the study required consent from a parent or guardian, it means that our participants all had guardians who were supportive of mental health care – and we likely had a sample of teens who probably had relatively good relationships with those caregivers.
“This means that it’s unclear whether these effects would generalize to other populations, and replication in other populations is always important. In particular, because some argue that parents and caregivers are the gatekeepers to mental health care for youth – but those who had unsupportive guardians might be the ones who need these resources most, trying to access that population is really important.”
Further studies could also explore the impact of digital interventions on other relevant outcomes like anxiety or depression, and consider the role of these tools in reaching adolescents with different backgrounds and needs, particularly those who might not have supportive home environments.
“In addition to the replication I mentioned above, I’d love to explore the utility of digital mental health interventions for teens with marginalized identities,” Boucher said. “We know that LGBTQ youth are even more likely to be struggling with their mental health, and we don’t have enough tools to support them specifically. Working with groups like this to identify how to make these interventions more relevant to them is something I’d love to explore.”
“Similarly, just doing more work with the teens themselves to help expand solutions like ours – we know that young people are struggling with all kinds of stressors that those of us who are older didn’t grapple with at their age. Research shows that they have higher levels of stress about gun violence and climate change, among other things – so can we develop content that is more directly relevant to this kind of anxiety?”
“Finally, Dr. Jessica Schleider is doing some great work on single-session interventions with young people, and I’d love the opportunity to explore how to bring in these kinds of brief interventions into these broader digital tools – because some users may not commit to longer-term use, or they need immediate support for something more acute,” Boucher added. “Digital tools have the flexibility of offering them what they need in the moment, on demand.”
The study, “Effects of a Digital Mental Health Intervention on Perceived Stress and Rumination in Adolescents Aged 13 to 17 Years: Randomized Controlled Trial,” was authored by Eliane M. Boucher, Haley Ward, Cynthia J. Miles, Robert D. Henry, and Sarah Elizabeth Stoeckl.
