The Youth Compass-the effectiveness of an online acceptance and commitment therapy program to promote adolescent mental health: A randomized controlled trial

Purpose: Mental health problems affect 10-20% of adolescents worldwide. Prevention and early interventions for promoting adolescent mental health are therefore warranted. The aim of this randomized controlled trial was to examine the effects of a 5-week web-intervention (Youth COMPASS) based on the principles of Acceptance and Commitment Therapy on adolescents' depressive symptoms, life satisfaction and psychological flexibility. Methods: The sample comprised 243 adolescents at the age of 15-16 years (51%females) from 15 lower secondary schools. Participants were randomly assigned to three groups of which two groups received an ACT-based online-intervention including support via WhatsApp. The two ACT interventions + WhatsApp contact differed from each other regarding the amount of personal support (iACT + two face-to-face sessions vs iACT with no face-to-face sessions). These two iACT interventions were compared to no intervention (control). Adolescents' psychological wellbeing was measured pre and post intervention using the Depression Scale (DEPS), Satisfaction with Life Scale (SWLS), and Avoidance and Fusion Questionnaire for Youth (ATQ-Y). Results: Adolescents showing more avoidance of unpleasant thoughts and feelings, and cognitive fusion reported more depressive symptoms and a lower level of satisfaction with life. This association was stronger among girls than boys. The iACT online-intervention + WhapApp contact with two face-to-face meeting or without them decreased adolescents' depressive symptoms and increased life satisfaction among those who had completed more than half of the program (d = 0.20). No significant effect was obtained for avoidance (psychological flexibility). The iACT intervention including face-to-face contact showed different effects on girls and boys in regards to depression symptoms and psychological flexibility skills. Conclusions: Findings showed that the ACT-based web-intervention for adolescents could be a viable early intervention for preventing mental health problems in adolescents and for promoting adolescent wellbeing. Our findings call for further studies investigation whether girls and boys benefit of different type online interventions.