No Time to Wait: Single Session Intervention

Summary

Mental health problems in youth are prevalent, but early intervention effectively reduces symptoms, substance abuse risk, suicide, and comorbidities. In Hong Kong, however, only 26% of people with common mental disorders seek services (Lam et al., 2015), and even then, they face long delays-e.g., 90 weeks (90th percentile) for stable cases in public psychiatry clinics (Hospital Authority, 2024). Barriers include high costs, transportation issues, stigma, and preference for self-help, creating a strong need for scalable, accessible digital solutions, especially for youth. Single-Session Interventions (SSI) offer promise as brief, time-efficient tools that provide immediate support with minimal engagement burden. Online SSIs are often free, publicly available, and evidence-based. Research shows they reduce symptoms (moderate effect size Hedges' g = 0.32; 58% chance of better outcome vs. control), improve functioning, and boost satisfaction (Schleider \& Weisz, 2017). They work well for specific phobias and acute stress. Yet, their real-world acceptability, effectiveness outside trials, and integration with public services remain understudied-particularly for children/adolescents on waitlists. This pilot study evaluates an online single-session psychotherapy for youth (children/adolescents) on Hong Kong public psychotherapy waitlists, targeting depression and anxiety symptoms. It extends prior work by: Targeting two key constructs prominent in Asian contexts: Alexithymia - difficulty identifying/describing emotions; affects \~10% generally but 36% of Hong Kong adolescents (higher in females). It worsens depression, lowers well-being, complicates therapy, and reduces help-seeking. Fixed mindset (vs. growth mindset) - Asian groups show lower growth mindset levels; growth mindset buffers mental health issues (meta-analysis r = -0.220 with anxiety/depression/stress) and promotes better emotional regulation and treatment engagement. Examining how SSI influences acceptability and expectancy toward subsequent face-to-face psychotherapy. Hypotheses: SSI will reduce depression/anxiety symptoms more than treatment-as-usual. SSI will increase acceptability and positive expectancy for future in-person treatment. Change mechanisms-perceived behavioral control and emotional control-will mediate and sustain post-intervention outcomes. Overall, the study aims to test SSI as a bridge intervention to bridge service gaps, address culturally relevant barriers, and inform scalable mental health strategies in resource-constrained settings like Hong Kong's public system.

Eligibility

Inclusion Criteria:

(1) being Hong Kong residents aged 12 - 17; (2) having anxiety and/or depression symptoms, scoring 10 or above, in accordance with Patient Health Questionnaire (PHQ-9) or General Anxiety Disorder-7 (GAD-7); (3) having access to the internet and a valid email address for communication, (4) being able to understand and read Chinese and, (5) participants' parent or legal guardian will be willing to give informed consent.

Exclusion Criteria:

(1) they have received another psychological treatment for depression and/or anxiety in the past 3 months, (2) they report a diagnosis of other comorbid severe psychiatric disorder, including psychotic disorder, bipolar disorder, dissociative disorder, or other neurocognitive disorders that make participation infeasible or interfere with the adherence to the digital self-help intervention, (3) they would participate in another similar study concurrently, (4) any suicidal ideation is reported (score \> 2 on Question 9 of the Beck Depression Inventory), (5) they report substance abuse history, (6) having changes in psychotropic medication within 2 weeks before baseline assessment; or (7) they report pregnancy.

Conditions3

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