Purpose

The goal of this study is to test the efficacy and feasibility of a clinician-guided, app-based cognitive behavioral therapy (CBT) program, SilverCloud, as a school-based mental health intervention for vulnerable youth. An open trial of SilverCloud will be conducted to determine preliminary efficacy in this sample and inform program refinements by collecting outcome self-report assessments and conducting interviews on feasibility and acceptability. After the program and its implementation strategy are refined, we will conduct an randomized controlled trial. Adolescents who screen positive for significant mental health symptoms and who are enrolled in their school-based health center (SBHC) will be randomized to receive SilverCloud or treatment as usual (TAU). Efficacy will be assessed through outcome self-reports. Feasibility and acceptability feedback will again be collected from participants, SBHC staff, and community members.

Conditions

Eligibility

Eligible Ages
Between 13 Years and 22 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

In order to be eligible to participate in the phase I open trial of this study, an individual must meet all of the following criteria: - Enrolled in the SBHC at the high school - Score of 10+ on GAD-7 or PHQ-9 - Speak/read English. The current investigational version of SilverCloud that will be used in this study is only available in English. In order to be eligible to participate in the RCT of this study, an individual must meet all of the following criteria: - Enrolled in 9th through 11th grades. - Score of 10+ on GAD-7 or PHQ-9 - Enrolled in the SBHC at the high school - Speak/read English. The current investigational version of SilverCloud that will be used in this study is only available in English.

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in the phase I open trial of this study: - Current (within 1 month of enrollment) mental health treatment at the SBHC - Does not use a smartphone - Mental health concerns for which intensive treatment is indicated. Because SilverCloud has not been evaluated in people with serious mental illness, participants who exhibit symptoms of mania or psychosis will be referred to a higher level of care. - Current suicidal ideation with intent. Participants who have a suicide plan and intent to act on it will be referred to the SBHC suicide risk protocol and will not be eligible until their suicidal thoughts have abated. An individual who meets any of the following criteria will be excluded from participation in the RCT of this study: - Current (within 1 month of enrollment) mental health treatment at the SBHC - Does not use a smartphone - Mental health concerns for which intensive treatment is indicated. Because SilverCloud has not been evaluated in people with serious mental illness, participants who exhibit symptoms of mania or psychosis will be referred to a higher level of care. - Current suicidal ideation with intent. Participants who have a suicide plan and intent to act on it will be referred to the SBHC suicide risk protocol and will not be eligible until their suicidal thoughts have abated.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
SilverCloud
Adolescents who screen positive for significant mental health symptoms and who are enrolled in their school-based health center (SBHC) randomized to receive SilverCloud.
  • Behavioral: App-based Cognitive Behavioral Therapy (CBT)
    SilverCloud is organized into eight core modules that follow evidence-based principles of CBT, along with six additional modules that can be prescribed by the clinician to address a participant's specific needs.
    Other names:
    • SilverCloud
Active Comparator
Treatment as Usual (TAU)
Adolescents who screen positive for significant mental health symptoms and who are enrolled in their school-based health center (SBHC) randomized to receive psychotherapy.
  • Behavioral: Psychotherapy
    Psychotherapy with a licensed clinician in the school-based health center.

Recruiting Locations

More Details

Status
Recruiting
Sponsor
NYU Langone Health

Study Contact

Anna Van Meter, PhD
646-754-5085
anna.vanmeter@nyulangone.org

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.