Unlocking Digital Pathways to Improving Adolescent Mental Health
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The prevalence of behavioral health concerns among teens in the U.S. has reached alarming levels. Studies show that one in five adolescents experiences a mental health disorder. Suicide is now the second leading cause of death among teens, and research has documented a surge in symptoms of anxiety and depression, particularly following the COVID-19 pandemic (Jones et al., 2022; Smith & Keller, 2021). Despite the growing need for care, access to traditional mental health services remains limited. The Unlocking Digital Pathways to Improving Adolescent Mental Health webinar series will explore how digital innovations can directly address these issues and empower parents to implement evidence-based strategies at home that target their teens’ problems.

‍Aijah Goodwin, PhD, will kick off our webinar series by delving into the structural, systemic, familial, and individual stressors impacting Black teens that increase risks for suicide and mental health problems, and how digital technology can help overcome some significant barriers to evidence-based and equitable care. Next up, Cindy Schaeffer, PhD, will give an overview of the digital mental health intervention landscape for teens. She’ll dive into an efficacious mobile app (WisePath) she and colleagues have developed that delivers evidence-based care to teens with a variety of concerns, including conduct problems, substance use, and suicidal behaviors, as well as depressed and anxious mood. Allison Ruork, PhD, will discuss how digital technologies can address the vexing challenge of skills generalization, e.g., how to help ensure that skills honed in therapy rooms and over Zoom show up in the real-world when they are needed most, including when teens are feeling suicidal. Finally, Cari McCarty, PhD, and Laura Richardson, MD, will describe how an innovative digital technology originally built for adults who are acutely suicidal (Jaspr Health) is being adapted for suicidal teens in primary care and other medical settings.

Participants who attend an event in this series will earn one free continuing education credit, NBCC approved. To receive credit, participants must attend for the entire event.

Black youth in the United States experience various structural, institutional, familial, and individual stressors that may increase their risk of mental health concerns (Sohail et al., 2014). The consequences of unmet mental health needs for Black youth may include academic difficulties, social concerns, increasing rates of suicide, and other detrimental long-term outcomes (Planey et al., 2019). However, there are significant individual-level, provider-level, and system-level barriers to mental health help-seeking for Black adolescents (Planey et al., 2019). Furthermore, adolescents, especially those with anxiety, depression, and other internalizing concerns, are less likely to seek professional help and are more likely to prefer self-reliance and personal coping (Cauce et al., 2002; Planey et al., 2019). As a result, there is an increase in teenagers utilizing inaccurate or noncredible social media and other digital sources for mental health psychoeducation and support (Miller, 2022). Youth are often not centered in our understanding and use of existing engagement techniques; therefore, the strategies do not utilize the help-seeking preferences of Black youth including the increase in digital technology in their lives.  

‍Learning Outcomes:
By the conclusion of this event, participants will be able to:

1. Build awareness of the current mental health needs of Black youth and families.  
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2. Understand the role of digital technology in the mental health help-seeking process that centers on the needs and preferences of Black youth.  
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3. Learn strategies to apply digital technology in the mental health help-seeking process for Black youth and families.

‍Presenter | Dr. Aijah K. B. Goodwin is an Assistant Professor at the National Center for School Mental Health (NCSMH) within the Division of Child and Adolescent Psychiatry (DCAP) at the University of Maryland School of Medicine. She is also a licensed psychologist at the Outpatient Child and Adolescent Psychiatry Clinic in DCAP, where she provides evidence-based and culturally tailored mental health therapy and consultation services in Baltimore City. Dr. Goodwin's research interests include enhancing cultural and contextual mental health help-seeking pathways for Black teens with anxiety, depression, and other internalizing concerns and sociocultural practices in schools that enhance mental health and well-being. She has also engaged in research and clinical practice focused on implementing evidence-based practices in school and community settings to improve mental and behavioral health outcomes for children and families.

‍abarutigoodwin@som.umaryland.edu  

Most adolescents with mental or behavioral health needs never receive treatment, and those who do are unlikely to receive an evidence-based approach. Treatment completion rates are also low. In the past decade, many new digital tools have emerged to facilitate treatment delivery, improve youth treatment access, and help youth and parents directly (i.e., self-help). However, standards for professionals and caregivers to evaluate the quality of these technologies are still lacking, and uptake of high-quality tools is still low. This webinar will provide an overview of the digital mental health intervention (DMHI) landscape as it pertains to adolescents and the potential for DMHIs – or “digital therapeutics” – to improve youth mental health and functioning. Ideas for how digital therapeutics can be incorporated into existing care systems, and how they might also be provided directly to youth and families through a public health-oriented, direct-to-consumer approach, will be discussed. One evidence-based DMHI that targets youth conduct problems, substance use, suicide risk, and related concerns, WisePath, will be presented as a case example. WisePath is based on the principles of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 2009), dialectical behavior therapy (DBT; Rathus & Miller, 2014), and other evidence-based treatments.  

‍Learning Outcomes:‍
By the conclusion of this event, participants will be able to:

1, Describe the categories of digital tools available to support youth mental health and the pros and cons of each approach.  
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2. Articulate the potential for digital mental health interventions (DMHIs), also known as “digital therapeutics,” to expand youth access to high-quality and evidence-based behavioral health interventions and enhance existing services.    

3. Visualize potential real-world applications of digital therapeutics by exploring a case study of one app-based DMHI, WisePath, that flexibly addresses youth conduct problems, substance abuse, suicide risk, and related concerns.  

Presenter | Dr. Cindy Schaeffer is a child-clinical psychologist and Associate Professor of Psychiatry within the University of Maryland Baltimore Division of Child and Adolescent Psychiatry. Her research and clinical activities focus on developing and evaluating family-based interventions for adolescents engaging in serious conduct problems and substance abuse. Her work draws from ecological conceptualizations of youth development and seeks to address risk factors and proximal causes of conduct problems across individual, family, peer, and school contexts. Dr. Schaeffer’s research has been funded by the National Institutes of Mental Health, the National Institute on Drug Abuse, the National Institute of Justice, the Annie E. Casey Foundation, and several state-level behavioral health systems. She is the author of over 40 academic articles, many scholarly book chapters, and one clinical volume published by the American Psychological Association. She is a co-developer of WisePath, a linked parent-teen app system and digital mental health intervention designed to address adolescent conduct problems. In her free time Dr. Schaeffer enjoys rocking out at her bass-playing husband’s shows, spoiling her dog, and engaging in racial and climate justice activism.

‍cschaeff@psych.umaryland.edu

As providers we are thrilled when we hear our clients tell us they have practiced outside of session! We recognize that generalization is one of the most important ingredients for change to happen. In therapies like Cognitive Behavior Therapy and Dialectical Behavior Therapy generalization of therapeutic skills is primarily accomplished via client homework and in DBT between-session phone coaching. Indeed, preliminary data suggest that both of these strategies are important to clinical outcomes (Chalker et al. 2015, Edwards et al., 2021, Ruork et al., 2021; Ruork et al., In prep). However, there are barriers and limitations associated with both strategies: providers may have high caseloads and limited time, they forget to follow-up on homework; clients do not have their binders, they fear being a burden to their providers and do not call; on and on. By increasing our own repertoire of strategies for facilitating generalization and thinking creatively we can work with clients to overcome barriers and increase use of therapeutic skills in the wild. Digital tools are highly portable, available 24/7, and provide options for increasing generalization opportunities without relying on additional time from providers, clinic resources, etc. However helpful, digital tools also come with limitations (e.g., availability, lack of evidence-base), which can make it difficult to know which to use. The current presentation will discuss some of the barriers and limitations to traditional generalization strategies, including some potential solutions and the importance of not giving up. It will also cover digital options (e.g., mobile apps, online resources) for skills generalization that providers can consider including in their practice, as well as potential barriers, limitations, and related ethical issues.

Learning Outcomes:
By the conclusion of this event, participants will be able to:

1. Describe the theoretical and empirically supported benefits of traditional methods of skills generalization (i.e., homework and between-session phone coaching)  
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2. Describe common myths, barriers, and limitations to traditional generalization strategies and how digital interventions can address some of these issues  
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3. Identify options for digital interventions that can be incorporated into their practice  
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4. Describe some of the barriers and limitations of digital interventions  

‍Presenter | Dr. Ruork received her doctorate in clinical psychology from the University of Nevada, Reno (Advisor: Alan E. Fruzzetti, PhD), completed her clinical internship at Duke University Department of Psychiatry and Behavioral Sciences, and a postdoctoral fellowship at Rutgers University (Supervisor: Dr. Shireen Rizvi). Currently, she is a Senior Behavior Scientist at Evidence-Based Practice Institute where she manages grants and works with the product development team to build digital support tools for individuals and families struggling with suicide and multi-problem presentations. She provides consultation on DBT adherence for the CAMPUS Multisite Grant through NIMH (R01 MH116061). Her research focuses on digital treatment development and evaluation for individuals with significant emotion regulation difficulties, suicidality, and self-harming behavior. She has particular research experience in multilevel modeling of intensive longitudinal data, leveraging digital technologies for assessment and intervention, and environmental interventions and risk factors. Her clinical areas of expertise include suicide, dialectical behavior therapy, adherence in DBT, adolescent and family interventions, process based cognitive behavioral therapy, and behavior therapy.

‍allison.ruork@jasprhealth.com