Self-administered single-session interventions for mental health in young people: A systematic review and meta-analysis

Abstract

Background: Children and young people's mental health is an area of concern worldwide. In the face of barriers such as long waits to access evidence-based treatment, perceived stigma, and a desire to tackle challenges independently, self-administered single-session interventions (SSIs) have arisen as one potential solution. The aim of this systematic review and meta-analysis is to synthesise evidence of the efficacy of self-administered SSIs for youth mental health. Methods: This random-effects meta-analytic review was preregistered on PROSPERO (CRD42023457030). Systematic search of randomised controlled trials (RCTs) from the Cochrane CENTRAL Register of Trials, EMBASE, MEDLINE and PsychINFO databases was conducted. Results: Following screening, 25 RCTs met eligibility criteria (5,628 participants), 19 of which were meta-analysed. Most of the included studies exhibited either ‘Low Risk’ or ‘Some Concerns’, with several of them having a ‘High Risk’ of bias. We found a small effect for anxiety symptoms (g = −0.24, 95% CI [−0.41, −0.07]) with substantial heterogeneity (I2 = 62.68%) and a wide prediction interval (95% PI [−0.67, 0.19]). Furthermore, there was a small effect for depressive symptoms (g = −0.11, 95% CI [−0.22, −0.02]) with substantial heterogeneity (I2 = 53.86%) and a wide prediction interval (95% PI [−0.42, 0.19)]. Studies not included in the quantitative synthesis were discussed narratively. Conclusions: The findings suggest that self-administered SSIs may be efficacious in reducing anxiety and depressive symptoms in young people. Although the evidence has limitations, including a small number of studies and diverse clinical and statistical characteristics, these findings indicate the need for further exploration of SSIs to address the treatment gap in child and adolescent mental health care.