A Brief, Affordable, Broad-Access Transdiagnostic Intervention (Project RE-THINK) for Adolescents: Quasi-Experimental Study

Abstract

Background: Adolescence is a crucial developmental period characterized by elevated stress and significant mental health challenges, including depression and anxiety. With barriers, such as stigma, accessibility, and cost hindering effective treatment, leveraging school systems for mental health interventions offers a strategic advantage due to their reach and potential for scalability. Objective: This study aimed to investigate the immediate impact of “Project RE-THINK,” a single-session, digital thought record intervention delivered in a school setting, on negative cognitions and overall emotional valence among adolescents. Methods: Project RE-THINK helps adolescents to identify, examine, and challenge negative cognitions to improve their mental health, as demonstrated through changes in negative cognition and overall emotional valence. Adolescents (N=1052) in grades 10‐12 enrolled in high school during the 2023‐2024 school year completed the digital thought record intervention activity. Using a quasi-experimental pre/post design, participants read through an example thought record and completed their own thought record, which involved identifying and describing a recent upsetting situation, answering a series of questions to challenge their negative cognition, and learning and using emotion regulation skills regarding the upsetting situation. Measures of pre- and postintervention overall emotional valence and negative cognition were collected to determine the intervention effect on participants’ mental health. Results: Descriptive statistics confirmed that smaller proportions of adolescents endorsed feeling negative emotions, such as anger, shame, anxiety, disgust, guilt, sadness, and fear, after the intervention. Paired samples t tests showed that adolescents experienced a significant reduction in their belief in their negative cognition from pre- to postintervention (t1051=27.71; P