TOUCHminds: Help-seeking in Adolescents With Anxiety

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age15-17
SponsorAveiro University

About this trial

Adolescents frequently experience clinical and subclinical anxiety symptoms, yet many avoid seeking professional help. While universal interventions exist to promote help-seeking, targeted programs for adolescents with elevated anxiety symptoms remain scarce. Therefore, accessible and tailored strategies are needed to effectively promote help-seeking among this group.

TOUCHminds is a web-based intervention designed to enhance help-seeking among adolescents with clinical or subclinical anxiety. The program consists of six self-guided modules featuring interactive activities (e.g., images, videos, simulation activities, and audio recordings), combined with three synchronous sessions led by a psychologist via videoconference. The intervention explicitly targets precursors of help-seeking, including mental health literacy, mental health stigma, self-compassion, readiness to change, and stage of change.

This research project comprises two studies. Study I, a feasibility study involving 10 adolescents aged 15 to 17, will assess recruitment procedures, dropout rates, usage patterns, therapist fidelity, acceptability, usability, satisfaction, and preliminary effects. Study II, a randomized controlled trial (RCT), intends to include 96 adolescents randomly assigned to four groups: clinical intervention, clinical control, subclinical intervention, and subclinical control. Clinical participants are those who meet diagnostic criteria for one or more anxiety disorders, whereas subclinical participants present high self-reported anxiety but no mental disorder diagnosis. Intervention effects will based on self-report assessments conducted at pre-intervention, post-intervention (9 weeks later), and at 3-month follow-up.

This research will provide evidence regarding the suitability and effectiveness of TOUCHminds in promoting help-seeking among adolescents experiencing different levels of anxiety symptoms. Findings will contribute to the field of empirically validated web-based interventions tailored specifically for adolescents.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Aged between 15 and 17 years old at the time of screening;

Fluent in Portuguese;

Have access to a smartphone, tablet, or computer;

Have reliable internet access.

Disqualifiers

Psychotic symptoms or suicidal risk as assessed via the Mini-Kid (Rijo et al., 2016);

Being part of the special needs teaching system.

Currently receiving psychological counselling.

Trial design

Design model

Crossover

Treatments tested in this trial

  • TOUCHminds - Web-Based Intervention

    Behavioral

    A web-based intervention designed to promote help-seeking in adolescents with clinical or subclinical anxiety symptoms. The program combines six self-guided online modules with three individual videoconference sessions with a trained psychologist. It integrates core components from Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Compassion-Focused Therapy (CFT), Motivational Interviewing, and the Transtheoretical Model of Change. The intervention is tailored to the developmental stage of adolescents and is delivered remotely to participants meeting the inclusion criteria.

Treatment groups

96 Participants
are divided into 4 treatment groups
Group A: Experimental: Clinical Group (study I and study II)Experimental treatment 1 intervention
Group B: Control: Clinical Group (study II)No intervention 0 interventions
Group C: Experimental: Subclinical Group (study I and study II)Experimental treatment 1 intervention
Group D: Control: Subclinical Group (study II)No intervention 0 interventions

Trial outcomes

Primary outcomes

1

General Help-Seeking Questionnaire (GHSQ).

The GHSQ is a 12-item self-report scale that assesses adolescents' intentions to seek help for personal-emotional problems from various sources. Responses are rated on a 7-point Likert scale (1 = 'extremely unlikely' to 7 = 'extremely likely'). Its items refer to formal help (e.g., mental health professionals), semi-formal help (e.g., priests), informal help (e.g., partner), and self-help (e.g., the internet). sources. Higher scores indicate stronger intentions to seek help. The GHSQ has been adapted for use in Portugal and, despite the lack of formal psychometric studies, has been widely applied in research. For this study, the scale is further adapted to better reflect adolescents' social context. The adapted version includes formal help (e.g., psychologist), semi-formal help (e.g., teacher), informal help (e.g., friend), and self-help (e.g., online websites) sources. In addition, the original response option "I would not seek help from anyone" will be retaine.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).
2

Adolescent Help-Seeking Behavior Scale (AHSBS).

The AHSBS is a 17-item self-report scale developed for this study to assess how often adolescents seek help for emotional or psychological difficulties. Using the same items as the adapted GHSQ, but with new instructions, participants are asked to indicate how frequently they have turned to various sources of help in recent weeks. Responses are given on a 5-point Likert scale (1 = 'never' to 5 = 'always'). Help sources are categorized into formal, semi-formal, informal, and self-help. The total score reflects overall help-seeking frequency, with sub-scores available for each category. The AHSBS is currently under study for its psychometric properties and is expected to show good internal consistency, a structure consistent with help-seeking categories (formal, informal, semi-formal, and self-help), and construct validity in relation help-seeking intentions, stigma, and well-being.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).

Secondary outcomes

1

Adolescents' Mental Health Knowledge (AMHK).

The AMHK is a 15-item self-report scale assessing mental health literacy in adolescents, including symptom recognition, help-seeking, and attitudes toward mental health. Items (e.g., "If someone, over a period of time, avoids or misses school parties or oral presentations because they are afraid of being judged, to what extent do you consider it likely that they are experiencing symptoms of social anxiety?") are rated on a 4-point Likert-type scale ranging from 1 ("Very unlikely" or "Very useless") to 4 ("Very likely" or "Very useful"). It was adapted from the Mental Health Literacy Scale (MHLS) and developed with input from adolescents through think-aloud sessions to ensure developmental and cultural relevance. The measure is currently undergoing validation in a Portuguese adolescent sample to assess its internal consistency, construct validity, and factorial structure.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).
2

Peer Mental Health Stigmatization Scale (PMHSS).

The PMHSS is a 24-item self-report scale that assesses peer attitudes toward adolescents with mental health problems. Of these, 16 negative items measure two components: Stigma Agreement (personal endorsement of stigmatizing beliefs) and Stigma Awareness (perceptions of societal stigma). In this study, only these 16 items were used. Items (e.g., "Most people believe that young people with emotional or behavioral problems are dangerous") are rated on a 5-point Likert scale ranging from 'strongly disagree' to 'strongly agree'. Previous psychometric information indicates good internal consistency for the negative items and acceptable values for Stigma Agreement and Stigma Awareness. The Portuguese version is currently undergoing validation in an adolescent sample to assess its internal consistency, construct validity, and factorial structure.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).
3

Self-Compassion Scale for Adolescents (SCS-A).

The SCS-A is a 26-item self-report measure that assesses adolescents' self-compassion, defined as the ability to respond to personal difficulties with understanding and non-judgment. Items (e.g., "How I typically act toward myself in difficult times") are rated on a 5-point Likert scale (1 = 'almost never' to 5 = 'almost always'). The scale includes six subscales reflecting both compassionate (Self-Kindness, Common Humanity, Mindfulness) and uncompassionate (Self-Judgment, Isolation, Over-Identification) self-responding. Previous psychometric information on its Portuguese version indicates good internal consistency for the total scale and acceptable reliability for the subscales. Construct validity has been supported by positive associations with positive emotional memories and negative associations with symptoms of depression, anxiety, and stress.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).
4

University of Rhode Island Change Assessment (URICA).

The URICA is a 32-item self-report scale designed to evaluate motivation for behavior change across four stages: pre-contemplation, contemplation, action, and maintenance. Items (e.g., "I have been thinking that I could change something about myself") are rated on a 5-point Likert scale (1 = 'strongly disagree' to 5 = 'strongly agree'). Each stage is scored from 8 to 32, allowing identification of the individual's predominant stage. A readiness to change score is derived by summing the scores of contemplation, action, and maintenance, and subtracting the pre-contemplation score. Previous psychometric information indicates acceptable internal consistency for the total score in late adolescents and young adults, although subscale reliability was more variable. No analyses of item quality or factorial structure were previously performed. This measure is currently being further adapted and validated for use with Portuguese adolescents.

Time frame
Administered one week before the intervention (T0), one week after completion (T1), and 3 months after completion (T2) in experimental groups (Studies I-II), and at corresponding times (9 weeks after T0 and 3 months later) in control groups (Study II).

Other outcomes

1

Clinical Global Impression Scale (CGI).

The CGI is a clinician-rated measure designed to evaluate both the global severity of illness and changes in clinical status over time. It consists of three subscales: Severity of Illness (CGI-S), Global Improvement (CGI-I), and Efficacy Index. In the present study, only the CGI-S and CGI-I will be used. The CGI-S, which evaluates the severity of psychopathology, is rated on a seven-point scale, ranging from 1 = 'normal' to 7 = 'among the most extremely ill'. The CGI-I, which assesses the perceived change since the initiation of the intervention, is also rated on a seven-point scale, ranging from 1 = 'very much improved' to 7 = 'very much worse', and reflects clinical change relative to the participant's initial evaluation. For the current study, items were translated and adapted to European Portuguese by experts in clinical assessment and intervention, ensuring both linguistic and cultural adequacy.

Time frame
Completed after the interview at baseline for all groups (CGI-S), and after each intervention session for experimental groups only (CGI-S and CGI-I; Studies I-II).

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Aveiro University

Lead sponsor

Foundation for Science and Technology

Collaborator

This trial is not recruiting at the moment. You can still explore other options: