Youth Compass Plus

The aim of this randomized control trial is to examine the effectiveness of a novel web- and mobile-based Acceptance and Commitment Therapy program (Youth Compass plus) to promote adolescents' psychological flexibility and well-being and subsequently support their successful transition from basic education to upper secondary education. Our aim is also to compare the efficacy of Youth Compass plus using either an eCoach providing automated personal support to the user or an eCoach and a Human Coach providing personal support to the user. Additionally, we will investigate whether the efficacy of the Youth Compass plus varies according to different individual and contextual factors.

Using the internet to deliver interventions is assumed to be particularly motivating for youth who enjoy spending time online using different social media. Web-based interventions have several advantages; they can include more information and treatment components than traditionally delivered treatments and they are accessible at any time and place. The five-week structured intervention is delivered using the novel web- and mobile-based program Youth Compass plus. Youth Compass plus has been developed based on the feedback for the Youth COMPASS pilot program (see ClinicalTrials.gov, NCT03274934). The exercises of Youth Compass plus have been modified, visual aspects have been improved and new game-based interactive elements have been developed. In the Youth COMPASS pilot study, psychology students acted as (human) coaches for the users. While interaction with a personal coach increases commitment to the program, the need to train and supervise coaches limits large scale dissemination. To provide an alternative that is less demanding in terms of resources, we have developed a chatbot (eCoach) as a new feature within the new Youth Compass plus program. The automated eCoach provides personal support within the program and via text messages. The eCoach provides support and encouragement, reminds about using Youth Compass plus, sends individualized feedback, and recommends different exercises.

The aim of this randomized trial is to examine whether Youth Compass plus enhances adolescents' (a) psychological skills, particularly with respect to finding a purpose, and psychological flexibility and adaptation skills as the ACT process outcomes; (b) career preparation and psychological well-being as the proximal outcomes; and (c) the initiation of upper secondary education studies and engagement in upper secondary education as the distal outcomes.

In addition, our aim is to investigate the ACT processes and mediating mechanisms of the Youth Compass plus program, and to explore the extent to which the effectiveness of the Youth Compass plus varies according to the differences in various individual and contextual factors.

H1: The study expects that the Youth Compass plus is more effective than no intervention. Youth Compass plus is expected to promote ACT proximal youth outcomes, as well as the youth distal outcomes.

H2: In addition, the study expects that the Youth Compass plus will promote the distal outcomes through enhancing the ACT process outcomes and the proximal outcomes.

H3: The study expects that Youth Compass plus is more effective for those adolescents who accept the intervention well, take part intensively and diversely in different exercises, as well as among the adolescents who are initially highly emotionally reactive.

Eligibility Criteria:
Inclusion and Exclusion Criteria:

Approximately 600-1000 Finnish 14-16 year old adolescents from non-clinical school-age population will fill in a pre-questionnaire. Based on this data the participants for the randomized control trial will be selected from the two gender-balanced groups of Finnish adolescents:

1. Adolescents (n = 150) who have heightened (pre-clinical) level of symptoms of stress/anxiety/depression in the screening measures (no diagnosis is required for participation).
2. Randomly chosen adolescents (n=150) who have no symptoms of stress/anxiety/depression in the screening measures

Adolescents from both groups are randomly assigned in three conditions: (a) five weeks of Youth Compass plus with support from chatbot + face-to-face support (altogether two face-to-face meetings); b) five-weeks of Youth Compass plus with support from chatbot only; or (c) no intervention. At the baseline (fall 2020) the participants will be ninth-graders facing the transition to upper secondary education.