Developmental trajectories of experiential avoidance and depressive symptoms and association to health behaviors among adolescents during brief guided online acceptance and commitment therapy

While many children and adolescents experience psychological problems with up to 20 percent estimated to develop a mental health problem, only few receive treatment. Online interventions can help respond to the need of support among young people without requiring considerable resources. However, relatively few studies have examined the efficacy of online interventions for youth and more research is needed to understand individual differences in benefiting from these interventions. The current study sought to examine different developmental trajectories of experiential avoidance and depressive symptoms and their association to health behaviors measured at baseline during a brief guided online acceptance and commitment therapy (ACT) intervention implemented in the school context. A total of 123 ninth grade adolescents aged 14-16 years completed the five-week intervention including online support. The mixture modeling identified three separate sub-groups based on baseline and changes during the intervention: 1) high and decreasing experiential avoidance and depressive symptoms (16 %), 2) average and stable experiential avoidance and depressive symptoms (36 %) and 3) low experiential avoidance and mildly decreasing depressive symptoms (46 %). The results show that two thirds of adolescents benefited during online ACT, with the adolescents with high initial symptoms benefiting more than adolescents with low initial symptoms. Finally, adolescents following the trajectory of high and decreasing experiential avoidance and depressive symptoms during the intervention reported poorer health and sleep, higher substance abuse and less physical activity before the intervention than adolescents from other trajectories. The results suggest that guided online ACT may significantly reduce experiential avoidance and depressive symptoms among those adolescents reporting high-risk health behaviors, high depressive symptoms and experiential avoidance at baseline.