Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children

Abstract Ukraine’s war-exposed youth face a myriad of barriers to receiving mental health services, perhaps most notably a dearth of mental health professionals. Experts recommend evaluating digital mental health interventions (DMHIs), which require minimal clinician support. Based on the content of...

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Main Authors: Joshua S. Steinberg, Jingxuan Sun, Katherine E. Venturo-Conerly, Gauri Sood, Patrick Mair, Oksana Davydenko, Robert Porzak, Dennis Ougrin, John R. Weisz
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Mental Health Research
Online Access:https://doi.org/10.1038/s44184-025-00134-w
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author Joshua S. Steinberg
Jingxuan Sun
Katherine E. Venturo-Conerly
Gauri Sood
Patrick Mair
Oksana Davydenko
Robert Porzak
Dennis Ougrin
John R. Weisz
author_facet Joshua S. Steinberg
Jingxuan Sun
Katherine E. Venturo-Conerly
Gauri Sood
Patrick Mair
Oksana Davydenko
Robert Porzak
Dennis Ougrin
John R. Weisz
author_sort Joshua S. Steinberg
collection DOAJ
description Abstract Ukraine’s war-exposed youth face a myriad of barriers to receiving mental health services, perhaps most notably a dearth of mental health professionals. Experts recommend evaluating digital mental health interventions (DMHIs), which require minimal clinician support. Based on the content of empirically supported treatments for war-exposed youth (e.g., Teaching Recovery Techniques), one strategy that might be useful is self-calming (e.g., paced breathing, progressive muscle relaxation). In this pre-registered randomized controlled trial (ClinicalTrials.gov Record: NCT06217705 ; first submitted January 12, 2024), we assessed the acceptability, utility, and clinical efficacy of one such DMHI (Project Calm) relative to a usual schoolwork control among a sample of Ukrainian students in grades 4–11. We analyzed outcomes for the full sample and subsamples with elevated symptoms at baseline. Although Calm was perceived favorably, there were no significant between-group differences in the full sample (N = 626); differences in subsample analyses demonstrated that while internalizing, externalizing, and trauma symptoms held steady for the Calm group, control participants’ symptoms reduced. We generated potential explanations for these results (e.g., interference with youths’ natural coping skills or fear extinction) through a focus group with school staff. Given that we found no evidence that calming skills taught via DMHI are effective for Ukrainian youth, we suggest that researchers test other strategies delivered by DMHI and that calming skills continue to be taught in provider-guided formats.
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spelling doaj-art-52d3d1ba7faa450f95a5f26d48f2ee402025-08-20T03:54:00ZengNature Portfolionpj Mental Health Research2731-42512025-05-014111410.1038/s44184-025-00134-wRandomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian childrenJoshua S. Steinberg0Jingxuan Sun1Katherine E. Venturo-Conerly2Gauri Sood3Patrick Mair4Oksana Davydenko5Robert Porzak6Dennis Ougrin7John R. Weisz8Department of Psychology, Harvard UniversityDepartment of Psychology, Harvard UniversityDepartment of Psychology, Harvard UniversityDepartment of Psychology, Harvard UniversityDepartment of Psychology, Harvard UniversityDepartment of Psychology, Political Science, and Sociocultural Technologies, Sumy State UniversityInstitute of Psychology and Human Sciences, WSEI UniversityYouth Resilience Unit Centre for Psychiatry and Mental Health Wolfson Institute of Population Health WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of LondonDepartment of Psychology, Harvard UniversityAbstract Ukraine’s war-exposed youth face a myriad of barriers to receiving mental health services, perhaps most notably a dearth of mental health professionals. Experts recommend evaluating digital mental health interventions (DMHIs), which require minimal clinician support. Based on the content of empirically supported treatments for war-exposed youth (e.g., Teaching Recovery Techniques), one strategy that might be useful is self-calming (e.g., paced breathing, progressive muscle relaxation). In this pre-registered randomized controlled trial (ClinicalTrials.gov Record: NCT06217705 ; first submitted January 12, 2024), we assessed the acceptability, utility, and clinical efficacy of one such DMHI (Project Calm) relative to a usual schoolwork control among a sample of Ukrainian students in grades 4–11. We analyzed outcomes for the full sample and subsamples with elevated symptoms at baseline. Although Calm was perceived favorably, there were no significant between-group differences in the full sample (N = 626); differences in subsample analyses demonstrated that while internalizing, externalizing, and trauma symptoms held steady for the Calm group, control participants’ symptoms reduced. We generated potential explanations for these results (e.g., interference with youths’ natural coping skills or fear extinction) through a focus group with school staff. Given that we found no evidence that calming skills taught via DMHI are effective for Ukrainian youth, we suggest that researchers test other strategies delivered by DMHI and that calming skills continue to be taught in provider-guided formats.https://doi.org/10.1038/s44184-025-00134-w
spellingShingle Joshua S. Steinberg
Jingxuan Sun
Katherine E. Venturo-Conerly
Gauri Sood
Patrick Mair
Oksana Davydenko
Robert Porzak
Dennis Ougrin
John R. Weisz
Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
npj Mental Health Research
title Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
title_full Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
title_fullStr Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
title_full_unstemmed Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
title_short Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children
title_sort randomized trial testing a self guided digital mental health intervention teaching calming skills for ukrainian children
url https://doi.org/10.1038/s44184-025-00134-w
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