A digital intervention to improve mental health and interpersonal resilience in young people who have experienced Technology-Assisted Sexual Abuse: a feasibility clinical trial

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Abstract

Background

A digital mental health intervention (DMHI) to improve mentalisation in young people who have experienced technology-assisted sexual abuse (TASA) may reduce the risk of re-victimisation and future harm and make them more resilient and able to manage TASA-related distress. However, evidence-based interventions for TASA are nascent.

Method

We determined the feasibility, acceptability and safety of a 6-week mentalisation-based DMHI for young people with TASA in a pre-registered multi-centre non-randomised clinical trial ( ISRCTN43130832 ). Young people aged 12-18 years recruited across child and adolescent mental health services in two sites completed baseline and post-treatment assessments.

Results

Forty-six people were recruited; 43 were allocated to the i-Minds app; 86% completed follow-up assessments. The average participant age was 15.42 years. Most participants identified as female (69.8%), White British (95.3%), a notable percentage identified as non-binary/third gender or preferred not to disclose their gender identity (16.3%), and 20.9% reported their gender did not match their sex assigned at birth. We found signals of post-treatment improvement in TASA-related post-traumatic symptoms, resilience, internalising symptoms and reflective functioning. User feedback indicated that participants generally had a positive experience of using the app, positively impacting their knowledge/understanding of their own mental health and their motivation to address their mental health difficulties. There were no related adverse events.

Conclusions

It is possible to recruit and retain participants for a DMHI trial of TASA. The i-Minds app was safe, acceptable and showed promising signals of efficacy on valuable outcomes. A large-scale efficacy trial is warranted to confirm and extend findings.

Key Practitioner Message

What is known?

There are currently no evidence-based treatments to support young people exposed to technology-assisted sexual abuse.

What is new?

  • This co-designed, multi-centre non-randomised clinical feasibility trial provides signals of potential efficacy for a digital mental health intervention to improve clinical outcomes in vulnerable young people.

  • We found signals of post-treatment improvement in TASA-related post-traumatic symptoms, resilience, internalising symptoms and reflective functioning.

  • User feedback indicated that participants generally had a positive experience of using the app, positively impacting their knowledge/understanding of their own mental health and their motivation to address their mental health difficulties.

What is significant for clinical practice?

  • A large-scale efficacy trial is warranted to confirm and extend findings.

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