Implementing an Internet-Based Cognitive Behavior Therapy Intervention in School Settings 

Project Leader Katey Franklin, Ph.D.
MSU Department of Health & Human Development
kathryn.franklin1@montana.edu 

In the United States and rural Montana, a substantial health disparity exists for rural youths’ mental health and mental health care access. In 2017, nearly a third of all Montana high school students reported being impacted by depression; 21% considered suicide compared to 17% nationally. Over 30% of Montana adolescents indicated drinking alcohol, and 20% indicated using marijuana. Rural Montanans face enormous barriers to behavioral health care, including low mental health care provider coverage, long distances to adequate care, and stigma.

With the collaboration of scientific advisor Mark Schure, Ph.D., this project built on the previous development and evaluation of an adult version of the Internet-based Cognitive Behavior Therapy (iCBT) program known as Thrive. This project, "A feasibility study for implementing and evaluating an Internet-based cognitive behavior therapy intervention in school settings and its impact on adolescent mental and behavioral health," piloted a youth version of Thrive (Y-T), a fully automated, stand-alone program. Y-T delivers CBT skills through educational, real-life adolescent scenarios and tailored feedback videos to address symptoms of depression, anxiety, and co-occurring (addiction) behaviors.

The research conducted feasibility analyses of pilot study implementation in school communities, documenting and assessing organization-level facilitators and barriers that impact the study processes at each study site. The short-term goal for this research was to understand how to effectively conduct trials within school community settings and to obtain preliminary information on the acceptability and effectiveness of the Y-T program to address depression and anxiety symptoms and addictive behaviors. Additionally, Dr. Franklin conducted a longitudinal waitlist control group study with adolescents aged 13-18 years with assessments at baseline, 4, and 16 weeks.