Adolescent depression and anxiety symptoms are prevalent in sub-Saharan African countries, yet treatment options are scarce, and stigma limits help-seeking. Brief, computerized single-session interventions (SSIs) that contain empirically supported stigma-reducing elements may help expand access to treatment. We developed and evaluated such an intervention for Kenyan adolescents.
High school students (N 103, age 13–18) were randomized to a digital SSI Shamiri-Digital (Shamiri means “thrive” in Kiswahili) or a study-skills control intervention. Shamiri-Digital consisted of reading and writing activities about 3 concepts: growth mindset, gratitude, and value affirmation. Both Shamiri-Digital and the study-skills control condition were delivered electronically in schools.
Compared to the control, Shamiri-Digital pro- duced a greater reduction in adolescent depressive symptoms in both the full sample (p .028, d 0.50) and a subsample of youths with moderate to severe depression symptoms (p .010, d 0.83) from baseline to 2-week follow-up. The effects exceed the mean effects reported in meta-analyses of full-length, face-to-face psychotherapy for youth depression. There were no significant effects on anxiety symptoms, well-being, or happiness.
This is the first report that a brief, computerized SSI may reduce depressive symptoms in adolescents in sub-Saharan Africa. Replication trials with extended follow-ups will help gauge the strength and durability of these effects.
Keywords: depression, adolescents, global mental health, digital mental health, sub-Saharan Africa
Supplemental materials: http://dx.doi.org/10.1037/ccp0000505.supp