Background

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.

Method

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.

Results

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.

Conclusion

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

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