Current Environment:


The aim of this study is to test the effectiveness of a single-session, digital intervention teaching the principle of practicing the opposite, when administered to youths on the waitlist for psychotherapy, with usual waitlist procedures as a control condition.


Anxiety, Depression, Conduct Disorder, Stress

Recruitment Status


Detailed Description

There is a massive unmet need for youth mental health care in America; only ¼ of youth in need receive services. The problem has been underscored and exacerbated by the pandemic. The need for child and adolescent mental health care, particularly for depression and anxiety, has surged while clinician availability and clinic funding have shrunk. One result is that clinic waitlists, always lengthy, have stretched, with youths and families who seek care waiting for up to 12 months for a first appointment, and many giving up and dropping out before the much-delayed appointment. There is a clear need-in both pandemic and normal times-for efficient mental health support that can be provided when need is acute, to sustain young people through periods of delayed access, and to reduce burden for professionals. Fortunately, recent evidence shows the surprising potential of brief, low-cost, digital interventions that could go a long way toward bridging the need-to-access gap. Single-session interventions have substantial effects, in some cases rivaling effects of full-length in-person psychotherapy. Remote therapies for youth mental health problems are beneficial on average and approximately as beneficial as in-person psychotherapy. The current trial will test a brief (one 30-45-minute session), online, interactive mental health and behavior change intervention for adolescents (9-17 years old), who have been placed the waitlist for outpatient treatment at a Boston area mental health clinic. Previous RCTs show beneficial effects of the principle of Practicing the Opposite (PTO) on youth mental health when using the therapeutic elements present in PTO (e.g., exposure, to overcome anxiety; behavioral activation, to overcome depression). The single-session PTO intervention uses stories, interactive activities, and engaging graphics to teach youths a key principle: by practicing the positive opposite of unhelpful behaviors, one can, over time, change their emotions thoughts, and actions.

Eligibility Criteria

Inclusion Criteria:

Youth/family has contacted a participating Boston area outpatient clinic to seek mental health care, and is placed on the waitlist.
Youth is between the ages of 9-17 years (inclusive) at the time of study enrollment.
Youth and at least one guardian consent to the youth's participation in study.
Youth reads English well enough to effectively complete the digital programs (defined as taking classes in English, as opposed to ESL classes).
Youth has access to a digital device.

Exclusion Criteria:

Youth is non-English speaking, as the program is only available in English.
Youth does not have access to a digital device.


Intervention Type

Intervention Name


Practicing the Opposite (PTO)


Usual Clinical Care


Not Applicable



Min Age

9 Years

Max Age

17 Years

Download Date

September 13, 2022

Principal Investigator

Katherine Venturo-Conerly, A.B.

This field has been modified from to show a contact specific to Boston Children's.

Primary Contact Information

Ashley Flynn

This field has been modified from to show a contact specific to Boston Children's.

For more information on this trial, visit


For more information and to contact the study team:

Digital Single Session Intervention for Youth Mental Health NCT05449002 Ashley Flynn