MindTrails

Eleven percent of adolescents in the US currently struggle with anxiety, and a third have not received treatment in the last year _{(Ghandour et al., 2019)}. Not surprisingly, children from less affluent households are less likely to receive treatment compared to wealthier peers. There are also ethnic and racial disparities in access to mental health care, and there are particular challenges to accessing mental health care for marginalized youth. Compared to American youth nationally, youth in formal mentoring programs are more likely to be from families living below the poverty line, from a single parent household, or experiencing a mental health challenge _{(Jarjoura et al., 2018).} Youth in mentoring programs also tend to come from diverse racial and ethnic backgrounds. In a survey of parents with children enrolling in a youth mentoring program in Canada, 25% of parents reported that their child’s disability or psychiatric illness was the reason for referring their child to the formal mentoring program _{(Sourk et al., 2019)}. However, mentors are not intended or trained to serve as treatment providers in mentoring contexts.

Technology-delivered interventions (TDIs) are one promising way to reach under-served youth. However, TDIs can only work when used properly. Unfortunately, TDIs are plagued with attrition and improper or inconsistent use. One way to increase correct use is by adding human support through a supportive accountability model _{(Mohr et al., 2011)}. Supportive accountability is process-oriented: individuals with lived experience participating in TDIs are assigned coaches to support their use of the intervention. Thus, although mentors in formal mentoring programs are not trained in directly providing mental health interventions, they can be trained to support TDI use among the youth they are mentoring.

This project examines the efficacy of a free, scalable TDI for youth anxiety used within the context of formal mentoring programs. MindTrails is a free web-based intervention for adults with anxiety that teaches users how to think more flexibly during anxiety-provoking situations. The program has served thousands of adults in more than 50 countries. We are currently adapting the site to meet the needs of youth participating in mentoring programs, i.e., youth from low-income, marginalized, and underserved communities. To support mentor’s success in providing support for TDI use among youth, we are partnering with MentorHub, which enables mentors to track and monitor youth’s app and platform usage through shared API, and guides mentors in providing effective supportive accountability to encourage consistent use of the TDIs. MentorHub has been adopted by several schools as well as the nation’s largest mentoring programs (Big Brothers Big Sisters, Friends of the Children, My Brother’s Keeper) and has over 70 programs waiting to onboard. Thus, the potential reach of a MindTrails + MentorHub partnership is huge.

Big Brothers Big Sisters anxious mentee/mentor pairs will participate in MindTrails paired with MentorHub with the goal of reducing the mentee’s anxiety. Mentees (ages 13-17-years-old) will complete brief assessments of anxiety symptoms, anxious thinking style, and user experience with MindTrails pre- and post-treatment, as well as mid-way through the 10-week study. During the intervention, participants will complete twice-weekly, brief cognitive bias modification interventions to learn how to think more flexibly during common anxiety-provoking situations (e.g., taking a test or making new friends). This research project directly impacts the lives of those with lived experience of anxiety by providing a free TDI within the context of their youth mentoring relationship.