Can Immediate Gains in Single-Session Intervention Predict Long-Symptom Change?

Panayiota Siskos ’23

Figure 1: In clinical intervention science there is work that suggests early improvements predict longer-term treatment effects.

Single-session interventions (SSIs) for youth mental health problems show promise to prevent and reduce youth psychopathology and may be a good alternative to the more traditional multi-session ones that are inaccessible due to logistical and financial obstacles. However, SSIs may not be beneficial for everyone, and it is important to differentiate the needs of youths. Immediate gains, or improvements, in program-specific targets, such as anxiety sensitivity or body esteem, after SSIs suggest adolescents’ receptivity to and engagement in the SSIs and the degree to which the SSI targeted a key underlying mechanism of broader mental disorders. This study investigated whether larger immediate gains in youths’ primary control (perceived control of behavior in response to stressors and failures), secondary control (emotions), and growth mindsets of personality can lead to greater long-term improvements in youth anxiety and depressive symptoms and outcomes.Intervention trials included 96 early adolescents aged 12-15 with a T-score in the 84th percentile on the Revised Child Anxiety and Depression Scale, school-based accommodations for anxiety or depression symptoms, and anxiety or depression treatment in the previous 3 years. Youths first completed questionnaires assigning them to one of two 30-minute computer-based intervention programs, one that encourages  growth mindset development and one that encourages youths to identify and share their emotions, respectively. After the intervention program, subjects completed post-intervention questionnaires anda social stress task. After the lab visit, subjects completed follow up questionnaires at 3-, 6-, and 9-month time points and self-reported depression and anxiety symptoms.

As predicted by the researchers of the study and by prior literature, lesser gains in primary and secondary control correlated with more severe symptoms of depression and anxiety. Youths that experienced greater immediate gains in primary control reported larger post-intervention improvements in primary control and more rapid declines in depressive symptoms across the 9-month follow-up period. Similarly,youths that had larger immediate gains in secondary control reported greater post-intervention improvements in secondary control and more rapid declines in anxiety symptoms during the 9-month follow-up period. Finally, youths that received the growth mindset intervention program had lower levels of depression and better primary control compared to those that did not receive this intervention program.

This study is crucial for developing different methods of reducing youth psychopathology because the results of this study  show how SSIs offer many benefits and can be a useful addition for better personalizing treatments to suit the needs of every youth. More research is needed to determine the sensitivity, acceptability, and clinical utility of SSIs. Future studies should also investigate whether   similar results can be reproduced with larger and more diverse subject samples and whether early gains in key target symptom trajectories are similarly observed in youths from different backgrounds.

Works Cited:

[1] J. Schleider, et al., Do Immediate Gains Predict Long‑Term Symptom Change? Findings

from a Randomized Trial of a Single‑Session Intervention for Youth Anxiety and Depression. Child Psychiatry & Human Development 50, (2019). doi:

[2] Image retrieved from:


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