RecruitingNot ApplicableNCT07639736

Teen Helpline Motivational Interviewing Study

Using Performance Feedback and Facilitation to Integrate Motivational Interviewing in Teen Helpline Services

Sponsor

San Diego State University

Enrollment

206 participants

Start Date

Aug 28, 2025

Study Type

INTERVENTIONAL

Conditions

Help seeking Implementation Research

Summary

The proposed study will establish a foundation for research within peer-delivered helplines for teens. It aims to evaluate the impact of a Motivational Interviewing training at peer-to-peer helpline. The study will leverage emerging technologies to surmount the challenges of providing tailored training to a large and diverse mental health workforce at scale. Aim 1: Adapt Motivational Interviewing (MI) strategies for use in a teen peer-delivered text-based digital helpline. Aim 2: Co-design performance feedback (PF) and facilitated practice (FP) processes to support MI adherence among peer helpers. Aim 3: Examine feasibility, acceptability, and initial outcomes in a pilot feasibility trial. Peer helpers (N=50) will be randomized to receive MI training or MI training + PF-FP.

Eligibility

Min Age: 13 Years

Inclusion Criteria2

All current teen helpers (N=255) will be invited to participate in the research study prior to the MI workshops. Helper participants who provide assent and documented parental consent will be asked to complete study measures prior to the first MI training session (see Human Subjects Study Timeline, Aim 3). Helpers who wish to participate in the research study must have attended and completed the MI training activities. Additionally, helpers must have the ability to participate in online (i.e., access to a computer, tablet, or smart phone with a videocamera and microphone) research activities. Given that Teen Talk App helpers volunteer remotely on the Teen Talk App, they will likely all have access to electronics needed to participate in online activities. Teen Line staff will similarly have access to this technology. The age range of current Teen Talk peer helpers is 14-19 years.
To be eligible for the study, users must have at least 20 back-and-forth text exchanges with a Teen Talk App helper. The inclusion threshold for users is based on preliminary data indicating feasibility of reliable detection of MI skill use using adapted MITI codes. Given that the study clinical outcomes relate to help-seeking IRL via implementing MI's collaborative communication style, only users who display active communication and engagement with helpers (based on the minimum threshold described above) on the Teen Talk App/ Teen Line will be recruited. Additionally, users must have the ability to participate in an online (i.e., access to a computer, tablet, or smart phone, potentially with a videocamera and microphone) survey and potentially, interview. Given that users access the application via a similar technology, it is likely most qualifying users will meet this criterion. Teen Line users will likely have access as well. Between January- May 2023, Teen Talk received an average of 319 posts/month, with an average length of 18 posts per exchange. Therefore, it is conservatively estimated that a <10% response rate will be needed to recruit 100 eligible users over 4 months. Users between the ages 13-19 years are eligible for inclusion in this study. Users must be current US residents.

Exclusion Criteria2

Helpers who indicate they plan to end their Teen Talk App or Teen Line activities within the next 8 months will not be invited to participate in the research study, due to the study length. Helper study participants, regardless of condition, will attend a monthly training session (TAU: monthly CE offered by Teen Talk App; experimental condition: PF-FP sessions). The age range of current Teen Talk peer helpers is 14-19 years.
Users expressing current acute suicide risk ("high risk" flag based on Teen Talk App algorithm, identified by staff at Teen Line) will not be recruited to avoid interrupting the helplines' emergency workflows. Teen Talk App has an internal algorithm that automatically detects key words associated with suicidal risk. Posts with these keywords are automatically tagged as "high-risk". While all initial and off-hours posts on Teen Talk App receive an automatic message directing users to emergency services if they are in acute distress or suicidal, posts that are tagged as high-risk are given priority during Teen Talk App users' live hours. Teen Talk App has an internal process that involves helpers (with live supervisor support) assessing, responding to, and intervening with users who are experiencing acute suicidal risk. This includes directing users to or deploying emergency services. Given that the current study is focused on the feasibility of implementing MI within an existing service sector, it is critical to not disrupt Teen Talk App's workflow and emergency procedures. More importantly, users in acute crises require priority services and support, including possibly emergency transport. Thus, the current study will exclude users associated with "high-risk" flags to avoid interfering with Teen Talk App's emergency protocol and workflow, and to support users in prioritizing accessing needed support including potentially emergency services. Users between the ages 13-19 years are eligible for inclusion in this study.

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Interventions

OTHERMotivational Interviewing Training

All participants will receive Motivational Interviewing training through an educational workshop. Participants in the intervention arm will receive performance feedback and facilitated practice (implementation strategy). Those in the control arm will receive training as usual.