Top

05-12-2024 | Original Article

An Intervention for Applying Learning to Self and Others (I-ALSO): A Multi-Arm Randomized Experiment of Learning for Others in a College Student Mental Health Intervention

Auteurs: Joseph Levy, Sona Dimidjian

Gepubliceerd in: Cognitive Therapy and Research

Abstract

Purpose

This study evaluates in college students a novel type of mental health intervention designed to both support the recipient and to help the recipient share what they have learned with others. Through sharing intervention content with others, participants of an intervention for applying learning to self and others (I-ALSO) may benefit from the learning-by-teaching effect and expand the reach of an intervention to their broader social network. The learning-by-teaching effect is commonly employed in other fields that promote learning but has not yet been experimentally tested with therapeutic information.

Methods

Participants were randomized (1:1:1) to complete a mental health intervention designed as a typical self-focused intervention or designed as two different versions of an I-ALSO. Specifically, participants completed an intervention in one of three conditions: as a resource to help oneself (n = 71); as an I-ALSO with an opportunity to support one’s peers through teaching via writing (n = 69); or as an I-ALSO with an opportunity to support one’s peers through teaching in-person (n = 69). Participants completed surveys at baseline, post-intervention, and one-week follow-up to assess learning of intervention content, change in putative intervention targets, and theory-informed moderators.

Results

Results indicated that the I-ALSO with an opportunity to support one’s peer through teaching in-person supported recall of mental health intervention content at one-week follow-up but did not affect an ad-hoc measure of comprehension. No between-condition effects on putative intervention targets were detected; however, across conditions, lower perceptions of autonomy during the intervention predicted less benefit, and contrary to hypotheses, heightened social anxiety predicted stronger learning effects.

Conclusions

This study demonstrates that the learning-by-teaching effect can enhance therapeutic learning, a critical process in all cognitive-behavioral interventions. It also offers implementation-relevant insight into the importance of considering college-students’ sense of autonomy during mental health interventions.

Alleen toegankelijk voor geautoriseerde gebruikers

Arvanitis, A., Kalliris, K., & Kaminiotis, K. (2020). Are defaults supportive of autonomy? An examination of nudges under the lens of self-determination theory. The Social Science Journal. https://doi.org/10.1016/j.soscij.2019.08.003CrossRef

Becker, C. B., Bull, S., Smith, L. M., & Ciao, A. C. (2008). Effects of being a peer-leader in an eating disorder prevention program: Can we further reduce eating disorder risk factors? Eating Disorders, 16(5), 444–459. https://doi.org/10.1080/10640260802371596CrossRef

Brewin, C. R. (1996). Theoretical foundations of cognitive-behavior therapy for anxiety and depression. Annual Review of Psychology, 47, 33–57. https://doi.org/10.1146/annurev.psych.47.1.33CrossRefPubMed

Bruijniks, S. J. E., DeRubeis, R. J., Hollon, S. D., & Huibers, M. J. H. (2019). The potential role of learning capacity in cognitive behavior therapy for depression: A systematic review of the evidence and future directions for improving therapeutic learning. Clinical Psychological Science, 7(4), 668–692. https://doi.org/10.1177/2167702619830391CrossRef

Byrd-Bredbenner, C., Eck, K., & Quick, V. (2020). Psychometric properties of the generalized anxiety disorder-7 and generalized anxiety disorder-mini in United States university students. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2020.550533CrossRefPubMedPubMedCentral

Caporale-Berkowitz, N. A. (2020). Let’s teach peer support skills to all college students: Here’s how and why. Journal of American College Health. https://doi.org/10.1080/07448481.2020.1841775CrossRefPubMed

Chang, J.-J., Ji, Y., Li, Y.-H., Pan, H.-F., & Su, P.-Y. (2021). Prevalence of anxiety symptom and depressive symptom among college students during COVID-19 pandemic: A meta-analysis. Journal of Affective Disorders, 292, 242–254. https://doi.org/10.1016/j.jad.2021.05.109CrossRefPubMedPubMedCentral

Cohen, M., Buzinski, S. G., Armstrong-Carter, E., Clark, J., Buck, B., & Reuman, L. (2019). Think, pair, freeze: The association between social anxiety and student discomfort in the active learning environment. Scholarship of Teaching and Learning in Psychology, 5(4), 265–277. https://doi.org/10.1037/stl0000147CrossRef

Daou, M., Buchanan, T., Lindsey, K., Lohse, K., & Miller, M. (2016). Expecting to teach enhances learning: Evidence from a motor learning paradigm. Journal of Motor Learning and Development. https://doi.org/10.1123/jmld.2015-0036CrossRef

Duffy, M. E., Twenge, J. M., & Joiner, T. E. (2019). Trends in mood and anxiety symptoms and suicide-related outcomes among U.S. undergraduates, 2007–2018: Evidence from two national surveys. Journal of Adolescent Health, 65(5), 590–598. https://doi.org/10.1016/j.jadohealth.2019.04.033

Duran, D. (2017). Learning-by-teaching. Evidence and implications as a pedagogical mechanism. Innovations in Education and Teaching International, 54(5), 476–484. https://doi.org/10.1080/14703297.2016.1156011CrossRef

Fiorella, L., & Mayer, R. E. (2014). Role of expectations and explanations in learning by teaching. Contemporary Educational Psychology, 39(2), 75–85. https://doi.org/10.1016/j.cedpsych.2014.01.001CrossRef

Garlow, S. J., Rosenberg, J., Moore, J. D., Haas, A. P., Koestner, B., Hendin, H., & Nemeroff, C. B. (2008). Depression, desperation, and suicidal ideation in college students: Results from the American foundation for suicide prevention college screening project at emory university. Depression and Anxiety, 25(6), 482–488. https://doi.org/10.1002/da.20321

GBD 2019 Mental Disorders Collaborators. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: A systematic analysis for the global burden of disease study 2019. The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3CrossRefPubMedCentral

Harvey, A. G., Lee, J., Smith, R. L., Gumport, N. B., Hollon, S. D., Rabe-Hesketh, S., Hein, K., Dolsen, M. R., Haman, K. L., Kanady, J. C., Thompson, M. A., & Abrons, D. (2016). Improving outcome for mental disorders by enhancing memory for treatment. Behaviour Research and Therapy, 81, 35–46. https://doi.org/10.1016/j.brat.2016.03.007CrossRefPubMedPubMedCentral

Harvey, A. G., Lee, J., Williams, J., Hollon, S. D., Walker, M. P., Thompson, M. A., & Smith, R. (2014). Improving outcome of psychosocial treatments by enhancing memory and learning. Perspectives on Psychological Science, 9(2), 161–179. https://doi.org/10.1177/1745691614521781CrossRefPubMedPubMedCentral

Heimberg, R. G., Mueller, G. P., Holt, C. S., Hope, D. A., & Liebowitz, M. R. (1992). Assessment of anxiety in social interaction and being observed by others: The social interaction anxiety scale and the social phobia scale. Behavior Therapy, 23(1), 53–73. https://doi.org/10.1016/S0005-7894(05)80308-9CrossRef

Hoogerheide, V., Deijkers, L., Loyens, S. M. M., Heijltjes, A., & van Gog, T. (2016). Gaining from explaining: Learning improves from explaining to fictitious others on video, not from writing to them. Contemporary Educational Psychology, 44–45, 95–106. https://doi.org/10.1016/j.cedpsych.2016.02.005CrossRef

Jackson, H. M., Calear, A. L., Batterham, P. J., Ohan, J. L., Farmer, G. M., & Farrer, L. M. (2023). Skill enactment and knowledge acquisition in digital cognitive behavioral therapy for depression and anxiety: Systematic review of randomized controlled trials. Journal of Medical Internet Research, 25(1), e44673. https://doi.org/10.2196/44673CrossRefPubMedPubMedCentral

Joëls, M., Pu, Z., Wiegert, O., Oitzl, M. S., & Krugers, H. J. (2006). Learning under stress: How does it work? Trends in Cognitive Sciences, 10(4), 152–158. https://doi.org/10.1016/j.tics.2006.02.002CrossRefPubMed

Kim, J., & Morgül, K. (2017). Long-term consequences of youth volunteering: Voluntary versus involuntary service. Social Science Research, 67, 160–175. https://doi.org/10.1016/j.ssresearch.2017.05.002CrossRefPubMedPubMedCentral

Kobayashi, K. (2019). Learning by preparing-to-teach and teaching: A meta-analysis. Japanese Psychological Research, 61(3), 192–203. https://doi.org/10.1111/jpr.12221CrossRef

Kohrt, B. A., Miller, B. F., & Patel, V. (2023). Community initiated care: A blue-print for the practical realization of contextual behavioral science. Journal of Contextual Behavioral Science, 27, 54–60. https://doi.org/10.1016/j.jcbs.2022.11.008CrossRef

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.xCrossRefPubMedPubMedCentral

Lattie, E. G., Cohen, K. A., Hersch, E., Williams, K. D. A., Kruzan, K. P., MacIver, C., Hermes, J., Maddi, K., Kwasny, M., & Mohr, D. C. (2022). Uptake and effectiveness of a self-guided mobile app platform for college student mental health. Internet Interventions, 27, 100493. https://doi.org/10.1016/j.invent.2021.100493CrossRefPubMed

Lee, J. Y., & Harvey, A. G. (2015). Memory for therapy in bipolar disorder and comorbid insomnia. Journal of Consulting and Clinical Psychology, 83(1), 92–102. https://doi.org/10.1037/a0037911CrossRefPubMed

Lee, J. Y., Worrell, F. C., & Harvey, A. G. (2016). The development and validation of the memory support rating scale (MSRS). Psychological Assessment, 28(6), 715–725. https://doi.org/10.1037/pas0000219CrossRefPubMed

Lee, P. H. (2016). Covariate adjustments in randomized controlled trials increased study power and reduced biasedness of effect size estimation. Journal of Clinical Epidemiology, 76, 137–146. https://doi.org/10.1016/j.jclinepi.2016.02.004CrossRefPubMed

Manos, R. C., Kanter, J. W., & Luo, W. (2011). The behavioral activation for depression scale-short form: Development and validation. Behavior Therapy, 42(4), 726–739.CrossRefPubMed

Muis, K. R., Psaradellis, C., Chevrier, M., Di Leo, I., & Lajoie, S. P. (2016). Learning by preparing to teach: Fostering self-regulatory processes and achievement during complex mathematics problem solving. Journal of Educational Psychology, 108(4), 474–492. https://doi.org/10.1037/edu0000071CrossRef

Onken, L. S., Carroll, K. M., Shoham, V., Cuthbert, B. N., & Riddle, M. (2014). Reenvisioning clinical science: Unifying the discipline to improve the public health. Clinical Psychological Science, 2(1), 22–34. https://doi.org/10.1177/2167702613497932CrossRefPubMedPubMedCentral

Pavarini, G., Reardon, T., Hollowell, A., Bennett, V., Lawrance, E., Brooks-Hall, E., Foster-Estwick, A., Juma, D. O., Lewis, P., Power, L., Rogers, M., Pinfold, V., Singh, I., Peer Support Young People’s Advisory Group. (2023). Online peer support training to promote adolescents’ emotional support skills, mental health and agency during COVID-19: Randomised controlled trial and qualitative evaluation. European Child & Adolescent Psychiatry, 32(6), 1119–1130. https://doi.org/10.1007/s00787-021-01933-0CrossRef

Reeve, J., Nix, G., & Hamm, D. (2003). Testing models of the experience of self-determination in intrinsic motivation and the conundrum of choice. Journal of Educational Psychology, 95(2), 375–392. https://doi.org/10.1037/0022-0663.95.2.375CrossRef

Renkl, A. (1995). Learning for later teaching: An exploration of mediational links between teaching expectancy and learning results. Learning and Instruction, 5(1), 21–36. https://doi.org/10.1016/0959-4752(94)00015-HCrossRef

Rodebaugh, T. L., Heimberg, R. G., Brown, P. J., Fernandez, K. C., Blanco, C., Schneier, F. R., & Liebowitz, M. R. (2011). More reasons to be straightforward: Findings and norms for two scales relevant to social anxiety. Journal of Anxiety Disorders, 25(5), 623–630. https://doi.org/10.1016/j.janxdis.2011.02.002CrossRefPubMedPubMedCentral

Roscoe, R. D., & Chi, M. T. H. (2007). Understanding tutor learning: Knowledge-building and knowledge-telling in peer tutors’ explanations and questions. Review of Educational Research, 77(4), 534–574. https://doi.org/10.3102/0034654307309920CrossRef

Schleider, J. L., Dobias, M. L., Sung, J. Y., & Mullarkey, M. C. (2020). Future directions in single-session youth mental health interventions. Journal of Clinical Child & Adolescent Psychology, 49(2), 264–278. https://doi.org/10.1080/15374416.2019.1683852

Schleider, J. L., Mullarkey, M. C., Fox, K. R., Dobias, M. L., Shroff, A., Hart, E. A., & Roulston, C. A. (2022). A randomized trial of online single-session interventions for adolescent depression during COVID-19. Nature Human Behaviour, 6(2), 258–268. https://doi.org/10.1038/s41562-021-01235-0CrossRefPubMed

Schleider, J. L., Mullarkey, M. C., Mumper, E., & Sung, J. Y. (2019). The ABC project: Action brings change. Open Science Framework. https://doi.org/10.17605/OSF.IO/QJ94C

Schneider, S., Nebel, S., Beege, M., & Rey, G. D. (2018). The autonomy-enhancing effects of choice on cognitive load, motivation and learning with digital media. Learning and Instruction, 58, 161–172. https://doi.org/10.1016/j.learninstruc.2018.06.006CrossRef

Snyder, C. R., Sympson, S. C., Ybasco, F. C., Borders, T. F., Babyak, M. A., & Higgins, R. L. (1996). Development and validation of the state hope scale. Journal of Personality and Social Psychology, 70(2), 321–335. https://doi.org/10.1037/0022-3514.70.2.321CrossRefPubMed

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092CrossRefPubMed

Strandskov, S. W., Ghaderi, A., Andersson, H., Parmskog, N., Hjort, E., Wärn, A. S., Jannert, M., & Andersson, G. (2017). Effects of tailored and ACT-influenced internet-based CBT for Eating disorders and the relation between knowledge acquisition and outcome: A randomized controlled trial. Behavior Therapy, 48(5), 624–637. https://doi.org/10.1016/j.beth.2017.02.002CrossRefPubMed

van Buuren, S., & Groothuis-Oudshoorn, K. (2011). mice: Multivariate imputation by chained equations in R. Journal of Statistical Software. https://doi.org/10.18637/jss.v045.i03CrossRef

van Os, J., & Guloksuz, S. (2023). Population salutogenesis—The future of psychiatry? JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2023.4582CrossRef

Wade, L., Leahy, A. A., Babic, M. J., Beauchamp, M. R., Smith, J. J., Kennedy, S. G., Boyer, J., Nathan, N., Robinson, K., & Lubans, D. R. (2022). A systematic review and meta-analysis of the benefits of school-based, peer-led interventions for leaders. Scientific Reports, 12(1), 21222. https://doi.org/10.1038/s41598-022-25662-9CrossRefPubMedPubMedCentral

Zieve, G. G., Dong, L., Weaver, C., Ong, S. L., & Harvey, A. G. (2019). Patient constructive learning behavior in cognitive therapy: A pathway for improving patient memory for treatment? Behaviour Research and Therapy, 116, 80–89. https://doi.org/10.1016/j.brat.2019.02.006CrossRefPubMed

Zieve, G. G., Woodworth, C., & Harvey, A. G. (2020). Client memory and learning of treatment contents: An experimental study of intervention strategies and relationship to outcome in a brief treatment for procrastination. Journal of Behavior Therapy and Experimental Psychiatry, 69, 101579. https://doi.org/10.1016/j.jbtep.2020.101579CrossRefPubMedPubMedCentral

Zuroff, D. C., & Koestner, R. (2023). Autonomy support and autonomous motivation: Common factors in counseling and psychotherapy. In R. M. Ryan (Ed.), The Oxford handbook of self-determination theory (p. 0). Oxford University Press.

Titel: An Intervention for Applying Learning to Self and Others (I-ALSO): A Multi-Arm Randomized Experiment of Learning for Others in a College Student Mental Health Intervention
Auteurs: Joseph Levy
Sona Dimidjian
Publicatiedatum: 05-12-2024
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-024-10555-0

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Purpose

Methods

Results

Conclusions

Log in om toegang te krijgen