4 - (SYM 43) Textsavvy: Examining the Effectiveness of a Text Messaging Adjunct to a DBT Skills Intervention for Youth in a Low Resource Community

Introduction. Dialectical Behavioral Therapy (DBT) has been shown to effectively treat several adolescent mental health concerns. Automated text messaging is a potential tool to further enhance clinical outcomes of DBT and increase engagement. Automated text messaging shows potential to enhance DBT outcomes and engagement, especially in resource-poor communities. However, there is a lack of research evaluating the effectiveness of automated text messaging as an adjunct to DBT. The goal of the present study was to examine the effectiveness of a text messaging adjunct intervention offered to a community sample of at-risk adolescents participating in a school-based tier-2 DBT skills treatment within an underserved community.

Methods. A graduate student of clinical psychology created concise messages based on the DBT-STEPS-A manual and previous interventions. Draft messages were evaluated by a licensed clinical psychologist and seven clinical psychology graduate students. Messages were revised or discarded based on their feedback. A feasibility study was conducted with six youth who received text messages twice daily for two weeks. Finally, a pilot trial examined the effectiveness of the text messaging adjunct (n = 37) compared to a historical control (n = 39).

Results. Feedback from clinical researchers and group participants indicated that the intervention was positively received overall, and constructive feedback informed modifications to intervention content and implementation. Individuals who received text messages attended more sessions and reported significantly higher perceived learning at several time points during the intervention (ps < .05). No significant differences were observed in terms of clinical outcomes. Overall, youth enjoyed receiving the messages (85.7% endorsed “liked a little” or “liked a lot”). One respondent noted “receiving daily messages helped me have the skills I learned in mind and made me feel more secure...”

Discussion. This inexpensive and ubiquitous approach holds promise for improving DBT treatment engagement for those in underserved communities.