Implementation of a text-messaging intervention for adolescents who self-harm (TeenTEXT): a feasibility study using...

Area of Science:

• Adolescent mental health
• Digital health interventions
• Self-harm research

Background:

• Limited interventions directly target adolescent self-harming behaviors.
• An adult SMS text-messaging intervention was adapted for adolescents in Child and Adolescent Mental Health Services (CAMHS).
• This adaptation was requested by and developed in collaboration with CAMHS clinicians in England.

Purpose of the Study:

• To assess the feasibility of delivering a text-messaging intervention (TeenTEXT) to adolescents who self-harm through CAMHS.
• To identify barriers and facilitators to the implementation of TeenTEXT within CAMHS.
• To utilize Normalisation Process Theory (NPT) to evaluate implementation potential.

Main Methods:

• A feasibility study using Normalisation Process Theory (NPT).
• Planned recruitment of 27 clinician/adolescent dyads using the TeenTEXT intervention for 6 months.
• Focus on assessing the practical implementation within the CAMHS context.

Main Results:

• Recruitment was significantly lower than planned, with only three dyads enrolled; two dropped out due to client severity.
• Identified implementation barriers included: CAMHS crisis context (workload, stress), organizational gatekeeping, clinician technophobia, and perceived burden.
• Clinicians suggested alternative delivery settings like schools or universal youth services might be more suitable than CAMHS.

Conclusions:

• User-centered design does not guarantee intervention implementability.
• Barriers to implementation can be unforeseen, and NPT is crucial for identifying potential widespread clinical support.
• Further research is required to determine the optimal delivery setting for the TeenTEXT intervention before efficacy trials.