Understanding acceptability of a brief intervention for intrusive thoughts: A mixed- methods study

Intrusive thoughts (ITs) are common yet distressing experiences for many adolescentsand young adults. Brief, accessible interventions that provide psychoeducation andcoping strategies are needed, yet little is known about how youth perceive suchinterventions. The present study examined both qualitative and quantitative indicatorsof acceptability in adolescents and young adults with ITs who completed a digitalsingle-session intervention (SSI). The study aimed to gather intervention feedback anddetermine whether symptom improvement and/or demographic factors predictedacceptability. We conducted a secondary analysis of a randomized controlled trialcomparing our SSI to an information-only control group in individuals aged 13-25,focusing solely on acceptability factors of the SSI condition. Thematic analysesrevealed that young people with ITs prefer interventions that normalize the experienceof ITs, are emotionally validating, accessible and engaging, stimulate self-reflection,and contain evidence-based strategies. Importantly, those who reported qualitativelyaccepting the intervention were more likely to experience a reduction in hopelessnesssymptoms at post-intervention; however, acceptability was not associated with distressreduction. Of interest, those who identified as non-Caucasian were less likely to reportthey had a positive intervention experience compared to Caucasian individuals.Participants reported wanting more diverse examples of ITs to connect more with thepsychoeducation, as well as more personalized examples for validation. These findingsindicate acceptability factors and barriers that young adults with ITs experienced duringa brief SSI. Future studies, employing more diverse examples of ITs, will be crucial forunderstanding further effects on acceptability and engagement.