Mark Tebbs Hello, and welcome to the Papers Podcast series for the Association for Child and Adolescent Mental Health, or ACAMH for short. I’m Mark Tebbs, I’m a Freelance Consultant. Today, I’m really delighted to be talking to Cameron Hecht, who’s a Research Fellow, who is also the Lead Author of a paper entitled “When Do the Effects of a Single-Session Interventions Persist? Testing the mindset and supportive context hypothesis in a longitudinal randomised trial,” recently published in JCPP Advances. Cameron, thank you for joining me. Cameron Hecht Yeah, thanks for having me. Mark Tebbs Really looking forward to our conversation. So, could we start with just some introductions? If you could say a little bit about yourself, maybe a little bit about your career to date and the people that you worked with on the paper. Cameron Hecht Sure thing. Yeah, my name is Cameron Hecht. I am currently a Postdoctoral Research Fellow at the University of Texas at Austin, but in the fall, I’ll actually be starting as an Assistant Professor of Psychology at the University of Rochester. And the other folks on this paper are David Yeager, Sam Gosling, Chris Bryan and Jared Murray. Those are all Researchers here at the University of Texas. And then, also, Jeremy Jamieson, who’s a Psychologist at the University of Rochester. Mark Tebbs Brilliant, thank you. So, let’s turn to the paper. If we can start by just giving a brief overview of the paper and as you’re providing that overview, if you can just define any of the key terms as you, kind of, go along, that’d be great. Cameron Hecht So, unlike a lot of other interventions, like different types of cognitive or behavioural therapies, single-session interventions are usually self-administered activities that take about 30-45 minutes. They usually occur just once, and the way these interventions work is that they try to identify some sort of single belief or perspective that if you could change that belief, it could potentially help to improve somebody’s life in a meaningful way. So, the synergistic mindsets intervention, specifically, is a single-session intervention that aims to change how people think about their own abilities and the role stress can play in changing and growing those abilities. So, first, the intervention teaches people the growth mindset. This is the idea that their intellectual abilities aren’t set in stone. Instead, we show people neuroscientific evidence that the brain is malleable and that it’s possible to improve your abilities with effort and good strategies and support from other people when you need it. And this belief is especially relevant to students because it can help them understand stressful academic demands differently, right? Like not as problems that they need to avoid, but instead, as opportunities for growth and improvement. And then, second, the intervention teaches people a new way of thinking about stress. So, it explains that the physiological stress response isn’t always debilitating, even though we’ve learned to think of it that way. Instead, it can actually be a positive force that helps us to perform better. For example, when we feel our heart rate increase, that’s actually our body sending more oxygenated blood to the brain so that we can think more quickly and clearly. So, this helps people to see their stress response not as, like, barriers for their growth and improvement, but instead, as a valuable aspect that can help energising the pursuit of value goals. And so, what we were testing in this study is what we call the mindset + supportive context hypothesis, and this is, basically, the idea that the same intervention won’t have the exact same effects for all people in all places. Instead, there are features of the context that can, kind of, allow or prevent an intervention from having a positive effect. So, the mindset + supportive context hypothesis says that interventions will be more effective in environments that support and reinforce that mindset that the intervention is communicating. Because in an unsupportive context, that new way of thinking might ring false and fail to actually change how people think or how they behave. Mark Tebbs Thank you for that overview. So, what were your, like, original research hypothesis? It would be really helpful to understand what you were originally trying to test. Cameron Hecht Yeah, so we knew from previous work that the synergistic mindsets intervention can be really effective at changing how people think about stressors in their lives, like whether they think the feeling of stress during a quiz is helpful or harmful. And it can also change related behaviours, like whether they’re willing to try more challenging work that might be more stressful in the moment, but would improve their learning in the long run. So, our question in this study was whether making the context more supportive could amplify the benefits of the intervention and how much these benefits would actually persist over time. And more specifically, we were curious whether having the Course Instructor send messages that reinforced the synergistic mindsets message could lead to stronger and more sustained intervention effects. Mark Tebbs Okay. So, how did you go about the study? Were there any particular methodological challenges that you had to overcome? Cameron Hecht So, we conducted the study in a large introductory psychology course. It had more than 1,500 students over the course of two semesters, and in fact, it was a course where we had previously tested this exact same intervention. So, that was nice because we already, basically, knew exactly what to expect from the intervention, which made it, kind of, perfect to look at the added benefit of adding supportive Instructor messages. So, at the beginning of the semester, we randomly assigned students to either get the synergistic mindsets intervention or to complete a control activity where they learned a bit about the brain. And then, over the course of the semester, we had the Course Instructor send messages to students through their online course management system about the weekly quizzes in the class, which make up a big part of students’ grades in this particular class. But we randomly varied what kinds of messages these students got. So, half of them received messages that explicitly reinforced the intervention message. For example, these messages described how the quizzes were included in the class, in part to give students the chance to practice using their physiological stress response to perform their best. The other half of students received messages that weren’t really relevant to the intervention message. For example, those messages talked about how students could use these quizzes to gauge what material they had or hadn’t already mastered so far. And then, what was cool about this study is we were able to collect measures every week right after students took their quiz. So, we asked them about how they perceived the role of stress in the course, like whether they thought it helped them to do better on the quiz or was debilitating. And we also asked them to choose an additional quiz question and told them that they’d receive full credit whether they got it right or wrong. And they got to choose between a hard question that would push their learning or a, kind of, an easy review question. So, that measure allowed us to look at whether the intervention could change students’ actual willingness to take on hard academic challenges. Mark Tebbs Okay, so – and so, what were the key findings? Cameron Hecht Yeah, so in general, when we compared students who received the synergistic mindsets interventions, the control group, they were more likely to view stress as a helpful and positive force within the class and they were also more likely to choose challenging quiz questions, so that was great. But when they also received supportive messages from their Instructor over the course of the semester, these effects were much larger. So, for example, the intervention effect on students’ views of stress was almost twice as large when students received the supportive messages as compared to when they received those neutral messages. Mark Tebbs And were there any aspects of the results that surprised you? Cameron Hecht Well, one thing that was really exciting was that when students received these supportive messages from their Instructor, the intervention effects actually grew larger over time. So, it was like the intervention message, kind of, sunk in and was able to have a stronger and stronger effect on how students thought and behaved in the class. And in comparison, when students didn’t receive those supportive messages, the intervention effects, if anything, got a little bit smaller. So, showing, like, kind of, a fadeout effect over time. And so, these results, I think, have some exciting implications for what we can do to make the effects of these brief single-session interventions actually last longer. Mark Tebbs Yeah, so, could you tell us a little bit more about the implications of the study from the intervention perspective? What are the potential opportunities from the learning from this study? Cameron Hecht On this note of preventing the fadeout of an intervention effect, a lot of previous research has looked at whether providing, like, what are called, like, booster doses of an intervention, that essentially, just to reiterate the intervention message, can amplify the effects of these types of single-session interventions. And unfortunately, in large part, the answer seems to be no, looking at the past work. Just changing people’s beliefs or perspectives at a critical time, like when they’re starting a new course or when they’re entering high school or college or something, seems to be a lot more important than repeating the same message over and over again. But in this work, we, of course, found that providing intervention and supportive messages from an Instructor did help to amplify intervention effects. So, these findings suggest that maybe boosters can be effective, but I think it matters how they’re implemented. They shouldn’t just repeat the same message that people have already received. Instead, they should change how people see the context. So, presenting it as one in which that targeted mindset is welcome and more supportive. Mark Tebbs Excellent, and I’m just wondering about the implications of the study from a, kind of, research perspective. Cameron Hecht There’s been a lot of focus in the field recently on the heterogeneity of intervention effects. So, the same intervention might have a strong effect in one study and then, a much weaker effect in another study, for example. And Researchers have been trying to get their heads around this. Like, does this mean that the interventions are unreliable, or on the other hand, do we just need to, kind of, figure out what the necessary preconditions are for an intervention to be effective? So, this study adds to, kind of, a growing body of research over the last few years, that’s been starting to answer this question in a more systematic way. And so, it shows how features of the context, in this case the Teachers’ expressed attitudes about learning and stress, can set the stage for an intervention message to either resonate with students or totally fall flat. And by nailing down these features of the context that, kind of, turn on or turn off an interventions effect, Researchers can do a much better job now of predicting when and where an intervention will actually pay off, and maybe even change the context to set the stage for bigger intervention effects in the future. Mark Tebbs Okay, and I’m just wondering about any messages to parents, carers or Teachers who are, you know, caring or looking after a young person who’s, kind of, experiencing stress or anxiety. Cameron Hecht I think the big takeaway for parents and Teachers is that even though we, kind of, have a cultural narrative that treats stress as something that’s inherently bad and to be avoided, in certain circumstances, like when we need to perform our best under pressure, stress can actually help us. And when young people understand this, then that can be really empowering, because they stop worrying when they, you know, feel their heart racing or their palms sweating before a big test, because they know their body’s actually just preparing them to take on that challenge. And this study suggests that parents and Teachers can help reinforce that message by reminding young people about this role of the stress response and encouraging them to make use of this physiological response when it’s time to do something hard. Mark Tebbs Okay, and are you planning any follow-up research? Is there anything in the pipeline that you would like to share with us? Cameron Hecht So, in this paper, we only looked at students’ reports on how they thought about stress, but we also know that the synergistic mindsets intervention can actually change the physiological stress response itself. So, in previous work, we found that people who received the intervention show more of what we call a challenge-oriented response. So, for example, you’ll see increased blood flow to the periphery of the body, that helps the body ramp up to do something difficult. Whereas without the intervention, people are more likely to experience what we call, like, a threat response, where the body, kind of, shuts down and goes into survival mode. But it’s an open question of whether Teachers’ messages can amplify these physiological effects, as well. So, during the study, we actually collected from a subset of the participants some physiological data, like their saliva. We had indicators of how much they sweated, with a measure called skin conductance, and we’re analysing those data right now. And another exciting development, this is a new project we’ve got going on, is that we’re now preparing to collect a similar data from Teachers to see if the synergistic mindsets message can help improve their stress response when they’re teaching a hard lesson or, like, answering difficult questions for students. Mark Tebbs Well, that sounds really interesting. Is there any final take home message for our listeners that you’d like to, kind of, end with? Cameron Hecht I think the main take home message is that we can actually help young people process stress a lot more effectively, without necessarily spending a lot of time and resources, as long as the approach we take is thoughtful and precise. And in this work, we identified some core beliefs that make a big difference in how students interpret the academic stressors that they encounter. And by changing those beliefs and also shifting the environment to support those beliefs more effectively, we were able to help students think about stress in a more adaptive way and encourage them to engage in the kinds of challenge seeking behaviours that we know will help set them up for future success. Mark Tebbs Cameron, thank you so much for your time today. Thank you for such a interesting podcast. For more details on Cameron Hecht, please visit the ACAMH website, www.acamh.org, and Twitter @ACAMH. ACAMH is spelt A-C-A-M-H, and don’t forget to follow us on your preferred streaming platform, let us know if you’ve enjoyed the podcast, with a rating or review, and do share with friends and colleagues.