Randomized trial of a single-session digital intervention targeting emotion-related beliefs and emotion regulation

There is a lack of accessible and efficacious interventions for emotionally distressed adults. We developed a single-session digital intervention, called Visitor Mindset, targeting beliefs about negative emotions and awareness, clarity, and acceptance of negative emotions. We evaluated the acceptability, feasibility, and short-term efficacy of Visitor Mindset among emotionally distressed adults (n = 530). Participants were recruited via CloudResearch and randomized to Visitor Mindset or control (nature videos with relaxing music). The primary outcome was emotional distress. Secondary outcomes were functional impairment and alcoholic drinks per week. Outcomes were assessed before randomization and at 2-week follow-up. All participants randomized to Visitor Mindset completed the intervention. Acceptability ratings (e.g., perceived helpfulness) for Visitor Mindset were favorable. There was not a significant difference in changes in emotional distress between treatment conditions (d=0.13, p>.05). However, Visitor Mindset, versus control, resulted in greater reductions in functional impairment (d=0.21, p< .05) and drinks per week (d=0.21, p< .05). Improvement in acceptance and reduction in the belief negative emotions last a long time significantly mediated the effects of Visitor Mindset on emotional distress and functional impairment (p's< 0.05), but not drinks per week. Among participants with at least moderate-to-severe emotional distress, the effect of Visitor Mindset on emotional distress in this case was significant (d=0.34, p< .05), and the effect of Visitor Mindset on functional impairment was stronger (d=0.31, p< .05) in this subsample relative to the effect in the full sample. Functional impairment, but not other outcomes, demonstrated clinical significance. That is, Visitor Mindset participants were 61% more likely than control participants to change from a clinical score to a subclinical score for functional impairment. Visitor Mindset is feasible and acceptable, and may be promising for improving functioning and reducing alcohol use among emotionally distressed adults. Additionally, Visitor Mindset appears to mobilize theorized mechanisms. Future research is warranted with longer-term follow-ups.