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Program aims to help rural Montanans reduce depression

From left, Mark Schure and Bill Bryan pose for a photo. The pair presented about their Thrive-Montana program at the Butte Archives on Thursday. The online program aims to help Montana adults in urban and rural areas decrease depression-related symptoms.

A video played through a projector for about a dozen members of the Butte Community Action Team on Thursday. The introductory video showed a woman speaking about how life is a path of ups and downs and about how small changes in daily habits can result in big mood changes.

“Act the way you want to feel,” the woman said to her Butte viewers.

This is the first of the over 300 videos and 100 interactive elements that comprise Thrive-Montana, an online program proven to help Montana adults with anxiety, depression, and emotional well-being.

Starting early November, up to 1,000 state residents with mild to severe depression or anxiety will be able to try the program for free — and participate in state-funded mental health therapy research.

In an upstairs Butte Archives conference room, Mark Schure and Bill Bryan talked about Thrive-Montana. Schure is leading the research as Thrive-Montana’s principal investigator and an assistant Health and Human Development professor at Montana State University; Bryan is a co-founder and former president of One Montana, a group that aims to better connect the state’s rural and urban communities.

Together, Schure and Bryan are working to provide easy access to evidence-based mental health therapy for rural and urban Montanans by researching the effectiveness of Thrive-Montana.

“This program isn’t meant to replace in-person therapy but to enhance it and be available to those with little or no access to treatment,” Bryan said during Thursday’s presentation.

Thrive was created by a Seattle-based company, Waypoint Health Innovations, and has decreased depression-related symptoms among adults in urban settings like Southern California, according to Schure. The program uses common therapy practices aimed at changing thought patterns and behavior to help participants hone three different skill sets: communicating more effectively, identifying and replacing negative thinking with positive thoughts, and taking up hobbies and daily activities that promote joy.

As participants get deeper into the potentially weeks-long program, Schure and Bryan said, it becomes more personalized and encourages the person to practice their online learning in daily life.

“The program is beneficial, not only because it’s available to anyone with access to internet but also because it’s completely anonymous” Bryan said before the presentation. “It gets at the stigma. No one knows you’re taking the program, and you can take it on your own time.”

In 2015, MSU’s year-old Center for Mental Health Research and Recovery pitched Schure the idea of testing Thrive on rural Montana communities, which he secured internal MSU project funding from the National Institute of Health for.

With help from One Montana and MSU Extension offices, Schure conducted 18 interviews and facilitated 19 focus groups across Montana to help guide his research and recruitment for Thrive program trials.

“We wanted to set up these interviews and meetings with people across the state to see if they felt it could be an effective tool,” Schure said. “Overall, our feedback was yes, it could be useful, but it had too much of a city flavor.”

Based on this feedback, Schure and Bryan co-produced about 10 new videos that aligned better with Montana lifestyles, translating some of the original program’s urban office workspaces into rural ranch settings.

In Sept. 2017, Schure and his colleagues ran roughly 340 people anonymously through their new, culturally-adapted program. The Thrive-Montana trial aimed to analyze the program’s effectiveness in decreasing the severity of various depression-related symptoms. Looking at how participants evaluated these symptoms before and after the eight-week program period, Schure said the mean improvement was dramatic.

“Our results aren’t quite published yet, but they show the program had a positive impact on depression and anxiety symptoms,” Schure said.

The preliminary results of the first Thrive-Montana trial, along with the success of the original program in more urban settings, led the Montana Department of Health and Human Services and the Montana Healthcare Foundation to support and promote a second trial.

The signup for this second wave of research should open in early November and may last up until early June, depending on how quickly Schure and Bryan can fill all 1,000 free spots. Recently, Bryan and Schure have traveled to various Montana communities like Butte to talk about their research and encourage participation.

“There is always room for improvement,” Bryan emphasized. “The program can be helpful to most everyone, even people experiencing mild depression.”

If this second trial proves successful, Bryan and Schure said it could potentially become a model for similar online programs that target things like substance abuse, obesity, and even sleep deprivation. However, if the trial is successful, they want their next focus to be on tailoring the program for Montana youth, Schure said.

“If our kids can get these skills sooner, it could help them deal with depression and anxiety later in life. It could change their whole life trajectory,” Schure said.

Bryan agreed. “This program could be the tip of a bigger iceberg.”

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