About

Tracy R.G Gladstone is an Associate Professor of Psychiatry and Human Behavior, as well as an Associate Professor of Behavioral and Social Sciences at Brown University. She completed her PhD at Emory University in 2011. Her professional focus includes adolescent and young adult health, and she is involved in teaching courses related to this area. Her work is affiliated with the departments of Behavioral and Social Sciences and Psychiatry and Human Behavior at Brown University.

Research topics

• Clinical psychology
• Medicine
• Psychiatry
• Psychotherapist
• Family medicine
• Medical emergency
• Internal medicine
• Developmental psychology
• Psychology

Selected publications

• COVID-19, Adverse Experiences, and Mental Health in Autistic Youth: A Population Based Study

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Preventing depression: Challenges and innovations.

  Journal of Consulting and Clinical Psychology · 2025-03-24 · 2 citations

  articleOpen accessSenior author

  The articles in this special issue provide an important resource for researchers and clinicians in the field of depression prevention. Prevention of depression is one of the most important public health challenges today, and the articles in this issue provide a helpful overview of ways in which the field has progressed over the past decades. This article provides a brief synopsis of the articles in this special issue. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Validating a digital depression prevention program for adolescents in Jordan: cultural adaptation and user testing in a randomized controlled trial

  Frontiers in Psychiatry · 2025-02-12 · 6 citations

  articleOpen access

  Purpose: Digital health interventions (DHIs) offer scalable solutions for improving mental health care access in underserved settings. This study is part of a multi-phased project aimed at adapting a depression prevention DHI for Jordanian adolescents. It evaluated the feasibility, cultural acceptability, and effectiveness of the translated and culturally adapted DHI, named Al-Khaizuran, with comparisons to school-based group CBT. Methods: A two-arm, single-blind randomized controlled trial with a mixed-methods design was conducted among 109 Jordanian adolescents aged 15-17 years experiencing mild to moderate depression. Participants were randomly assigned to either Al-Khaizuran DHI (n=55) or school-based group CBT (n=54). The adaptation of Al-Khaizuran DHI components was guided by the Ecological Validity Framework, while the procedural adaptation followed Barrera and Castro's Heuristic Framework, incorporating iterative refinement based on user feedback and contextual considerations. Results: Al-Khaizuran DHI was found to be a culturally relevant and acceptable intervention for Jordanian adolescent. Over half of the participants reported that the intervention was effective, empowering, and easy to use, with 51% expressing satisfaction and willingness to recommend it. However, challenges such as limited access to personal devices, privacy concerns, and participants' reliance on shared family resources emerged as significant barriers to consistent engagement. Participants showed a preference for individualized, blended interventions, with a significant reduction in support for group CBT. No significant difference was found in depression scores between the two groups. However, the Al-Khaizuran DHI group demonstrated higher post-intervention resilience scores (p=0.026). Beliefs about the effectiveness of the intervention significantly predicted behavioral intention (p=0.022), while perceived difficulty was a barrier to adherence (p=0.015). Conclusions: Al-Khaizuran DHI exemplifies the potential of culturally adapted digital interventions in bridging mental health care gaps in resource-limited settings. However, its effectiveness is contingent upon addressing barriers to access, enhancing program interactivity, and integrating hybrid support systems that combine digital tools with in-person guidance. Future implementations should consider strategies to actively engage parents to foster a supportive environment that promotes the well-being of adolescents. Clinical trial registration: https://doi.org/10.1186/ISRCTN14751844, identifier ISRCTN14751844.

  PublisherOA PDFDOI

• A whole-of-society approach to depression prevention during the global pandemic: Preliminary data from three large-scale trials.

  Journal of Consulting and Clinical Psychology · 2025-02-18

  articleOpen access1st authorCorresponding

  OBJECTIVE: Despite the prevalence of depressive disorders among youth, there is no health system model to address the prevention of these disorders. METHOD: = 780), which examines the feasibility and potential benefit of a coordinated care, risk stratification, and intervention matching approach for adolescents with intellectual and developmental disabilities using both CATCH-IT (lower risk) and the Coping with Depression Course-Adolescent (higher risk). RESULTS: The study samples for all three trials include youth from traditionally underrepresented groups (71.8%) with some economic distress (47.6%). Intervention utilization was moderate across trials. Feedback from study teams reveals general barriers to implementation and challenges specific to the pandemic. CONCLUSIONS: We review these trials, report preliminary data on demographics and intervention utilization, and provide feedback from study teams on implementation challenges encountered. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Future directions in depression prevention.

  Journal of Consulting and Clinical Psychology · 2025-02-27 · 2 citations

  articleOpen access

  OBJECTIVE: Rising rates of mental illness in young people over recent decades are a trend that represents a wake-up call across the globe. The causes of this increase are not known. We also know little about effective interventions or implementation strategies to prevent depression in either youth or adults. The need for the prevention of mental ill health represents an outstanding research opportunity for our field. METHOD: This conceptual article identifies current challenges in our field, provides potential solutions, and suggests the most promising avenues for future solutions and how we might investigate them. RESULTS: Key challenges include the following: poor implementation with low fidelity; methodological challenges related to appropriate sampling, time frames, interventions, and active controls; and lack of fit between interventions and their context. Potential solutions include the following: supplementing trials with evidence from large-scale epidemiological studies, establishing prevention models that work at scale including those that address social determinants and show effectiveness in low- and middle-income countries, building capacity in methods, and strengthening geographically dispersed networks of prevention researchers and practitioners. CONCLUSIONS: There are major challenges in conducting prevention research and demonstrating effects. New perspectives and collaborations are needed to overcome existing barriers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• 4.32 Dimensionality and Measurement Invariance of the Generalized Anxiety Disorder-7 (GAD-7) Among Adolescents With and Without Depression Symptoms

  Journal of the American Academy of Child & Adolescent Psychiatry · 2024-10-01

  articleOpen access
  PublisherOA PDFDOI

• Involving youth with intellectual and/or developmental disabilities as collaborators in a comparative effectiveness trial: A community-engaged research approach

  Contemporary Clinical Trials Communications · 2024-11-22 · 2 citations

  articleOpen access

  Background: Practices to include youth with intellectual and/or developmental disabilities (IDD) are necessary to design and implement research that specifically meets the behavioral health needs of this population. This article describes a protocol for engaging youth with IDD as collaborators in a comparative effectiveness clinical trial using a community-engaged research (CEnR) approach. Methods: Our engagement protocol, guided by the Community Engaged Research (CEnR) Framework, emphasized harm avoidance, accessibility, demonstrated value, capacity bridging and co-learning, shared power and equity in decision-making, accountability and respect, and transparent communication. We involved seven youth with IDD in a Youth Advisory Committee (YAC) and four youth with IDD in a Summer Scholars program, ensuring consistent and structured engagement throughout the study. Results: Youth with IDD maintained high levels of engagement in both the YAC and Summer Scholars Program with 100 % retention across two years. Youth used multiple modalities to provide feedback on aspects of the research project, resulting in study modifications, the co-development of products, and tangible improvements in the accessibility and relevance of the study for youth with IDD. Conclusion: Researchers and clinicians seeking to engage the historically underserved population of disabled youth in clinical trial research can leverage our findings to enhance the accessibility and inclusivity of their studies.

  PublisherDOI

• Cognitive behavioral program for the prevention of depression in at-risk adolescents: isolating the effects of dose

  American Journal of Epidemiology · 2024-06-18 · 3 citations

  articleOpen access

  The current study estimated effects of intervention dose (attendance) of a cognitive behavioral prevention (CBP) program on depression-free days (DFDs) in adolescent offspring of parents with a history of depression. As part of secondary analyses of a multisite randomized controlled trial, we analyzed the complete intention-to-treat sample of 316 at-risk adolescents ages 13 to 17 years. Youth were randomly assigned to the CBP program plus usual care (n = 159) or to usual care alone (n = 157). The CBP program involved 8 weekly acute sessions and 6 monthly continuation sessions. Results showed that higher CBP program dose predicted more DFDs, with a key threshold of approximately 75% of a full dose in analyses employing instrumental variable methodology to control multiple channels of bias. Specifically, attending at more than 75% of acute phase sessions led to 45.3 more DFDs over the 9-month period after randomization, which accounted for over 12% of the total follow-up days. Instrument sets were informed by study variables and external data, including weather and travel burden. In contrast, conventional analysis methods failed to find a significant dose-outcome relation. Application of the instrumental variable approach, which better controls the influence of confounding, demonstrated that higher CBP program dose resulted in more DFDs. This article is part of a Special Collection on Mental Health.

  PublisherOA PDFDOI

• Internet-based cognitive behavioral therapy intervention for youth with type 1 diabetes and depressive symptoms: a pilot and feasibility study

  mHealth · 2024-01-01 · 2 citations

  articleOpen access

  Abstract: Depression is more common in youth with type 1 diabetes (T1D) compared to youth without diabetes. This study aims to assess the efficacy of Competent Adulthood Transition with Cognitive Humanistic and Interpersonal Teaching (CATCH-IT), an internet-based cognitive behavioral therapy (CBT) intervention, in adolescents with T1D and depressive symptoms. Adolescents (13 to 17 years old) with T1D and mild (score 5–9) or moderate (score 10–14) depressive symptoms on Patient Health Questionnaire-Adolescent (PHQ-A) screening assessment were recruited to participate and received online access to the CATCH-IT modules for 6 months (requested to complete in 12 weeks). Statistical analyses included paired t-test for changes in Center for Epidemiologic Studies Depression Scale (CES-D), PHQ-A, Problem Areas in Diabetes-Teen version (PAID-T), and hemoglobin A1c (HbA1c). Nineteen patients were consented, 15 met inclusion criteria and received the intervention. In the seven participants that completed the modules, there was a trend towards improvements in PHQ-A, CES-D and HbA1c. Participants provided robust qualitative feedback on the modules and areas for improvement in subsequent iterations, such as inclusion of diabetes-related content. Given the prevalence of depression in diabetes, feasible, low resource interventions are needed. Internet programs such as CATCH-IT can serve as an effective first line intervention in this high-risk population. A modified version of CATCH-IT tailored for adolescents with T1D may be beneficial in this patient population.

  PublisherDOI

• Primary care-based screening and recruitment for an adolescent depression prevention trial: Contextual considerations during a youth mental health crisis

  Implementation Research and Practice · 2024-01-01 · 4 citations

  articleOpen access

  Background Rising rates of adolescent depression in the wake of COVID-19 and a youth mental health crisis highlight the urgent need for accessible mental healthcare and prevention within primary care. Digital mental health interventions (DMHIs) may increase access for underserved populations. However, these interventions are not well studied in adolescents, nor healthcare settings. The purpose of this study was to identify barriers and facilitators to screening and recruitment activities for PATH 2 Purpose (P2P): Primary Care and Community-Based Prevention of Mental Disorders in Adolescents, a multi-site adolescent depression prevention trial comparing two digital prevention programs within four diverse health systems in two U.S. states. Method This qualitative study is a component of a larger Hybrid Type I trial. We conducted semi-structured key informant interviews with clinical and non-clinical implementers involved with screening and recruitment for the P2P trial. Informed by the Consolidated Framework for Implementation Research (CFIR), interviews were conducted at the midpoint of the trial to identify barriers, facilitators, and needed adaptations, and to gather information on determinants that may affect future implementation. Findings Respondents perceived the P2P trial as valuable, well aligned with the mission of their health systems. However, several barriers were identified, many of which stemmed from influences outside of the healthcare settings. Universal and site-specific outer setting influences (COVID-19 pandemic, youth mental health crisis, local community conditions) interacted with Inner Setting and Innovation domains to create numerous challenges to the implementation of screening and recruitment. Conclusion Our findings emphasize the need for ongoing, comprehensive assessment of dynamic inner and outer setting contexts prior to and during implementation of clinical trials, as well as flexibility for adaptation to unique clinical contexts. The CFIR is useful for assessing determinants during times of rapid inner and outer setting change, such as those brought on by the COVID-19 pandemic, youth mental health crisis, and the corresponding exacerbation of resource strain within healthcare settings Clinical trial registration PATH 2 Purpose: Primary Care and Community-Based Prevention of Mental Disorders in Adolescents https://www.clinicaltrials.gov/study/NCT04290754 .

  PublisherOA PDFDOI

Recent grants

• Primary Care Internet-Based Depression Prevention for Adolescents (CATCH-IT)

  NIH · $3.2M · 2012–2018

• NIH Grant R01MH064717

  NIH · $2.8M · 2013

Frequent coauthors

• William R. Beardslee

  Boston Children's Hospital

  133 shared

• Benjamin W. Van Voorhees

  University of Illinois Chicago

  82 shared

• Joshua Fogel

  City University of New York

  53 shared

• V. Robin Weersing

  University of California, San Diego

  48 shared

• David A. Brent

  43 shared

• Gregory N. Clarke

  Kaiser Permanente

  40 shared

• Carl C. Bell

  39 shared

• Judy Garber

  Vanderbilt University

  39 shared

Education

• Ph.D.

  Emory University

  2011