Brioney Gee and colleagues in the UK recently compiled a Practitioner Review for the Journal of Child Psychology and Psychiatry on the effectiveness of school-based interventions for adolescent depression and anxiety. Their review looks specifically at the evidence on indicated school-based interventions that aim to reduce symptoms in young people already experiencing mental health symptoms.
Gee et al. conducted a systematic search for randomised controlled trials of indicated psychological interventions delivered in an education setting. They focused on trials of interventions for adolescents aged 10-19 with elevated symptoms of depression and/or anxiety. They identified 45 trials that met their inclusion criteria: most of these trials were of CBT-based interventions. “When we pooled together the findings of these trials, we found that immediately post intervention, the school-based interventions were successful at reducing depression and anxiety symptoms”, says Gee. “However, the size of the effect was small for depression symptoms and medium for anxiety symptoms”.
The researchers also looked at follow-up data. Here, they found some evidence that the effects on depression could be maintained for up to 6 months, but not later. They also found no evidence that the effects on anxiety were maintained beyond the end of the intervention. Gee explains that future trials incorporating longer-term follow-ups are thus needed to confidently determine whether the benefits of school-based interventions are maintained beyond the end of the intervention. Finally, in their subgroup analyses, Gee and colleagues found that the trials of interventions that were delivered by internal school staff didn’t have a significant effect on symptoms, whereas those delivered by external practitioners did.
“The conclusions we drew from this review were that indicated school-based interventions are effective at reducing symptoms of depression and anxiety in adolescents immediately post-intervention, but based on current evidence we can’t be confident that these reductions are sustained”, explains Gee. “In addition, we didn’t identify any trials of interventions delivered in sixth form or further education colleges. Given that in the UK, many young people aged 16-18 attend further education colleges rather than schools, we felt this represented a significant gap in the literature that was worth highlighting”.
Watch Brioney’s video abstract.
Gee, B., Reynolds, S., Carroll, B., Orchard, F., Clarke, T., Martin, D., Wilson, J. & Pass, L. (2020), Practitioner Review: Effectiveness of indicated school-based interventions for adolescent depression and anxiety – a meta-analytic review. J. Child Psychol. Psychiatr. doi: 10.1111/jcpp.13209.