青少年抑郁 团体辅导

Adolescents are tasked with developing identity vs. role confusion, where the search for identity will shape the individual's character. There has been an increase in the use of social media among adolescents, causing an increase in the number of depression in adolescents. The need for promotive and preventive efforts to prevent depression in adolescents. This study aims to determine the effect of therapeutic group therapy and cognitive behavioral therapy in preventing depression in adolescent social media users. This study was conducted on 70 students aged 15-18 years old using a purposive sampling technique according to inclusion and exclusion criteria. This study uses a quasi-experimental pre-post-test design with intervention and control groups. The intervention group was given therapeutic and cognitive behavioral therapy, and the control group was given therapeutic group therapy without cognitive behavioral therapy. The results of this study indicate a significant effect on the control group. The combination of therapeutic group therapy therapy and cognitive behavioral therapy can be recommended as a therapy for reducing depression in adolescent social media users.

Objective: This study aimed to investigate the effectiveness of humor-based group therapy on depression and self-esteem among adolescents. Methods and Materials: A randomized controlled trial design was employed, involving 30 adolescent participants from Bulgaria randomly assigned to either an experimental group (humor-based group therapy; n = 15) or a control group (no intervention; n = 15). The experimental group participated in eight weekly 90-minute sessions focused on humor-based techniques designed to enhance emotional regulation, self-esteem, and social interactions. Dependent variables were measured using standardized tools: depression was assessed via the Beck Depression Inventory-II, and self-esteem was assessed with the Rosenberg Self-Esteem Scale at three time points—pre-test, post-test, and a five-month follow-up. Data were analyzed using repeated-measures ANOVA and Bonferroni post-hoc tests through SPSS-27. Findings: The findings revealed significant reductions in depression (F(2,54) = 28.94, p < .001, η² = .539) and significant increases in self-esteem (F(2,54) = 26.75, p < .001, η² = .498) for the experimental group compared to the control group, with substantial improvements maintained at five-month follow-up. Specifically, depression scores in the experimental group significantly decreased from pre-test (M = 27.60, SD = 4.12) to post-test (M = 15.87, SD = 3.45, p < .001) and remained stable at follow-up (M = 16.53, SD = 3.72). Self-esteem scores significantly improved from pre-test (M = 18.80, SD = 3.67) to post-test (M = 28.40, SD = 4.18, p < .001) and remained high at follow-up (M = 27.87, SD = 4.01). Conclusion: Humor-based group therapy effectively reduced depressive symptoms and significantly enhanced self-esteem among adolescents, with beneficial effects persisting at five months post-intervention, suggesting it as a promising therapeutic option for adolescent mental health interventions.

Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14–18) with depression completed self-report measures of social support and parental conflict and were offered an established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.

Background: Depression is a serious mental health issue that negatively impacts the quality of life and development of adolescents. This study aims to determine the influence of self-help group-based health education on preventing depression in adolescents in Pekanbaru, Riau. Methods: This quasi-experimental study utilized a pre-post test design with a control group. The intervention, QS Al-Fatihah murottal therapy, was provided twice a week for two weeks, with sessions lasting 55-60 minutes. A stratified random and simple random sampling technique was used to select a total of 68 adolescent participants. Instruments included a characteristics questionnaire and the Depression Anxiety Stress Scales (DASS 42) for adolescents. Data analysis was conducted using dependent and independent t-tests. Results: The study found that most respondents were female (61.8%), aged 16 years (58.8%), of Minang ethnicity (45.6%), and had a high school education level (45.6%). Most came from employed families (fathers 86.8%, mothers 52.9%) and were Muslim (100%). Additionally, 45.6% of parents had a high school education level, and 54.4% of respondents lived with their nuclear family. The self-help group-based health education significantly prevented adolescent depression (p-value <0.0001). Conclusions: The study recommends incorporating self-help group-based health strategies as a nursing intervention to reduce depression in adolescents.

Abstract Objective The present study aimed to evaluate the efficacy of a mindfulness-based cognitive therapy (MBCT) intervention in reducing problematic mobile phone use, depression, and sleep disorders among adolescents. Additionally, it sought to investigate whether the decrease in problematic mobile phone use acted as a mediator in the relationship between the MBCT intervention and adolescent depression and sleep disorders. Methods In a randomized controlled trial, a total of 104 adolescents were randomly assigned to the mindfulness group (n = 52) or the wait-list control group (n = 52). The mindfulness group students completed eight 45-min sessions of mindfulness training in four weeks. The outcomes were measured at baseline, postintervention, and at the 2-month follow-up. Results Compared with the control group, the mindfulness group had significantly greater levels of mindfulness and lower levels of problematic mobile phone use, depression, and sleep disorders postintervention. The intervention effects were maintained at the 2-month follow-up. In addition, decreased problematic mobile phone use significantly mediated the association between the MBCT intervention and decreased depression and decreased sleep disorders. Conclusion The findings suggest that MBCT could improve adolescent depression and sleep disorders and that decreasing problematic mobile phone use is an effective pathway accounting for the MBCT intervention effect on adolescent depression and sleep disorders.

Depression is a leading cause of disability among adolescents, with the burden disproportionately affecting low- and middle-income countries (LMICs) where access to mental health care is limited. Interpersonal therapy (IPT), a structured psychological intervention, has shown promise in treating adolescent depression but there is limited evidence from LMICs and research on how it works and in which contexts it works best. This protocol describes a realist cluster-randomised controlled trial (cRCT) assessing the effectiveness, cost-utility and mechanisms of school-based group IPT for adolescents with depression in Nepal. This superiority phase III cRCT will be conducted in 48 public secondary schools across Chitwan and Nawalpur districts, with schools randomised 1:1 to intervention or enhanced usual care. Adolescents aged 13–19 with depression (Patient Health Questionnaire modified for adolescents, PHQ-A score ≥11) will be recruited from grades 7–9. The intervention comprises two individual and ten weekly group IPT sessions delivered by trained lay facilitators. Adolescents will be surveyed pre-randomisation (baseline) and five (midline), 17 (endline) and 32 weeks (follow-up) post randomisation. The primary outcome is depression severity at 17 weeks post-randomisation assessed using the PHQ-A. Secondary outcomes include anxiety, post-traumatic stress disorder, functional impairment, school attendance and quality of life. Intermediate outcomes including hope, emotion regulation, and social support will be assessed to examine mechanisms of change. A priori hypotheses concerning IPT’s mechanisms and contextual factors influencing these (context-mechanism-outcome configurations) will be refined through analysis of qualitative process data and tested in mediation, moderation and moderated mediation analyses of trial data. Economic evaluation will estimate cost-utility and benefit-cost ratios from both provider and modified societal perspectives. The process evaluation will assess fidelity, reach, and acceptability in various school settings. This trial is the first to integrate realist evaluation into a cRCT of a psychological intervention for adolescents in a LMIC and has potential to advance research and practice by elucidating how IPT works in a real-world context. If IPT is effective in Nepal, it could be scaled up through the education system as a part of a comprehensive school mental health care package. ISRCTN52852397 (registered 21/03/2025).

Abstract Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13–19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.

BACKGROUND Adolescent-onset type 2 diabetes (T2D) is a major public health concern of growing proportions. Prevention, therefore, is critical. Unfortunately, standard-of-care treatment for T2D prevention (e.g., exercise training) show insufficient effectiveness and do not address key modifiable barriers (e.g., depression symptoms) to exercise engagement. Depression symptoms are associated with both poorer physical fitness and greater insulin resistance, the key risk factor in adolescent-onset T2D. Thus, a targeted prevention approach that addresses depression symptoms in combination with exercise training may offer a novel approach to mitigating T2D risk. METHODS This manuscript describes the design and study protocol for a multi-site, four-arm randomized controlled trial comparing the efficacy of group cognitive-behavioral therapy, group exercise training, and their combinations for the targeted prevention of worsening insulin resistance in N = 300 adolescent females at-risk for T2D with BMI ≥85th percentile and elevated depression symptoms. All four intervention arms will run in parallel and meet weekly for 1 h per week for 6-week to 6-week segments (12 weeks total). Outcomes are assessed at baseline, 6-week mid-treatment, 12-week follow-up, and 1-year follow-up. RESULTS The primary outcome is insulin resistance. Key secondary outcomes include insulin sensitivity, cardiorespiratory fitness, physical activity, depression symptoms, and body measurements. CONCLUSION Study findings will guide the ideal sequencing of two brief T2D prevention interventions for ameliorating the course of insulin resistance and lessening T2D risk in vulnerable adolescents. These interventions will likely be cost-effective and scalable for dissemination, having the potential for significant public health impact on communities at risk for T2D.

Children and young people with long-term physical conditions may develop mental health problems that have an impact upon their daily lives and families. Rates of anxiety and depression in children with juvenile idiopathic arthritis are higher than in peers without this diagnosis. The impact of long-term conditions on children and young people’s mental health and the pressure it puts on family life has been observed and reported in paediatric rheumatology clinics in the UK. Art therapy has long been considered to be a developmentally appropriate way to support children and young people with long-term conditions and it is routinely provided in some NHS services. A service evaluation of manualised online art therapy groups was carried out at the Great North Children’s Hospital to seek further understanding about the accessibility, acceptability, and uptake of this service. A service evaluation was registered and undertaken at the Great North Children’s Hospital, Newcastle Upon Tyne. Art therapy groups consisted of six online 90min sessions with additional resources provided to parents to encourage conversations at home prior to the young people attending the group. Groups were facilitated by a HCPC registered art psychotherapist and included completion of structured activities/worksheets and art making time. Young people who attended the rheumatology service art therapy groups were asked for feedback about their experiences and a audio-recorded focus group style discussion with the art therapy delivery team was conducted. In addition, children and parents were asked to comment on the acceptability of standardised assessment measures that could be utilised in future outcome studies of psychosocial interventions of this kind. Thirteen young people who had accessed the art therapy group were included in the service evaluation which was carried out by members of the therapy team and nursing staff. Young people attending the group reported experiencing personal benefits, including valuing opportunities to speak with other young people who had a long-term condition and engagement and sharing a group experience through art activities. Parents responded positively to having time to reflect using the home-based resources and some observed their children appearing calmer and more able to express themselves. Online and digital access difficulties did create barriers to consistent attendance for some group members. Measures of outcome that were considered acceptable for completion by young people and family members included a validated quality of life assessment. Parents and staff reported underestimating the severity of mental health symptoms (anxiety and depression) indicated in young people’s response to completion of a validated measure. Online group art therapy was considered to be accessible and acceptable as routinely provided in a paediatric and adolescent rheumatology service. Future research could be undertaken to formally assess the effectiveness of these types of psychosocial interventions. S.S. Hackett: None. S. Jandial: None. L. Craig: None. P. Watts: None.

Abstract School sandplay group therapy is a useful clinical treatment method for adolescents who cannot adapt to school due to various emotional and behavioral problems. In this study, we conducted 10 weeks of group therapy in 70 adolescents referred to as maladjustment behavior problem in the school. The purpose of this study was to evaluate the clinical effects of sandplay therapy on the emotions and behaviors objectively through minnesota multiphasic personality test -2. There was a statistically significant difference in clinical scales such as depression, masculinity- femininity, social introversion, anger, subjective depression, need for affection, somatic complaint, and internal/external alienation after school sandplay group therapy. Sandplay therapy is estimated to have clinical effects not only on the emotional problems of maladapted high school students but also on physical problems.

OBJECTIVE Depression in adolescence is linked to risk for type 2 diabetes (T2D). In this secondary data analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) to a control program to ameliorate insulin resistance via reducing depression symptoms, we examine which CBT change mechanisms (e.g., behavioral activation, cognitive restructuring) contributed to decreased depression and subsequent improvements in body mass index (BMI), percent body fat, and insulin resistance. METHODS Girls 12-17y with overweight/obesity and family history of T2D were randomized to six-week group CBT (n = 61) or health education (HealthEd; n = 58). At baseline and post-treatment, adolescents completed questionnaires assessing activities, thoughts, and depression symptoms. At baseline, post-treatment, and one-year, BMI was calculated and insulin outcomes were derived from two-hour oral glucose tolerance testing. At baseline and one-year, percent body fat was assessed with dual-energy x-ray absorptiometry. Indirect effects of CBT components were tested on one-year changes in BMI, percent body fat, and insulin indices through decreases in depression symptoms during treatment. Intervention was tested as a moderator. RESULTS In CBT, but not HealthEd, there was an indirect effect of increased physical activity during treatment on decreased one-year BMI via reductions in depression symptoms during treatment. Also, there were conditional indirect effects in CBT of increased pleasantness of physical and social activity during treatment on decreased one-year BMI via decreased depression symptoms during treatment. CONCLUSION Behavioral activation may be a useful intervention to decrease depression and reduce excess weight gain in the targeted prevention of T2D in at-risk adolescent girls. NCT01425905, clinicaltrials.gov.

No abstract available

Mindfulness-based therapies have indicated their efficacy for reducing symptoms of anxiety, depression and stress, and improving mindfulness in adolescent clinical and community populations. However, looked after children make up a distinct group of young people, many of whom have endured severe developmental trauma, such as neglect and abuse, and present with complex emotional and behavioural difficulties. Currently, there is a limited amount of research examining the efficacy of mindfulness-based therapy for this population. This article presents a preliminary exploration of the participation in a mindfulness-based group therapy by nine looked after children aged 14 to 17. Outcome measures were obtained at baseline and post-intervention. The Depression Anxiety Stress Scale-21 (DASS-21) was used to assess depression, anxiety and stress and the Child and Adolescent Mindfulness Measure (CAMM) was used to assess mindfulness. The results indicated a reduction in symptoms of depression, anxiety and stress and an increase in levels of mindfulness. Feedback questionnaires were also completed by all participants and in these, the young people rated the intervention as engaging and beneficial. Despite the small sample size, the results are promising and suggest that future research on mindfulness-based group interventions for looked after children is warranted.

No abstract available

BACKGROUND: Adolescence is a stressful time period. Adolescents experience new changes physically, mentally, emotionally, and socially. The purpose of this study was to determine the effects of acceptance and commitment therapy (ACT) on anxiety (primary outcome), depression, and quality of life (secondary outcomes) of adolescents. Materials And Method : This was a quasi-experimental study with pre and postintervention design. One hundred female students aged 16–18 years with mild to moderate anxiety selected through multistage cluster sampling from five educational districts of Tabriz. During six group counseling sessions, students were consulted with the acceptance and commitment approach according to the protocol. Beck Anxiety and Depression Inventory and the World Health Organization brief Quality of Life Questionnaire consultation were completed before, immediately after, and 8 weeks after the consultation. Data were analyzed using repeated measure ANCOVA. RESULTS: The mean anxiety score decreased significantly immediately after the intervention (mean difference [MD]: −4.0, 95% confidence interval [CI]: −5.9 to − 2.0; P < 0.001) and 8 weeks later (MD: −3.9, 95% CI: −5.8 to − 1.9; P < 0.001). The mean depression score immediately (P < 0.001) and 8 weeks after intervention (MD; −4.2, CI: −1.6 to − 6.8), P < 0.001) declined significantly. The mean overall quality of life score increased significantly after the intervention (P < 0.001) and 8 weeks later (MD: 4.7, 95% CI: 7.1–2.3, P < 0.001) compared to baseline. CONCLUSIONS: Based on the effectiveness of counseling based on ACT on anxiety, depression, and quality of life in the female students with the mild and moderate anxiety over time, it can be used as a helpful method in high schools.

Background The widespread occurrence and devastating impact of adolescent depression warrant health service research focused on feasible and acceptable digital health tools to supplement evidence-based intervention (EBI) efforts, particularly in the context of shelter-in-place guidelines disrupting youth socialization and service use in the wake of the COVID-19 pandemic. Given the promise of SMS text message interventions to enhance EBI engagement, our team developed the HealthySMS system as an adjunct to one of the most empirically supported interventions for adolescent depression: cognitive behavioral therapy (CBT) group services. The system sends daily SMS text messages requesting responses assessing mood, thoughts, and activities; weekly attendance reminder messages; daily tips about adherence (eg, a prompt for activity completion); and personalized responses based on participants’ texts. Objective This study aims to evaluate the feasibility and acceptability of HealthySMS in a real-world setting and explore potential mechanisms of change in EBI engagement, before evaluating the system’s impact on adolescents’ group CBT engagement and, ultimately, depression outcomes. Methods Over the course of 2020, we invited all 20 adolescents receiving CBT group services for depression at an outpatient psychiatry clinic to enroll in our HealthySMS study; ultimately, 17 (85%) adolescents agreed to participate. We tracked participant initiation and engagement with the HealthySMS system as well as the content of SMS text message responses to HealthySMS. We also invited each participant to engage in a semistructured interview to gather additional qualitative inputs on the system. Results All (n=17, 100%) research participants invited agreed to receive HealthySMS messages, and 94% (16/17) of the participants maintained use during the first month without opting out. We uncovered meaningful qualitative themes regarding the feasibility and acceptability of HealthySMS, as well as its potential impact on EBI engagement. Conclusions Taken together, the results of this pilot study suggest that HealthySMS adjunct to adolescent CBT group depression services is feasible and acceptable, as evidenced by high rates of HealthySMS initiation and low rates of dropout, as well as meaningful themes uncovered from participants’ qualitative feedback. In addition, the findings provide evidence regarding iterative improvements to the HealthySMS system and research protocol, as well as potential mechanisms of change for enhanced EBI engagement and, ultimately, adolescent depression outcomes, which can be used in future effectiveness research.

BackgroundThe goal of this pilot study was to examine the feasibility and clinical outcomes of a brief (6-session) group therapy programme in adolescent outpatients with depression. The programme had previously been assessed in in-patients, with positive results.MethodsA total of 15 outpatients aged 13 to 18 years took part in the programme between October 2010 and May 2011, in 3 separate groups of 4–6 participants each. The outcomes measured were feasibility of the programme, as assessed by attendance rate, user feedback, fidelity of implementation, and response to treatment, as assessed by pre- and post-intervention measurement of depressive symptoms, quality of life, and suicidal ideation.ResultsThe programme demonstrated good feasibility, with a mean attendance rate of 5.33 out of 6 sessions, a mean rating by participants on overall satisfaction with the programme of 7.21 out of 10 (SD = 1.89), and a 93% concurrence between the contents of the sessions and the contents of the treatment manual. Compared to baseline scores, depressive symptoms at follow-up test were significantly reduced, as assessed by the Children’s Depression Rating Scale Revised (F(1, 12) = 11.76, p < .01) and the Beck Depression Inventory Revision (F(1, 32) = 11.19, p < .01); quality of life improved, as assessed by the Inventory of Quality of Life (F(1, 31) = 5.27, p < .05); and suicidal ideation was reduced. No significant changes were seen on the measures of the Parent Rating Scale for Depression and the Clinical Global Impression scale.ConclusionsBased on the results of this pilot study, it is feasible to further assess this brief outpatient treatment programme in a randomized controlled trial without further modifications.

No abstract available

Background: Adolescence is a critical developmental stage characterized by identity formation and heightened vulnerability to academic stress stemming from demanding school tasks, competitive learning environments, and pressure for high achievement. These stressors may contribute to depressive symptoms, which can impair concentration, memory, social functioning, and academic outcomes. Globally, depression affects an estimated 280 million people, with the World Health Organization reporting higher rates among females. These trends underscore the need for effective and accessible mental-health interventions for adolescents, particularly those experiencing learning difficulties. Purpose: to examine the effect of group counseling focusing on self-potential exploration in adolescents with learning difficulties on reducing depressive symptoms. Methods: A quasi-experimental pre-test–post-test control group design was used. Fifty adolescents participated, with 25 assigned to the intervention group and 25 to the control group. The intervention group received structured group counseling sessions, whereas the control group took part in conventional lecture-based learning support. Depression levels were measured before and after the intervention using a standardized assessment tool. Results: Statistical analysis showed a significant difference in the reduction of depression scores between the intervention and control groups (p = 0.000). Adolescents who received group counseling experienced a greater decrease in depressive symptoms than those in the control group. Conclusion: Group counseling effectively reduces depression among adolescents with learning difficulties by fostering self-expression, emotional awareness, and positive self-potential exploration. Integrating group counseling into school-based mental-health services may strengthen psychological well-being and enhance academic resilience in this population.

Introduction Due to the acceleration of modern life rhythm, students with developing minds are susceptible to negative external influences, leading to a growing concern for their mental health. Boarding primary school students have limited interaction with relatives compared to their non-boarding counterparts, rendering them more prone to feelings of depression and loneliness, resulting in various negative emotions. Therefore, our study aimed to explore the effects of group counseling interventions on reducing depression and loneliness among adolescents. Methods The study analyzed loneliness and depression before and after the intervention in eight randomly selected classes of fifth-grade students at a boarding school in a region of Shandong Province, which were divided into an experimental group and a control group. Results Within the experimental group, there were no substantial variations in loneliness and depression levels. In the control group, post-test depression results significantly surpassed pre-test scores (p = 0.046), though loneliness levels did not differ significantly. Conversely, the experimental group displayed significantly reduced post-test depression levels compared to the control group (p = 0.037), with no significant variance in loneliness. Conclusion The findings indicated that group psychological counseling mitigates depression in the experimental group to a certain extent, affirming the efficacy of the intervention. The study demonstrated that group counseling alleviates depression in boarding students, emphasizing the value of the intervention.

No abstract available

Depression is a common phenomenon in Indonesia, particularly among adolescents. Many teenagers today suffer from mild to severe depression as a result of stress from both internal and external factors, which can lead to mental problems and even suicidal thoughts. This fact can be seen from the results of the pretest conducted on students in class 11 Mathematics and Natural Sciences  3, which resulted in eight students who have mild depression categories. Therefore, an effort should be made to reduce the level of depression symptoms by providing group counseling using motivational interviewing techniques so that the level of depression symptoms does not rise to the severe depression level. This study aims to see how effective group counseling with the motivational interviewing technique is in helping class 11 Mathematics and Natural Science 3 of State Islamic High School 2 Bandar Lampung students overcome mild symptoms of depression. This study employed a pre-experimental research method with a one-group pretest-posttest design. The data-collecting techniques employed were questionnaires, interviews, observations, and documentation. The purposive sampling technique was utilized to select eight students as the sample from class 11 Mathematics and Natural Sciences 3. The treatment consisted of six meetings, including pretests and posttests. The results revealed a pretest score of 263 with an average of 32.8 and a posttest score of 151 with an average of 18.8. There is a noticeable difference after receiving group counseling with motivational interviewing technique. The results of the T-test and N-gain indicated a decrease in the level of depression experienced by students, as seen by the pretest and posttest scores.

Objectives The purpose of this study is to verify the effects of the board games group counseling program on self-efficacy, peer relationships and depression of Adolescent with suicidal tendency. Methods The subjects of the study were 16 students in the first grade of O Middle School in U City who scored a sum of 2 or more on the suicide crisis questions (AMPQ-III Q53, Q57) in the 2019 Student Emotional and Behavioral Characteristics Test, and 8 students were randomly assigned to the experimental group and the control group, and the homogeneity test confirmed that they were the same group. Both the experimental and control groups were given a pretest on self-efficacy, peer relationships, and depression, and the experimental group was given a group counseling program using board games for a total of 12 sessions of 50 minutes twice a week. Afterwards, the two groups were given a post-test, and normality and an analysis of covariance (ANCOVA) were conducted to verify the effectiveness. Results First, suicidal adolescents who participated in the group counseling program using board games showed significant positive changes in self-efficacy and peer relationships. Second, suicidal adolescents who participated in the group counseling program using board games showed significant positive changes in depression. This means that the experimental group who participated in the program had less depression and improved self-effi-cacy and peer relationships than the control group. Conclusions This study confirmed that the group counseling program using board games is an effective program for improving self-efficacy and peer relationships and reducing depression in suicidal adolescents, and suggested the need to develop programs for suicidal adolescents that reflect their needs and characteristics.

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Purpose This study assessed the effects of character strengths-based invention (CSI) vs group counseling (GC) on mental health outcomes (ie, post-traumatic growth, well-being, and depression) among university students in Guangdong Province, China. Materials and Methods We conducted a randomized non-inferiority trial among 124 undergraduates at a medical university during the COVID-19 pandemic. We randomly allocated students to receive either CSI (n=62) or GC (n=62). A qualified psychologist delivered both activities on campus during two consecutive weekends with a total of 7.5 hours and also gave assignments to students during weekdays. We measured the outcomes at pre-intervention, post-intervention, and 1-month follow-up. We then analyzed data using descriptive statistics and a general linear mixed model. Results CSI and GC groups had similar baseline characteristics. Both CSI and GC experienced an increase in post-traumatic growth and well-being. The mean±SD scores for post-traumatic growth were significantly higher in CSI compared to GC groups (87.70±14.22 vs 78.15±20.72, respectively), whereas well-being scores were similar between CSI and GC (82.58±16.57 vs 83.68±15.59, respectively). Neither CSI nor GC experienced a reduction in depression scores. Conclusion CSI had non-inferior effects compared to GC with regards to improvement of post-traumatic growth and well-being during the COVID-19 pandemic. However, caveats regarding lack of blinding of investigator and limited generalizability should be considered in the interpretation of the study findings.

Violence among adolescents is an increasingly complex phenomenon, including relational aggression, which often goes undetected due to its covert nature. Relational aggression can have serious consequences, such as depression and even suicidal tendencies among victims. This study aims to analyze the effectiveness of group counseling services using the Cognitive Behavior Modification (CBM) approach in preventing relational aggression among students at SMK 6 Padang. This study employs a quantitative research method with a quasi-experimental design in the form of a pretest-posttest control group design. The research sample consists of 12 students divided into experimental and control groups, each comprising six students, selected using a stratified random sampling technique. The research instrument utilizes a Likert scale, while data analysis is conducted using the Wilcoxon Signed Ranks Test and the Mann-Whitney Test. The findings indicate that group counseling services using the CBM approach significantly reduce relational aggression in the experimental group compared to the control group. These results affirm that the CBM approach is effective in modifying students’ thought patterns and behaviors related to relational aggression. The implications of this study provide recommendations for guidance and counseling teachers to implement CBM-based group counseling services as an intervention strategy for addressing relational aggression in the school environment.

Purpose: We evaluated the outcomes of a school-based group counseling program for adolescent Internet Gaming Disorder (IGD). The program aimed to enhance self-regulation, resilience, parent–child attachment, and parental supervision and reduce gaming hours, IGD severity, IGD symptoms, depression, and parent–child conflict. Method: In this quasi-experimental study, out of 115 sary school students in Singapore ( M age  = 13.7, SD = 1.56 ) who reported five or more out of ten IGD symptoms, 61 participated in the intervention and 54 served as a nonintervention group. Results: Repeated Measures ANCOVA revealed that compared with the non-intervention, the program was effective in improving self-regulation ( F = 7.84, p =  .006), resilience ( F = 4.90, p =  .03), weekend gaming hours ( F = 9.18, p =  .003), IGD severity ( F = 7.68, p =  .007) and depression ( F = 14.3, p <  .000). Discussion: We suggest that the program improve parental support components while focusing on self-regulation.

Emerging adulthood, spanning roughly from ages 18 to 30, is characterized by significant psychological, emotional, and social transitions, often accompanied by elevated levels of anxiety, depression, and self-criticism. This study aimed to evaluate the effectiveness of a six-week group counseling intervention focused on cultivating self-compassion and cognitive-emotional awareness to improve the mental health of emerging adults. The intervention sought to enhance participants’ self-compassion and self-esteem while reducing depression, anxiety, and stress. Seventy undergraduate students from Panteion University were randomly assigned to either the intervention group (n = 35) or a waitlist control group (n = 35). Assessments were conducted at pre-intervention, post-intervention, and three-month follow-up. Measures included the Self-Compassion Scale (SCS), the Depression, Anxiety, and Stress Scale (DASS-21), and the Modified Differential Emotions Scale (mDES). Results revealed a significant increase in self-compassion and positive emotions, as well as a significant decrease in psychological distress in the intervention group compared to the control group. These benefits persisted at three-month follow-up. Findings highlight the potential of cost-effective, group-based interventions grounded in self-compassion to meet the mental health needs of university students. Future research should examine long-term effects and generalizability across diverse populations. The intervention reflects the core values of counselling psychology, emphasizing relational depth, empathy, and the promotion of self-awareness and well-being within a culturally sensitive, developmental framework. These principles underpin the study’s focus on prevention and the enhancement of psychological resilience among emerging adults.

A growing number of studies have examined the effects of group counseling on students' mental health or academic functioning in China; no meta-analysis of these studies has yet been conducted, which may limit school-based applicability or the development of service systems. This study sought to establish an overall effect size for group counseling interventions, as well as identify potential moderator variable effects on their efficacy for Chinese mainland adolescents in particular. A total of 611 studies, comprising 15,320 adolescent participants altogether, were included, with meta-analyses conducted for six mental health outcomes and five academic functioning outcomes. The results showed that, at posttest, group counseling had statistically significant medium to large effects on depression symptoms (standardized mean difference [SMD] = -0.835), anxiety symptoms (SMD = -0.722), loneliness (SMD = -0.791), sleep problems (SMD = -1.075), self-harm (SMD = -1.463), suicidal ideation (SMD = -1.055), learning motivation (SMD = 0.952), learning engagement (SMD = 1.478), academic self-efficacy (SMD = 1.264), academic procrastination (SMD = -1.528), and learning burnout (SMD = -1.591). The moderator results suggest that group counseling might work best as a small-scale intervention and that online intervention resulted in improvements comparable to face-to-face intervention. This study demonstrates that school-based group counseling effectively enhances both the mental health and academic functioning of Chinese adolescents. Our finding highlights the importance of such interventions in addressing psychological and educational challenges in schools, providing evidence for educators and policymakers to strengthen these support systems. Future research should explore how intervention components interact to optimize their impact in school settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This pilot study examines body image dissatisfaction, anxiety, and self-esteem, particularly among university and college students, which can significantly impact their mental well-being. Obsession with weight satisfaction and physical attractiveness can lead to depression, eating disorders, and social disorders. Twenty Psychology and Education students participated in this study, using tools such as the multidimensional body self-relations questionnaire-appearance scale, the physical appearance state and trait anxiety scale, and the body esteem scale for adolescents and adults. Additionally, a Cognitive Behavioral Group Counseling Intervention Module was utilized to restructure thinking and modify behavior. The module results of 0.897 suggested that this intervention can help individuals change their assumptions and beliefs regarding self-image dissatisfaction, particularly on physical appearance.

Group therapy may help young adults with neurodevelopmental differences (NDDs; such as autism spectrum disorder [ASD] or attention deficit hyperactivity disorder [ADHD]) socialize and manage mental health difficulties such as anxiety and depression during the transition to adulthood (18-25 years old). Family members may also benefit from group therapy during this transition period. Despite this need, few group therapy programs in a virtual/telehealth format have been developed to help young adults with NDDs and their families during the transition to adulthood. The present study sought to provide initial feasibility and acceptability data for a parallel young adult and family member group treatment program for young adults with NDDs transitioning to adulthood. Launching! to adulthood is an 8-week program utilizing evidence-based interventions to reduce distress and support the transition to independence for young adults with NDDs and their family members. Measures of well-being were collected pre- and post-intervention. Brief qualitative interviews were conducted post-intervention. From our pilot study, we found that the Launching! program was acceptable and feasible for both family members and young adults, with high ratings of satisfaction. Three themes were shared by young adults and family members, including gaining group connection and support from others in a similar life circumstance, learning the importance of self-care, and gaining new skills. Barriers to attendance included work conflicts and internet difficulties. This pilot trial of the Launching! program is novel in that few existing therapies have addressed challenges of the transition to adulthood for individuals with NDDs. Launching! has the potential to help young adults with NDDs prepare for postsecondary goals and may be utilized by businesses to support employees with NDDs.

No abstract available

BACKGROUND The depression of college students requires psychological intervention based on clinical drug treatment. Group psychological counseling is an effective psychological intervention. This study aims to explore the effect of group psychological counseling on negative emotions and Nonsuicidal Self-injury (NSSI) behaviors of college students with depression. SUBJECTS AND METHODS A total of 84 students with depression by screening diagnosis at Qingdao University in March 2018 were divided into the control group (n=42) and the intervention group (n=42). Students in the control group only received drug therapy, whereas the intervention group underwent group psychological counseling intervention based on drug therapy. A comparison between depression, self-injury behaviors, and sense of life purpose of the two groups before and after the intervention was performed. RESULTS The post-test Self-Rating Depression Scale (SDS) standard score of students in both groups was significantly lower than the pre-test SDS standard score (P<0.05). The SDS standard scores of the post-test and the trace test in the intervention group were significantly lower than those in the control group (P<0.05). Compared with the pre-test value, the total scores in the Meaning in Life Questionnaire (MLQ) of the post-test in both groups significantly increased. The intervention group received significantly higher scores in the MLQ of the post-test and trace test compared with the control group (P<0.05). Both groups also received significantly higher scores in the post-test in the Quality System Audit (QSA) compared with the pre-test (P<0.05). The intervention group also received higher scores on the post-test and trace test in some dimensions in the QSA compared with those of the control group (P<0.05). CONCLUSIONS Group psychological counseling intervention for college students with depression can alleviate their depressive symptoms, improve their sense of life meaning, reduce the risk of suicide, and control their NSSI behaviors.

This study aims to examine the effectiveness of the existential–humanistic approach in supporting the psychological recovery of verbal bullying victims in Islamic boarding schools. Verbal bullying can cause detrimental psychological impacts, such as decreased self-confidence, heightened anxiety, difficulty concentrating, declining academic performance, loss of interest in previous activities, and a reduction in previously positive social relationships, all of which hinder the emotional and academic development of students. Therefore, an intervention is needed to help victims of verbal bullying. The general objective of this study is to determine the extent to which group counseling using the existential–humanistic approach can improve the psychological condition of student victims of verbal bullying. The specific objectives are to measure changes in anxiety levels, concentration difficulties, academic performance, interest in activities, social relationships, and self-esteem after participating in group counseling sessions. This study employs a One Group Pre-Test Post-Test design, in which respondents are assessed before and after the group counseling intervention. Data will be collected using questionnaires measuring anxiety, depression, and self-esteem, and will then be analyzed to determine significant differences. The expected outcome of this study is to prove the effectiveness of group counseling with the existential–humanistic technique in reducing psychological disturbances among student victims of verbal bullying. The findings are anticipated to provide practical contributions to the development of counseling programs in Islamic boarding schools to support students’ mental well-being.

PURPOSE This study aimed to evaluate the effectiveness of cognitive behavioral therapy (CBT)-based group counseling focused on depressive symptoms, anxiety levels, automatic thoughts, and coping ways among undergraduate nursing students with mild to moderate depressive symptoms. DESIGN AND METHODS A randomized, nonblinded, controlled trial was conducted. The study was completed with a total of 63 participants (n = 31, intervention group; n = 32, control group). The effect of the intervention was evaluated with Beck depression inventory, Beck anxiety inventory, automatic thoughts questionnaire, and ways of coping questionnaire. The measurements were taken three times: pretest, posttest, and 2-months posttest. FINDINGS CBT-based group counseling was found to reduce depressive symptoms, automatic thoughts, and ineffective coping with stress and to increase effective coping with stress. In both groups, 2-months posttest mean anxiety score was lower than the pre-test mean score. PRACTICE IMPLICATIONS CBT-based group counseling reduced depressive symptoms, automatic thoughts, and emotion-focused/ineffective ways for coping with stress.

Background: Weight bias internalization (WBI) is a serious challenge because of its negative impact on psychological consequences. Although the cognitive-behavioral intervention has been applied to reduce WBI, little is known about its effectiveness among Thai obese youth. Thus, this study sought to determine the effects of a cognitive-behavioral group counseling (CBGC) program on WBI and psychological outcomes in obese youths. Study Design: A randomized controlled trial. Methods: Eighty obese youths were randomly allocated to two intervention (n=40) and control (n=40) groups. The intervention group received a CBGC program in three sessions with ten activities, while the control group performed their usual counseling process. Data were collected through standardized interviewers with a structured interview questionnaire. The chi-square test, independent samples t-test, Mann-Whitney U test, repeated measure ANOVA, and multivariate linear regression were applied for data analyses. Results: At the follow-up visit, the intervention group had a significant decrease in the mean of WBI, depression, and perceived stress and an increased mean of self-esteem compared to the control group. After adjusting baseline characteristics and baseline outcome values, the intervention also significantly improved WBI (B=-6.82, P<0.001), depression (B=-4.17, P<0.001), perceived stress (B=-6.01, P<0.001), and self-esteem (B=5.07, P<0.001). Conclusion: The CBGC program effectively reduced WBI, depression, and perceived stress while improving self-esteem among obese youths. This study recommends that group counseling programs be employed as part of a counseling process for obese youth who have experienced WBI.

There is a growing need for high-quality evidence to support the efficacy of online counseling and peer support via social networking sites (SNSs) as an intervention to reduce mental health symptoms in young people. This article presents Phase 2 of Kids Helpline (KHL) Circles, which used mixed methods to assess the acceptability, safety, user experience, and mental health benefits of a purpose-built, counselor-facilitated SNS. Young people aged 13–25 years (n = 552) were recruited to participate in one of six 8-week “Circles.” Of those, 154 participants completed study surveys at three timepoints (baseline, midpoint, endpoint). Significant reductions in depression, anxiety, stress, and general distress symptoms were reported at the midpoint of the intervention, with further significant reductions in depression and stress symptoms by the endpoint. More than half said that their mental health improved as a direct result of KHL Circles, and most felt less mental health stigma and would be more willing to seek help for mental health issues in the future. These results contribute to increasing the evidence base for SNS interventions to reduce mental health symptoms. Adjustments are necessary for the ongoing evolution of this service to ensure it is user-centered and scientifically rigorous.

Suicide is the second leading cause of mortality among Canadian youth. As wait times for mental health (MH) support have increased, adolescents with mild-to-moderate suicidal ideation (SI) are waiting longer for support compared to those with more acute SI. Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a 6-week virtual group intervention designed to provide support to adolescents with mild to moderate SI and their caregivers. We conducted a randomized controlled trial to assess the efficacy of BRAVA in reducing symptoms of SI, depression, and anxiety in adolescents, and improving life stress in caregivers. Outcome measures were administered to both groups [BRAVA, Enhanced Treatment-as-Usual (ETU)] at intake and exit, and at 3-month follow-up (BRAVA only) for SI (primary outcome), anxiety and depression (adolescent), perceived stress (youth and caregiver), attachment and family functioning (caregiver). SI was measured using Suicidal Ideation Questionnaire Junior. Intention to treat (ITT) analysis was performed for youth and caregiver cohorts. Ninety-nine eligible youth presenting with mild-to-moderate SI and their caregivers were recruited from hospital and community MH services. Families were randomized to BRAVA (n = 50) or ETU (n = 49). Adolescents were on average 14.6 years old, mostly female (64%), and of European racial heritage (44%). In ITT analysis, both BRAVA and ETU groups improved in youth SI from intake to exit, with no statistically significant differences between groups at exit. Sensitivity analysis without multiple imputations demonstrated a significant difference in SI scores at exit between the groups, where improvements in the BRAVA group were maintained at 3-month follow-up. Significant differences between groups on youth perceived stress, and depression and anxiety scores were also observed in BRAVA participants at post-treatment compared to the ETU control group. No statistically significant differences were observed for any caregiver outcomes measured except a trend for improved perceived caregiver stress in the BRAVA group post-treatment. BRAVA was associated with significantly greater improvements in anxiety/depression and adolescent perceived stress compared to ETU. Although the intervention did not result in significant caregiver reported improvements, group cohesion and treatment satisfaction were high for both youth and caregivers. BRAVA: Building Resilience and Attachment in Vulnerable Adolescents (BRAVA); https://clinicaltrials.gov/: NCT04751968.

Abstract Background Adolescents with depression often experience relationship problems with their caregivers, which predict poorer treatment outcomes. Personalising interventions by targeting factors associated with poor treatment outcomes may enhance the effectiveness of interventions. We report the development and initial evaluation of an intervention designed to target caregiver‐adolescent relationship problems in the context of adolescent depression. Methods Following a literature search to identify established caregiver interventions, we developed a new group intervention for caregivers through an iterative process including six rounds of the group with n = 53 caregivers of adolescents age 13–18 in the context of an integrated care pathway for adolescent depression. Caregivers rated their family functioning at the beginning and end of the program and provided anonymous satisfaction ratings. Enrolment and attendance data were examined. Youth with lived experience of depression and their caregivers provided input that was incorporated in the final version of the intervention. Results The final intervention consists of 8 weekly, 1.5 h group sessions, delivered face‐to‐face, addressing: psychoeducation, the cognitive‐behavioural model and caregiving, positive caregiving, listening and validation, expressing emotions effectively, and problem solving. Reach (56%), attendance (M = 63%, SD = 31%), and satisfaction (M = 92%; SD = 7%) supported the feasibility of the program. Caregivers reported significant improvements in family functioning, t(21) = 2.68, p = .014, d z = 0.56 [95% CI 0.11–1.0]. Discussion A group intervention is acceptable to caregivers of adolescents with depression and may be associated with improved family functioning. Further research is needed, including a randomised controlled trial to test effects of the intervention on various dimensions of the caregiver‐youth relationship and on youth depression outcomes.

ABSTRACT Objective Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth experience known inequities in mental health outcomes, including depression and suicidality. The Promoting Wellbeing & Resilience (PWR) class is an interactive, developmentally tailored group that provides strength-based, practical skills to LGBTQ+ teenagers with depression. It is designed to be implemented by paraprofessionals to increase community-based access to care. Method Investigators developed and piloted an eight-session cognitive-behavioral class for LGBTQ+ youth (N = 21) ages 12 to 17 (M = 14.8 years, 81% Caucasian, 57% gender diverse, 100% non-heterosexual) with depression symptoms. The youth received training in mood regulation, communication skills, stress management, and goal setting in a small group format (5–8 youth per group). Outcomes were youth-reported depression (primary), anxiety, and trauma symptoms at pre-treatment and post-treatment. Paired sample (dependent) one-tailed t-tests were used to examine treatment effects. Focus groups were also conducted with participants to assess satisfaction and collect qualitative feedback regarding class content and format. Result The resilience class was associated with reductions in depression symptoms post-treatment (t(17) = 3.3, p = .002, d = 0.5) but not anxiety (t(17) = 1.8, p = .049, d = 0.3) or trauma symptoms (t(17) = 1.2, p = .118, d = 0.1). Completion rates for all group sessions were high (95%), and the majority (57%) of participants returned for an optional review session. Conclusion Preliminary results suggest a manualized 8-week skills-based cognitive-behavioral group intervention designed to be delivered by paraprofessionals may be effective at reducing depression symptoms in actively depressed LGBTQ+ youth.

Youth mental health interventions in low-resource communities may benefit from including empirically supported elements, using stigma-free content, and using trained lay-providers. We developed and evaluated such an intervention, targeting adolescent depression and anxiety in Kenya, where mental health care is limited by social stigma and a paucity of providers. Kenyan adolescents (N = 51, ages 14-17, 60.78% female) from a school in an urban slum in Nairobi with self-reported moderate-to-severe symptoms of depression or anxiety were randomized to the 4-week "Shamiri" ("thrive") group intervention or a study skills control intervention of equal duration. The Shamiri intervention included growth mindset, gratitude, and value affirmation exercises. The content was delivered by recent high school graduates (ages 17-21, 60% male) trained as lay-providers. Participants met in school once-a-week in groups of 9-12 youths (average group size 10). Compared to the study-skills control, Shamiri produced greater reductions in adolescent depression symptoms (p = .038; d = .32) and anxiety symptoms (p = .039; d = .54) from baseline to 4-week follow-up, and greater improvements in academic performance (p = .034; d = .32) from the school-term before versus after the intervention. There were no effects on overall social support or perceived control, but the Shamiri group showed larger increases in perceived social support from friends (p = .028, d = .71). This appears to be the first report that a brief, lay-provider delivered, community-based intervention may reduce internalizing symptoms and improve academic outcomes in high-symptom adolescents in Sub-Saharan Africa. Larger replications with extended follow-ups will help gauge the strength and durability of these effects.

Background Developing low-cost, socio-culturally appropriate, and scalable interventions for youth depression and anxiety symptoms in low-income regions such as countries in sub-Saharan Africa is a global mental health priority. We developed and intend to evaluate one such intervention for adolescent depression and anxiety in Kenya. The intervention, named Shamiri (a Swahili word for “thrive”), draws upon evidence-based components of brief interventions that involve nonclinical principles rather than treatment of psychopathology (e.g., growth mindset, gratitude, and virtues). Methods Four hundred twenty Kenyan adolescents (ages 13–18) with clinically elevated depression and/or anxiety symptoms will be randomized to either the 4-week Shamiri group intervention or a group study-skills control intervention of equal duration and dosage. Participating adolescents will meet in groups of 8–15, led by a high-school graduate trained to deliver Shamiri as a lay-provider. Adolescents will self-report primary outcome measures (depression—measured by the PHQ-8, and anxiety symptoms—measured by the GAD-7) and secondary outcome measures (perceived social support, perceived academic control, self-reported optimism and happiness, loneliness, and academic grades) at the 2-week intervention midpoint, 4-week post-intervention endpoint, and 2-week post-intervention follow-up. We predict that adolescents in the Shamiri group, when compared to the study-skills control group, will show greater improvements in primary outcomes and secondary outcomes. Discussion Results may suggest that a brief, lay-provider delivered, school-based intervention may reduce depression and anxiety symptoms, improving academic outcomes and other psychosocial outcomes in adolescents with clinically-elevated symptoms in sub-Saharan Africa. Trial registration Pan African Clinical Trials Registry PACTR201906525818462 . Registered on 12 June 2019.

Objectives: this study examined the intervention effects of group sandplay therapy (GST) on children at risk of smartphone addiction. Methods: The participants consisted of 113 elementary school students in grades 5 and 6 (ages 11–12), with 57 in the intervention group and 56 in the control group. The intervention group participated in the GST program once a week for 40 min over 10 weeks, while the control group received no intervention. The Youth Smartphone Addiction Scale (S-scale) and the Korean Youth Self Report (K-YSR) were used to assess the program. Additionally, a repeated measures ANOVA was employed to examine changes between pre- and post-tests. Results: compared to the control group, the intervention group that received GST showed a significant reduction in smartphone addiction (F = 7.355, p = 0.020), withdrawal/depression (F = 5.540, p = 0.032), and somatic symptoms (F = 4.542, p = 0.040) compared to the control group. Conclusions: GST was found to be effective in reducing smartphone addiction, depression, and somatic symptoms in children at risk for smartphone addiction.

Background Adolescents and young adults aged <25 years (youth) are at a higher risk of perinatal depression than older adults, and they experience elevated barriers to in-person care. Digital platforms such as social media offer an accessible avenue to deliver group cognitive behavioral therapy (CBT) to perinatal youth. Objective We aim to develop the Interactive Maternal Group for Information and Emotional Support (IMAGINE) intervention, a facilitated social media group CBT intervention to prevent perinatal depression in youth in the United States, by adapting the Mothers and Babies (MB) course, an evidence-based in-person group CBT intervention. In this study, we report perspectives of youth and health care providers on perinatal youths’ mental health needs and document how they informed IMAGINE design. Methods We conducted 21 semistructured in-depth individual interviews with 10 pregnant or postpartum youths aged 14-24 years and 6 health care workers. All interviews were recorded, transcribed, and analyzed using deductive and inductive approaches to characterize perceptions of challenges and facilitators of youth perinatal mental health. Using a human-centered design approach, stakeholder perspectives were incorporated into the IMAGINE design. We classified MB adaptations to develop IMAGINE according to the Framework for Modification and Adaptation, reporting the nature, timing, reason, and goal of the adaptations. Results Youth and health care workers described stigma associated with young pregnancy and parenting, social isolation, and lack of material resources as significant challenges to youth mental wellness. They identified nonjudgmental support, peer companionship, and access to step-by-step guidance as facilitators of youth mental wellness. They endorsed the use of a social media group to prevent perinatal depression and recommended that IMAGINE facilitate peer support, deliver content asynchronously to accommodate varied schedules, use a confidential platform, and facilitate the discussion of topics beyond the MB curriculum, such as navigating support resources or asking medical questions. IMAGINE was adapted from MB to accommodate stakeholder recommendations and facilitate the transition to web-based delivery. Content was tailored to be multimodal (text, images, and video), and the language was shortened and simplified. All content was designed for asynchronous engagement, and redundancy was added to accommodate intermittent access. The structure was loosened to allow the intervention facilitator to respond in real time to topics of interest for youth. A social media platform was selected that allows multiple conversation channels and conceals group member identity. All adaptations sought to preserve the fidelity of the MB core components. Conclusions Our findings highlight the effect of stigmatization of young pregnancy and social determinants of health on youth perinatal mental health. Stakeholders supported the use of a social media group to create a supportive community and improve access to evidence-based depression prevention. This study demonstrates how a validated intervention can be tailored to this unique group.

OBJECTIVE To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D). METHODS This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6-7 weeks. Eligibility included 12-17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review. RESULTS 55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI. CONCLUSIONS This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial.

This study examined the preliminary feasibility, acceptability, and efficacy of an autism-adapted cognitive behavioral therapy for depression in autistic youth, CBT-DAY. Twenty-four autistic youth (11–17 years old) participated in the pilot non-randomized trial including 5 cisgender females, 14 cisgender males, and 5 non-binary youth. Youth participated in 12 weeks of, CBT-DAY and youth depressive symptoms (i.e., primary clinical outcome) and emotional reactivity and self-esteem (i.e., intervention mechanisms) were assessed through self-report and caregiver report at four timepoints: baseline (week 0), midpoint (week 6), post-treatment (week 12), and follow-up (week 24). Results suggested that CBT-DAY may be feasible (16.67% attrition) in an outpatient setting and acceptable to adolescents and their caregivers. Bayesian linear mixed-effects models showed that CBT-DAY may be efficacious in targeting emotional reactivity [βT1-T3 = −2.53, CrI95% (−4.62, −0.58), Pd = 0.995, d = −0.35] and self-esteem [βT1-T3 = −3.57, CrI95% (−5.17, −2.00), Pd > 0.999, d = −0.47], as well as youth depressive symptom severity [β = −2.72, CrI95% (−3.85, −1.63), Pd > 0.999]. Treatment gains were maintained at follow-up. A cognitive behavioral group therapy designed for and with autistic people demonstrates promise in targeting emotional reactivity and self-esteem to improve depressive symptom severity in youth. Findings can be leveraged to implement larger, more controlled trials of CBT-DAY. The trial was registered at Clinicaltrials.gov (Identifier: NCT05430022; https://beta.clinicaltrials.gov/study/NCT05430022). Lay Abstract Depression in youth is a significant public health problem worldwide, particularly for autistic youth who are over twice as likely to experience depression than their non-autistic peers. Although pathways to depression are complex, emotional reactivity and negative self-esteem are two risk factors for depression in autistic and non-autistic youth. Although autistic youth are more likely to experience depression than their non-autistic peers, psychotherapy options for autistic youth are very limited; community guidance in the development and testing of psychotherapy programs is a promising approach in autism. Therefore, in this study, we designed an autism-adapted CBT-DAY, in collaboration with autistic community members. Specifically, CBT-DAY combined neurodiversity-affirming and cognitive behavioral approaches to target emotional reactivity and self-esteem in youth to improve depressive symptom severity in a group setting across 12 weeks. We examined the preliminary feasibility, acceptability, and efficacy of CBT-DAY in a pilot non-randomized trial. In addition, we implemented a rigorous protocol for assessing, monitoring, and addressing potential harms in this intervention. Results from 24 autistic youth (11–17 years old) suggest that CBT-DAY may be feasible to use in an outpatient clinical setting and generally acceptable to youth and their caregivers. Participation in CBT-DAY may be associated with significant improvements in youth emotional reactivity and self-esteem, as well as depressive symptom severity per self-report only. Exploratory analyses showed that participation in CBT-DAY may also be associated with significant improvements in internalizing symptoms. Findings demonstrate the potential promise of neurodiversity-affirming and cognitive behavioral approaches to treating depressive symptoms in some autistic youth.

Abstract Background: A novel CBT-based intervention, tailored for young people, was developed in response to concerns about traditional diagnostically based approaches. Psychology of Emotions workshops use a normative approach to emotional difficulty instead of a diagnostic framework. Aims: To evaluate the acceptability and efficacy of Psychology of Emotions workshops within an IAPT service for young people aged 16–25 years. Method: This was a mixed-methods study, evaluating routinely collected self-report measures of depression and anxiety, and qualitative feedback forms. The main outcomes were rates of attendance, change in symptom severity, and participant views of the intervention. Results: From January to September 2016, 595 young people were invited to attend the Psychology of Emotions workshops, of whom 350 (58.8%) attended at least one session. Young people who attended all six sessions (8.1%) experienced significant reductions in self-reported anxiety (d = .72) and depression (d = .58) and 35.5% were classified as recovered at completion. Those who attended at least two sessions (41.3%) reported smaller but significant improvements in anxiety (d = .42) and depression (d = .45); 22.0% were classified as recovered at the last session attended. Participants provided largely positive feedback about the intervention. Conclusion: Psychology of Emotions is a promising treatment option, delivered outside of a diagnostic framework, for young people with mild to moderate mental health difficulties seen within IAPT services. Better understanding reasons for non-attendance might enable the intervention to be made accessible to more young people.

No abstract available

Objective Parental depression is one of the biggest risk factors for youth depression. This parallel randomized controlled trial evaluates the effectiveness of the German version of the family-group-cognitive-behavioral (FGCB) preventive intervention for children of depressed parents. Methods Families with (i) a parent who has experienced depression and (ii) a healthy child aged 8–17 years (mean = 11.63; 53% female) were randomly allocated (blockwise; stratified by child age and parental depression) to the 12-session intervention (EG; n  = 50) or no intervention (CG; usual care; n = 50). Self-reported (unblinded) outcomes were assessed immediately after the intervention (6 months). We hypothesized that CG children would show a greater increase in self-reported symptoms of depression (DIKJ) and internalising/externalising disorder (YSR/CBCL) over time compared to the EG. Intervention effects on secondary outcome variables emotion regulation (FEEL-KJ), attributional style (ASF-KJ), knowledge of depression and parenting style (ESI) were also expected. Study protocol (Belinda Platt, Pietsch, Krick, Oort, & Schulte-Körne, 2014) and trial registration (NCT02115880) reported elsewhere. Results We found significant intervention effects on self-reported internalising ( $$\eta_{p}^{2}$$ η p 2  = 0.05) and externalising ( $$\eta_{p}^{2}$$ η p 2  = 0.08) symptoms but did not detect depressive symptoms or parent-reported psychopathology. Parental depression severity did not modify these effects. Both groups showed equally improved knowledge of depression ( $$\eta_{p}^{2}$$ η p 2  = 0.06). There were no intervention effects on emotion regulation, attributional style or parenting style. Conclusion The German version of the FGCB intervention is effective in reducing symptoms of general psychopathology. There was no evidence that the mechanisms targeted in the intervention changed within the intervention period.

Youth depression is often associated with impairments in cognitive function, especially in executive function. This study examines the effect of an 8-session-long mindfulness training that can improve executive function in youth with depression. Sixty youths (age range 15-27 years) with depression were selected as participants and were randomized into a mindfulness training group (MTG) and a waitlist-control group (WCG). The MTG received an 8-week mindfulness training while the WCG received no intervention. Both groups performed the Stroop, N-back, and More-odd shifting tasks at baseline and after eight weeks to examine inhibitory control, working memory, and cognitive flexibility of executive function, respectively. The results showed that mindfulness training significantly reduced the Stroop effect size for MTG (p < 0.001), but the effect on the switching cost was not statistically significant (p = 0.975). There was an age effect of mindfulness training on working memory. For young adults, mindfulness training improved accuracy on the N-back task (p < 0.01) and shortened reaction time, although this effect slightly exceeded the significance level (p = 0.075). However, mindfulness training failed to improve the working memory of adolescents with depression. In conclusion, mindfulness training improved inhibitory control in youth with depression. It also improved working memory in young adults with depression, but future studies with large samples are needed to validate the improvement in working memory.

BACKGROUND Exercise is increasingly recognised as an efficacious intervention for major depressive disorder (MDD) but to our knowledge differential treatment effects on depressive symptom profiles (cognitive, somatic and affective) and associated changes in psychological, physiological and behavioural factors have not been examined among youth with MDD. METHODS Sixty-eight participants (mean age 20.8) meeting DSM-IV diagnostic criteria for MDD were randomised to an Immediate intervention or Control/delayed condition (n = 34 per group). The integrated intervention comprised an initial session of motivational interviewing (MI) followed by a 12-week, multi-modal exercise program. Changes in depressive symptom profiles were assessed with the Beck Depression Inventory-II (BDI-II) total score and factorial symptom subscales. RESULTS There were significant differential improvements in BDI-II total scores post-treatment among intervention participants, which were also observed across the cognitive and affective subscales. Individual BDI-II items from the cognitive subscale showing significant differential improvement related to negative self-concept, while those from the affective subscale related to interest/activation; the energy item within the somatic subscale also revealed significant differential improvement. Significant differential improvements were also observed in exercise participation, negative automatic thoughts, behavioural activation and bench press repetitions among intervention participants, which correlated significantly with depression improvements. LIMITATIONS The exercise intervention was delivered in a supervised, group format and potential social meditators of change cannot be excluded. CONCLUSIONS Exercise differentially effects depressive symptom profiles with similar antidepressant effects as would be expected from psychological therapies improving negative cognition and emotional health.

Abstract Abstract While many children in Africa face notable psychological problems, the majority do not receive needed mental health services. The My FRIENDS Youth Program, a universal cognitive-behavioral intervention for anxiety prevention and resilience enhancement, has demonstrated effectiveness across cultures in children and adolescents. This study explores whether the program’s effectiveness extends to Zambian children. Participants were 75 children and adolescents (53% female, ages 10–15) attending low-income schools in Zambia. Four schools were randomly assigned to an intervention (n = 44) or waitlist control (n = 31). The intervention consisted of 10 weekly sessions plus two booster sessions administered in group format. Assessments were conducted at pre-intervention, immediately post-intervention and 3-month follow-up. Data were analyzed using longitudinal multilevel modeling and controlled for child and parent sociodemographic characteristics. Intervention participation did not lead to reductions in anxiety, depression or parent-child relationship conflict but was associated with reductions in parent-reported internalizing and externalizing symptoms, attention problems and increases in positive parent-child relationships. However, both the intervention and control groups exhibited lower anxiety symptoms from Post-Intervention to 3-Month Follow-Up, suggesting potentially delayed effects. Future research may need to adapt this intervention to meet the needs of children in Zambia.

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Introduction Depression, anxiety and behavioural disorders are the leading causes of illness and disability in adolescents. This study aims to evaluate the feasibility of integrating mental health services into a youth-led community-based intervention targeting out-of-school adolescents, residing in Kariobangi and Rhonda informal settlements in Kenya. Method Youth mentors were trained on the Bridging the Gaps (BTG) curriculum that integrated a modified version of the World Health Organization’s (WHO) Problem Management Plus (PM+) psychological intervention into a sexual health, life-skills and financial education curriculum. Community lay mentors facilitated 72 weekly group sessions for 469 adolescent boys and girls, augmented with five enhanced one-on-one treatment sessions for those displaying signs of psychological distress. Adolescents displaying severe signs of psychological distress were referred directly to a primary health facility or connected to specialist services. A qualitative survey took place between February and March 2022, around four months before the end of the program. In-depth interviews were carried out with 44 adolescents, 7 partners, 19 parents and 11 stakeholders. Four focus group discussions were carried out with 17 mentors. Respondents were purposively selected to be interviewed based on their level of exposure to the intervention and ability to provide in-depth experiences. Themes focused on the program’s perceived effectiveness, ability to develop the capacity of lay mentors to address mental health issues, and increased access to mental health services. Results Adolescents reported that the intervention was able to improve their confidence in speaking up about their problems, equip them with essential first-aid skills to manage and treat anxiety or mild depression, provide them access to free one-on-one psychological help sessions, and increase their social network. Mentors were able to adhere to the core principles of psychological intervention delivery, providing preventative and treatment-focused psychosocial services. Furthermore, parents reported experiencing improved adolescent receptivity to parental suggestions or advice leading to improved parent-adolescent relationships. Mentors referred adolescents for a variety of reasons including severe mental illness, rape, and alcohol and substance use however, the high cost of transport was the main barrier limiting adolescents from following through with their referrals. Conclusion The findings demonstrate that integration of mental health services into community-based interventions is feasible and has benefits for adolescents, parents, and mentors.

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Aggression and depression are two of the most common forms of psychosocial difficulties in adolescents. High prevalence and disabling effects stress the need for more cost-effective interventions. Studies show that the two difficulties are closely linked regarding comorbidity, risk factors, consequences and theoretical background, making it interesting to investigate whether an intervention targeting one of them could also reduce the other. The aim of this study was therefore to assess the association between aggression and depression and to investigate whether a treatment that has been found effective in reducing depression—“Adolescents coping with depression course” (ACDC), a group-based cognitive behavioural intervention-, could also reduce aggression, either directly, or indirectly via reducing depression. The data came from a randomized control trial, with a pre- post- and follow-up longitudinal design. In total 228 youth participated in the study, of which 133 received the ACDC-intervention and 95 received usual care. Correlation analysis showed that aggression and depression were associated at all time points. Structural equation modelling showed that the intervention did have neither direct nor indirect effect on aggression. Our conclusion is that future CBT interventions with a primary aim to reduce depression might have to design intervention components that are more directly targeted toward aggression if also this potential comorbid difficulty should be addressed. Previous studies have found higher levels of comorbid aggression among depressed boys than girls. Few boys in our sample may thereby have reduced statistical power to detect potential influences on aggression. Trial Registration: ISRCTN registry ISRCTN19700389. Registered 6 October 2015. Full Protocol: https://doi.org/10.1186/s12888-016-0954-y

Digital mental health interventions may enable access to care for LGBTQA+ youth and young adults that face significant threats to their wellbeing. This study describes the preliminary efficacy of AFFIRM Online, an eight-session manualised affirmative cognitive behavioural group intervention delivered synchronously. Participants (Mage = 21.17; SD = 4.52) had a range of sexual (e.g., queer, lesbian, pansexual) and gender (e.g., non-binary, transgender, cisgender woman) identities. Compared to a waitlist control (n = 50), AFFIRM Online participants (n = 46) experienced significantly reduced depression (b = −5.30, p = 0.005, d = 0.60) and improved appraisal of stress as a challenge (b = 0.51, p = 0.005, d = 0.60) and having the resources to meet those challenges (b = 0.27, p = 0.059, d = 0.39) as well active coping (b = 0.36, p = 0.012, d = 0.54), emotional support (b = 0.38, p = 0.017, d = 0.51), instrumental support (b = 0.58, p < 0.001, d = 0.77), positive framing (b = 0.34, p = 0.046, d = 0.42), and planning (b = 0.41, p = 0.024, d = 0.49). Participants reported high acceptability. This study highlights the potential of digital interventions to impact LGBTQA+ youth mental health and explores the feasibility of digital mental health to support access and engagement of youth with a range of identities and needs (e.g., pandemic, lack of transportation, rural locations). Findings have implications for the design and delivery of digital interventions for marginalised youth and young adults.

OBJECTIVE While repetitive transcranial magnetic stimulation (rTMS) combined with group therapy has demonstrated efficacy for adolescent depression, clinical responses vary; this study aimed to identify baseline family environment and cognitive function predictors of symptomatic improvement to support personalized treatment strategies. METHODS A prospective cohort (August 2023-July 2024) enrolled 163 adolescents with major depressive disorder receiving a 4-week program of high-frequency rTMS (20 sessions) and group cognitive behavioral therapy (8 sessions). All participants were on stable antidepressants. Predictors included Family Environment Scale (cohesion, conflict) and neuropsychological tests (Stroop, Wisconsin Card Sorting Test [WCST]). The primary outcome was HAMD-24 reduction at week 4. RESULTS Of the 163 enrolled patients, 148 (90.8%) completed the study and were included in the final analysis. The mean HAMD-24 reduction was 48.6% ± 14.2%. Multivariate regression analysis, validated by bootstrapping, indicated that greater baseline family cohesion (β = 0.29, p = 0.002), lower family conflict (β = -0.25, p = 0.004), and better executive function indexed by fewer WCST perseverative errors (β = -0.24, p = 0.003) were independently associated with larger symptom reductions. The model explained 32.5% of outcome variance (adjusted R2 = 0.325). Medication dose was not a significant predictor. CONCLUSION Higher family cohesion, lower conflict, and intact executive function predict favorable response to combined rTMS and group therapy in adolescent MDD. Baseline screening for these factors may inform adjunctive approaches such as family therapy or cognitive remediation to optimize outcomes. These findings represent prognostic associations requiring further interventional validation.

Adolescent and young adult (AYA—between ages 15 and 39) cancer patients face unique psychosocial challenges due to their developmental stage and complex health problems. Research indicates psychotherapy and group support can be beneficial to AYAs. Group therapy offers an opportunity for connection among peers who are enduring similar struggles while also utilizing effective therapeutic intervention. The current project describes a model for an AYA cognitive behavioral therapy (CBT) group. The model was informed by existing CBT literature and was successfully implemented. Future research may evaluate the efficacy of the proposed group structure and content for reducing distress in AYA cancer patients.

Objective: The present study aimed to compare the effectiveness of the Responsible Adolescent Psychoeducational Training Package and Narrative Therapy on self-regulation and family affection among male adolescents. Methods and Materials: This quasi-experimental research employed a pretest–posttest–follow-up design with two experimental groups and one control group. The statistical population included high school boys in Isfahan, Iran, from which 60 students were selected via purposive sampling based on inclusion and exclusion criteria. Participants were randomly assigned into three groups (two intervention groups and one control group). The Responsible Adolescent group received an eight-session training focused on behavioral responsibility, adaptive thinking, planning, self-control, and social empathy. The Narrative Therapy group underwent eight sessions based on poststructuralist therapeutic principles, including externalization, re-authoring, and preferred narrative construction. The control group remained on a waitlist. All participants were assessed at three time points using the Adolescent Self-Regulatory Inventory and the Family Affection Questionnaire. Data were analyzed using repeated measures ANOVA and Bonferroni post hoc tests after checking assumptions. Findings: The results indicated significant improvements in both self-regulation and family affection for the intervention groups compared to the control group across posttest and follow-up phases (p < .001). Although both intervention methods were effective, no statistically significant difference was observed between the two experimental groups. Time and group × time interaction effects were significant for both variables, with large effect sizes (η² ranging from .24 to .76), indicating that changes were both statistically and practically meaningful. Conclusion: Both narrative therapy and responsible adolescent psychoeducation are effective interventions for enhancing self-regulation and family affection in adolescents. Given their comparable efficacy, implementation may be based on context, accessibility, and practitioner training. These findings support the use of integrative and developmentally sensitive approaches in adolescent intervention programs.

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Purpose: Given increasing rates of depression in adolescents, there is a clear need for innovative treatments. In this pilot randomized clinical trial, we assessed acceptability and feasibility of two group-based interventions: yoga and cognitive-behavioral therapy (CBT). The goal of this work is to prepare for a future fully powered randomized trial to test the hypothesis that yoga is not inferior to an established adolescent depression treatment, namely, group CBT. Methods: We enrolled 42 adolescents with elevated depression symptoms. Participants were randomly assigned to a 12-week group-based intervention, yoga or CBT. We had a priori feasibility and acceptability targets, including for recruitment rate, retention rate, expectancy, credibility, program satisfaction, class attendance, engagement in home practice, and instructor/leader manual adherence. We assessed adverse events, and within-subject changes in outcomes (depression, anxiety, impairment, sleep disturbance) and possible mediators (mindfulness, self-compassion). Results: Both interventions met most acceptability and feasibility targets. The only target not met related to low engagement in home practice. Participants within each study arm showed decreased depression symptoms over time and increased self-compassion. Conclusions: A yoga intervention appears to be acceptable and feasible to adolescents with depression. However, it may be challenging for this group to engage in unstructured home practice.

ABSTRACT Objective The aim of this study was to investigate age group, gender, and baseline depressive symptom severity as possible effect moderators in (1) cognitive versus behavioral based CBT-modules and (2) sequences of modules that started either with cognitive or behavioral modules in indicated depression prevention in adolescents. Method We conducted a pragmatic cluster-randomized trial under four parallel conditions. Each condition consisted of four CBT-modules of three sessions (cognitive restructuring, problem solving, behavioral activation, relaxation), but the sequencing of modules differed. The CBT-modules and sequences were clustered into more cognitive versus more behavioral based approaches. The sample involved 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). Assessments were conducted at baseline, after three sessions, at post-intervention and 6-month follow-up with self-reported depressive symptoms as the primary outcome. Results We found no evidence for substantial moderation effects. Age group, gender, and depressive symptom severity level at baseline did not moderate the effects of cognitive versus behavioral modules after three sessions. No evidence was also found that these characteristics moderated the effectiveness of sequences of modules that started either with cognitive or behavioral modules at post-intervention and 6-month follow-up. Conclusion Cognitive and behavioral based modules and sequences in the prevention of depression in adolescents might apply to a relatively wide range of adolescents in terms of age group, gender, and severity levels of depressive symptoms. Abbreviation: CDI-2:F: Children’s Depression Inventory-2 Full-length version; CDI-2:S: Children’s Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax, and repeat

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OBJECTIVE Depression is linked to excess weight, insulin resistance, and type 2 diabetes (T2D). We previously reported that in adolescent girls at-risk for T2D with moderately elevated depression, randomization to cognitive-behavioral therapy (CBT) produced greater decreases in depression at post-treament and greater decreases in fasting/2-h insulin at 1 year, compared to health education (HE). The current study is a secondary analysis of this parallel-group randomized controlled trial. We examined whether decreasing depression explained intervention effects on body composition and insulin outcomes. We hypothesized that decreases in depression would be an explanatory mediator and that indirect effects would be strongest at higher levels of baseline depression. METHODS Participants were 12-17 years girls with overweight/obesity and family history of T2D randomized to 6-week group CBT (n = 58) or HE (n = 61). Procedures took place at an outpatient pediatric clinic. At baseline, post-treatment, and 1 year, adolescents completed the Center for Epidemiologic Studies-Depression Scale to assess depression symptoms; body mass index (BMI [kg/m2]) was measured from height/fasting weight; insulin resistance was derived from 2-h oral glucose testing. Adiposity was assessed with dual-energy X-ray absorptiometry at baseline and 1 year. Indirect effects of intervention were tested on 1-year changes in BMI, adiposity, and insulin through decreases in depression. Baseline depression was tested as a moderator of mediation. RESULTS There was an indirect effect of CBT on decreased 1-year fasting insulin via decreases in depression during treatment, among adolescents with more elevated baseline depression. CONCLUSIONS Decreasing elevated depression may be one mechanism in the targeted prevention of T2D in at-risk adolescents.

Abstract Background: ‘DISCOVER’ one-day cognitive behavioural therapy (CBT) workshops have been developed to provide accessible, developmentally sensitive psychological support for older adolescents experiencing emotional difficulties. Previous school-based evaluations of the DISCOVER model have shown positive outcomes. Aims: The current study aimed to test the model for clinically referred adolescents, in real-world settings. Method: A randomized controlled trial (RCT) assessed feasibility, acceptability and preliminary outcomes of the DISCOVER intervention, in comparison with usual care, for 15- to 18-year-olds with emotional difficulties. Participants were recruited from outpatient clinic waiting lists in UK child and adolescent mental health services (CAMHS). Research feasibility indicators included rates of recruitment, randomization, intervention participation (group workshops and individualized follow-up telephone calls), and data collection (at baseline and 8-week follow-up). Intervention acceptability was assessed using a structured service satisfaction questionnaire and semi-structured qualitative interviews with intervention participants. Preliminary clinical outcomes were explored using adolescent-reported validated measures of depression, anxiety and well-being. Results: n = 24 participants were randomized to intervention and usual care groups. Workshop attendance was good and high levels of treatment satisfaction were reported, although feasibility challenges emerged in recruitment and randomization. Trends were found towards potential improvements in anxiety and well-being for the intervention group, but the effect estimate for depression was imprecise; interpretability was also limited due to the small sample size. Conclusions: DISCOVER appears to be a feasible and acceptable intervention model for clinically referred 15- to 18-year-olds with emotional difficulties. A full-scale RCT is warranted to evaluate effectiveness; protocol modifications may be necessary to ensure feasible recruitment and randomization procedures.

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Introduction Depression and anxiety have a long history of co-occurrence, with a relatively high prevalence in the Norwegian population both separate and combined. In adolescence, this prevalence increases significantly and may impact youths’ social and academic functioning drastically. Having effective treatments aimed at adolescents may have potential to prevent both short and long-term effects associated with these disorders. The aim of the current study was to examine whether the “Adolescent Coping with Depression Course” (ACDC), a cognitive behaviour therapy (CBT)-based group intervention aimed at adolescents with subclinical mild-to-moderate depressive symptoms, would also be effective in reducing anxiety symptoms. Methods Data, which came from a two-arm parallel cluster randomised control trial conducted in Norway, were collected from 228 adolescents, 133 of whom were assigned to the 14-week ACDC intervention and 95 were assigned to the usual care condition. The data were analysed with structural equation modelling Results The results indicated that the intervention is effective in reducing anxiety symptoms via reducing the depressive symptoms, thus illustrating an indirect effect. Discussion The findings suggested that ACDC has the potential to reduce anxiety symptoms over time through its effect on depressive symptoms. Implications of the results are presented. Clinical trial registration https://www.isrctn.com, identifier ISRCTN19700389.

Cognitive behavioral therapy (CBT) is effective in treating adolescent depressive symptoms but with variable treatment response. Heterogeneity in treatment outcome may be due in part to individual differences in cognitive and emotional processes in depressed adolescents, and there is a need to identify biomarkers associated with symptoms and treatment outcomes. There has been growing interest in leveraging electroencephalography (EEG) data to examine correspondence between multiple frequency bands, and delta-beta coupling in particular is thought to underlie emotion regulation and offers a promising biomarker in adolescent depression. In the present study, clinically depressed adolescents aged 14-18 years old (N=54) completed 6-minutes of EEG at rest before and after a 16-session group CBT program. Analyses were focused on associations of pre- and post-treatment delta-beta coupling power with age, depressive symptoms and clinician-rated severity at baseline and the end of treatment, and clinician-rated improvement. Results indicated that older adolescents showed lower delta-beta coupling than younger adolescents and girls showed higher coupling post-treatment. Greater delta-beta coupling before and after treatment was associated with greater clinician-rated severity. Surprisingly, greater pre-treatment delta-beta coupling was associated with lower self-reported depressive symptoms with treatment. These results suggest that elevated delta-beta coupling, potentially reflecting more difficulty regulating emotions, is associated with gender and age in adolescents with depression and may be related to greater severity and poorer treatment outcomes, but replication in larger samples is needed.

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Objectives: The overuse of the Internet among adolescents has increased dramatically in recent years, leading to pathological or problematic Internet use. Cognitive behavioral therapy (CBT) is known to be effective for the treatment of problematic Internet use, particularly for adolescents. The aim of the present study was to evaluate the therapeutic efficacy of group CBT for problematic Internet use in adolescents. Methods: A total of 17 patients aged 12-17 years who met Young’s diagnostic questionnaire criteria of problematic Internet use participated in a school-based eight-session group CBT program. The level of problematic Internet use among participating students was measured using Young’s Internet Addiction Scale (IAS). Depression and anxiety levels were evaluated using the Children’s Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI), respectively. Each construct was assessed at baseline, immediately after the intervention, and at a one-month follow-up visit. Statistical significance was based on a p-value of <0.05. Results: Immediately after the program, the IAS, CDI, and State Anxiety Inventory (SAI) scores were significantly lower than before the program. At the one-month follow-up assessment, the IAS scores remained low, and the CDI and SAI scores were even lower than immediately after the program. Conclusion: Group CBT was effective for adolescents with problematic Internet use, and was also demonstrated to improve depression and anxiety.

Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14–18 years) with depression ( N  = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.

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Anxiety and depression are increasingly prevalent public health concerns among adolescents. Group Behavioral Activation Therapy (GBAT), a structured school-based intervention, has shown promise as a potential approach for alleviating these conditions. This quasi-experimental trial evaluated the efficacy of school-implemented GBAT in reducing anxiety and depressive symptoms among Chinese adolescents. Participants (N = 139; aged 12–17 years; 44.6% male) were assigned to either a GBAT group (n = 72) or a waitlist control group (n = 67). The GBAT protocol consisted of eight weekly 90-minute sessions. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Depression Self-Rating Scale for Children (DSRSC). A total of 93.06% of students completed all eight GBAT sessions. Post-intervention SCARED scores decreased significantly, t (135) = 2.44, MD = 4.20, 95% CI [0.79, 7.60], p = 0.016, Cohen’s d = 0.42. Linear mixed-model analysis revealed a significant group effect (F (1,397) = 10.60, p = 0.001), indicating lower anxiety scores in the GBAT group compared with the waitlist control. A significant time effect was also observed, F (1,397) = 7.64, p < 0.001. At 3-month follow-up, GBAT maintained significant improvement in anxiety (SCARED: MD = 8.69, 95% CI [3.58, 13.80], p < 0.001 Cohen’s d = 0.82) and depressive symptoms (DSRSC: MD = 2.28, 95% CI [0.10, 4.46], p = 0.037, Cohen’s d = 0.43), indicating moderate to large effect sizes. These preliminary findings suggest that GBAT may be a promising primary prevention strategy for adolescent mental health. This study provides a foundation for future research exploring its potential integration into school-based mental health frameworks.

Adolescent mental health problems are becoming increasingly prevalent and concerning. This study aimed to evaluate the effectiveness of a school‐based music intervention program in improving the mental health of middle school students. From September 2023 to January 2024, a class‐based stratified randomized controlled trial was conducted at a rural middle school in Nanping City, Fujian Province, China. Seventh‐ and tenth‐grade students were recruited and randomly assigned to either an intervention group or a control group. The intervention group participated in a 17‐week structured music program, while the control group continued with regular school activities without additional intervention. Mental health status was assessed using the Depression Anxiety Stress Scale for Youth (DASS‐Y). A total of 414 students (mean age: 14.57 ± 1.53 years) were included. Baseline sociodemographic characteristics were similar between groups, although students in the control group were slightly more likely to report enjoying school (p = 0.029). Post‐intervention, the intervention group showed significant reductions in the detection rates of depression (13.14% to 1.71%), anxiety (14.29% to 5.14%), stress (5.17% to 0.00%), and overall mental health problems (18.29% to 5.71%) (all p < 0.001), while no significant changes were observed in the control group (all p > 0.05). Between‐group comparisons at post‐intervention further revealed significantly lower rates of depression (1.71% vs. 7.53%), anxiety (5.14% vs. 12.13%), stress (0.00% vs. 4.06%), and overall mental health problems (5.71% vs. 14.64%) in the intervention group. These findings suggest that school‐based music intervention programs may be an effective and scalable approach to promoting adolescent mental health. Further research is needed to explore their long‐term impact and broader applicability.

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Effectiveness research on depression prevention usually compares pre- to post-intervention outcomes across groups, but this aggregation across individuals may mask heterogeneity in symptom change trajectories. Hence, this study aimed to identify subgroups of adolescents with unique trajectories of change in a school-based depression prevention trial. It was also examined how trajectory membership was associated with the intervention conditions, depressive symptoms at 12-month follow-up, and baseline predictors. Hundred-ninety adolescent girls (Mage = 13.34; range = 11–16 years) with subclinical depression at screening (M = 57 days before pre-test) were allocated to four conditions: a face-to-face, group-based program (OVK), a computerized, individual program (SPARX), OVK and SPARX combined, and a monitoring control condition. Growth Mixture Modeling was used to identify the distinct trajectories during the intervention period using weekly depressive symptom assessments from pre-test to post-test. Analyses revealed three trajectories of change in the full sample: Moderate-Declining (62.1% of the sample), High-Persistent (31.1%), and Deteriorating-Declining (6.8%) trajectories. Trajectories were unrelated to the intervention conditions and the High-Persistent trajectory had worse outcomes at follow-up. Several baseline factors (depression severity, age, acceptance, rumination, catastrophizing, and self-efficacy) enabled discrimination between trajectories. It is concluded that information about likely trajectory membership may enable (school) clinicians to predict an individual’s intervention response and timely adjust and tailor intervention strategies as needed.

Background/Objectives: This study assessed the effectiveness of a school-based suicide prevention program in Hong Kong. Methods: 105 secondary school students aged 14–16, identified as having high levels of depression and suicidal ideation. Participants were divided into three intervention groups: one for adolescents only, another for adolescents with peers, and a third for adolescents with parental involvement. All groups engaged in weekly online exercises. Repeated measures ANOVA was used to analyze the within-group and between-group differences in the levels of adolescents’ suicidal ideation, depression and anxiety. Results: The results indicated a statistically significant reduction in suicidal ideation, depression and anxiety levels after participation in all three groups. No statistically significant between-group differences were identified, meaning the effects of the three interventions on the measured outcomes were similar. Conclusions: This study demonstrates the promise of implementing school-based suicide prevention programs in the Hong Kong context.

This study explores whether a school-based group counseling program for adolescent girls, implemented at scale, can mitigate trauma-related mental health harms. In a randomized trial involving 3749 Chicago public high school girls, we find that participating in the program for 4 months induces a 22% reduction in posttraumatic stress disorder symptoms and find significant decreases in anxiety and depression. Results surpass widely accepted cost-effectiveness thresholds, with estimated cost-utility well below $150,000 per quality adjusted life year. We find suggestive evidence that effects persist and may even increase over time. Our results provide the first efficacy trial of such a program specifically designed for girls, conducted in America’s third largest city. These findings suggest the promise of school-based programs to mitigate trauma-related harms.

Objective: To evaluate the effectiveness of a school-based Positive Mental Model within the MTSS framework in improving reproductive health knowledge and mental well-being among adolescent girls. Methodology: This quasi-experimental pretest–post-test control group design was applied in two public senior high schools in South Jakarta and West Jakarta. The study was conducted from March to July 2024. The intervention group was recruited from a public school in South Jakarta, while the control group was selected from a comparable public school in West Jakarta. The 12-week intervention followed the Multi-Tiered System of Supports (MTSS) framework, consisting of weekly sessions. A total of 70 participants were included in the analysis (intervention n=35, control n=35). Instruments included the Depression Anxiety Stress Scale–Youth (DASS-Youth), the Adverse Childhood Experiences–International Questionnaire (ACE-IQ), and a reproductive health knowledge questionnaire. Assessments were conducted at baseline (week 0), mid-intervention (week 4), and endline (week 12). The data were analysed using descriptive statistics, Spearman’s rho correlation, Wilcoxon signed-rank, Mann–Whitney U, and Friedman tests. Results: High ACE exposure was reported by 69.2% of participants. Moderate–severe depression, anxiety, and stress were present in 35 %, 31.6%, and 20.0%, respectively. Knowledge was moderate in 51.7% and good in 46.7%. Tier distribution was 30% Tier 1, 49.2% Tier 2, and 20.8% Tier 3. The intervention group exhibited significant reductions in their DASS-Youth scores, while the control group did not exhibit significant improvements in knowledge across all levels (p<0.05). Conclusion: The Positive Mental Model within the MTSS framework effectively improved reproductive health knowledge and reduced psychological distress among adolescent girls. Integrating this approach into existing school-based health and counselling programs could enhance sustainability and support early identification of students who need assistance.

BACKGROUND Mental health problems, including depression, anxiety, and suicide, pose a substantial burden on adolescents worldwide, making prevention a priority. In China, major challenges remain in implementing and evaluating school-based mental health programmes. The Adolescent Mental Health Service Package (AMHSP) is a multicomponent, culturally adapted, evidence-informed curriculum that is grounded in Positive Youth Development and designed to reduce depressive and anxiety symptoms and enhance mental wellbeing. The aim of this study was to evaluate the AMHSP for improving adolescent mental health in routine school settings. METHODS This cluster-randomised controlled trial included public schools across ten provinces in China, with participants nested within schools and classrooms within each school randomly assigned 1:1 to either ten weekly 40-min AMHSP sessions (intervention), delivered by trained school-based mental health teachers or counsellors (facilitators) using standardised manuals and multimedia materials, or routine curriculum without additional mental health content (control). Given the nature of the school-based intervention, neither students nor facilitators were masked to group allocation, but all statistical analyses were done by an independent statistician masked to group allocation, and student self-report data were collected anonymously using secure, standardised platforms. The four primary outcomes were depressive symptoms (measured by nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalized Anxiety Disorder Scale), subjective wellbeing (WHO Five-item Well-Being Index), and emotion regulation (ten-item Emotion Regulation Questionnaire, assessing both cognitive reappraisal and expressive suppression), which were self-reported at baseline, immediately after intervention, and at 1-month and 3-month follow-up. The primary outcome analysis of change from baseline at 3 months' follow-up in the four coprimary outcomes was analysed by linear mixed-effects models in the intention-to-treat population, which included all participants who completed at least one assessment. To control for multiple testing, we prespecified the use of the Benjamini-Hochberg false discovery rate (FDR) correction of p values. This trial was prospectively registered with the Chinese Clinical Trial Registry (ChiCTR2300076956) and has been completed. FINDINGS Between Oct 12, 2023 and Oct 10, 2024, 5222 students from 120 classrooms in 18 public schools (mean age 13·6 years [SD 1·7]; 2687 [51·5%] girls and 2535 [48·5%] boys) were randomly assigned to the AMHSP intervention (n=2620) or control (n=2602), completed the baseline assessments, and were included in the primary outcome analysis. At 3 months, the AMHSP intervention group showed lower depressive symptoms (standardised mean difference [SMD] -0·09 [95% CI -0·14 to -0·04], pFDR=0·0013) and anxiety symptoms (-0·11 [-0·16 to -0·05], pFDR=0·0002) relative to the control group. No differences were seen in subjective wellbeing (SMD 0·02 [-0·03 to 0·08], pFDR=0·85) or emotion regulation (cognitive reappraisal SMD 0·03 [-0·02 to 0·09], pFDR=0·33; expressive suppression -0·08 [-0·14 to -0·01], pFDR=0·10) at 3 months. No adverse events were reported. INTERPRETATION The reduction in depression and anxiety symptoms 3 months after completing ten AMHSP sessions indicates a slow but meaningful benefit of the programme and supports the potential of a low-intensity, curriculum-integrated approach to promoting adolescent mental health. Delivery of the AMHSP by trained school-based mental health teachers demonstrates a scalable strategy for early mental health promotion in schools. FUNDING UNICEF.

Background: Adolescent obesity and depression are escalating public health concerns. However, evidence regarding the efficacy of supervised group-based exercise specifically for adolescents with comorbid overweight/obesity and depression remains limited. Objectives were to evaluate the effectiveness of a moderate-intensity group-based aerobic exercise program on depressive symptoms and nutritional status in high-risk adolescents. Methods: This quasi-experimental study enrolled 48 junior high school students in Phra Nakhon Si Ayutthaya, Thailand, who presented with overweight or obesity [BMI-for-age Z-score (BAZ) >+1 SD] and mild-to-moderate depression [Children’s depression inventory (CDI) score ≥16]. Participants engaged in a supervised aerobic exercise program (30 minutes/session, 3 times/week) for 4 weeks. Outcomes, including CDI scores, body mass index (BMI), and waist circumference, were assessed at baseline, week 4, and week 12. Data were analyzed using the Friedman test and Wilcoxon signed-rank test with Bonferroni correction. Results: At the 12-week follow-up, CDI scores significantly decreased compared to baseline (p=0.016). Similarly, a significant reduction in BMI was observed (p=0.002). Although a significant overall variation in waist circumference was detected (p=0.006), pairwise comparisons did not reach statistical significance after correction. Conclusions: A school-based, supervised group exercise program effectively reduced depressive symptoms and BMI in adolescents with co-occurring obesity and depression. This intervention serves as a promising adjunctive strategy for integrated mental and physical health promotion within school health systems and primary care networks.

Adolescence represents a vulnerable developmental period for depression and an opportune time for prevention efforts. In this study, 186 adolescents with elevated depressive symptoms (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were randomized to receive either Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST; n = 95) delivered by research clinicians or group counseling (GC; n = 91) delivered by school counselors. We previously reported the short-term outcomes of this school-based randomized controlled trial: IPT-AST youth experienced significantly greater improvements in depressive symptoms and overall functioning through 6-month follow-up. Here, we present the long-term outcomes through 24 months postintervention. We examined differences in rates of change in depressive symptoms and overall functioning and differences in rates of depression diagnoses. Youth in both conditions showed significant improvements in depressive symptoms and overall functioning from baseline to 24-month follow-up, demonstrating the efficacy of school-based depression prevention programs. However, the two groups did not differ in overall rates of change or in rates of depression diagnoses from baseline to 24-month follow-up. Although IPT-AST demonstrated advantages over GC in the short term, these effects dissipated over long-term follow-up. Specifically, from 6- to 24-month follow-up, GC youth showed continued decreases in depressive symptoms, whereas IPT-AST youth showed a nonsignificant increase in symptoms. GC youth remained relatively stable in overall functioning, whereas IPT-AST youth experienced a small but statistically significant worsening in functioning. This study highlights the potential of school-based depression prevention efforts and the need for further research.

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ABSTRACT The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and non-participants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-participants: n=222) were 14–15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample.

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Introduction The Resourceful Adolescent Program (RAP) is an evidence-based resilience intervention for adolescents. Operating in a strength-focused paradigm, the programme uses an integration of cognitive behavioural therapy and interpersonal psychotherapy to improve coping skills and build resilience. This study aims to establish whether a culturally and linguistically adapted intervention informed by RAP principles is effective in increasing resilience, enhancing coping skills and preventing symptoms of depression and anxiety. Methods and analysis We will translate, back-translate and culturally adapt the RAP for adolescents and training materials for facilitators, and the adapted intervention will be called Happy House. A two-arm parallel controlled trial will be conducted in eight high schools in the north of Vietnam. In each of the selected schools, all students from four randomly selected grade 10 classes (an estimation of about 1204 students) will be invited to participate. The control group will receive the usual curriculum. The intervention group will receive six weekly 90 min school-based group sessions of Happy House in addition to the usual curriculum. The primary outcome, depressive symptoms, will be measured using a locally validated version of the Centre for Epidemiologic Studies Depression Scale Revised. Secondary outcomes are mental well-being, coping self-efficacy, school connectedness, anger management and health risk behaviours. Data will be collected at recruitment, and at two weeks and six months post intervention. Mixed-effect logistic regression for the main outcome and mixed-effect linear and logistic regression models for the secondary outcomes will be conducted to estimate the effects of the intervention on the outcomes. Ethics and dissemination This trial has been approved by Monash University Human Research Ethics Committee (No. 21455) and the Institutional Review Board of the Hanoi School of Public Health (488/2019/YTCC-HD3). Dissemination of findings will include peer-reviewed publications, international and national conferences, seminar and media presentations, national policy briefings in Vietnam, local language reports and lay language summaries for participants. Trial registration numbers Registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12620000088943 (3/2/2020). WHO Universal Trial Number: U1111-1246-4079.

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BackgroundAdolescents are at risk of developing depressive symptoms. Given the prevalence, recurrence and negative consequences of adolescent depression, it is crucial to implement prevention programs for high-risk adolescents. Prevention programs at an indicated level have shown to be successful in reducing depressive symptoms in adolescents. This study will evaluate the (cost)effectiveness of the prevention program ‘Op Volle Kracht (OVK 2.0)’ for adolescents with elevated depressive symptoms.MethodsWe will perform a Randomized Controlled Trial (RCT) with an intervention and control condition to test the effectiveness of an indicated prevention program aimed at depression in adolescents. Adolescents in their second year of secondary education (11–15 year) will be screened for depressive symptoms. Those with heightened levels of depressive symptoms (CDI-2 ≥ 14) will be randomly assigned to the intervention (N = 80) or control group (N = 80). The participants in the intervention condition will receive a prevention program comprising eight meetings of 60 min each. The participants in the control condition will receive psycho-educational information. All participants and their parents will complete assessment at baseline, post-intervention, and 6-, 12- and 24- month follow-up. Primary outcome will be depressive symptoms. Additionally, the present study will identify mechanisms that mediate and moderate the program effects and test the effect of OVK 2.0 on secondary outcomes.DiscussionThis paper describes a study designed to screen adolescents for depressive symptoms and offer them a prevention program to prevent the onset of depressive symptomatology. Adolescents in the intervention condition are expected to show lower levels of depressive symptoms at 12 month follow-up compared to adolescents in the control condition. If OVK 2.0 proves to be effective, the screening and intervention program could be implemented in schools on a large scale.Trial registrationDutch Trial Register NTR5725. Date registered: 11th of March 2016.

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The longitudinal effectiveness of a universal, adolescent school-based depression prevention program Op Volle Kracht (OVK) was evaluated by means of a cluster randomized controlled trial with intervention and control condition (school as usual). OVK was based on the Penn Resiliency Program (PRP) (Gillham et al. Psychological Science, 6, 343–351, 1995). Depressive symptoms were assessed with the Child Depression Inventory (Kovacs 2001). In total, 1341 adolescents participated, Mage = 13.91, SD = 0.55, 47.3 % girls, 83.1 % Dutch ethnicity; intervention group n = 655, four schools; control group n = 735, five schools. Intent-to-treat analyses revealed that OVK did not prevent depressive symptoms, β = −0.01, SE = 0.05, p = .829, Cohen’s d = 0.02, and the prevalence of an elevated level of depressive symptoms was not different between groups at 1 year follow-up, OR = 1.00, 95 % CI = 0.60–1.65, p = .992, NNT = 188. Latent Growth Curve Modeling over the 2 year follow-up period showed that OVK did not predict differences in depressive symptoms immediately following intervention, intercept: β = 0.02, p = .642, or changes in depressive symptoms, slope: β = −0.01, p = .919. No moderation by gender or baseline depressive symptoms was found. To conclude, OVK was not effective in preventing depressive symptoms across the 2 year follow-up. The implications of these findings are discussed.

Background: Adolescent depression prevention programs are typically delivered in groups in which adolescents share a common setting and interventionist, but the influence of the group is usually ignored or statistically controlled. We tested whether the primary outcomes of reductions in depressive symptoms and future onset of major depressive disorder (MDD) varied as a function of group membership. Methods: Data were available from two randomized trials in which 220 adolescents received the Blues Program indicated prevention intervention in 36 separate groups; participants were assessed at baseline, post intervention, and at 6-, 12-, and 24-month follow-ups. Results: Ten percent of participants had developed MDD 2 years post intervention. Group-level effects for MDD onset over follow-up were nonsignificant (accounted for <1% of variance; ICC = 0.004, ns). Group-level effects for depressive symptom change across the follow-up period were also nonsignificant (ICC = 0.001, ns) but group effects accounted for 16% of depressive symptom change immediately post intervention (ICC = 0.159, p < 0.05). Group-level clustering of posttest depressive symptoms was not associated with size of group or gender composition. Conclusions: Membership in specific adolescent cognitive-behavioral depression prevention groups may have an impact in terms of immediate symptom reduction but does not appear to have significant prevention effects in terms of long-term symptom change or MDD onset.

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OBJECTIVE Despite the prevalence of depressive disorders among youth, there is no health system model to address the prevention of these disorders. METHOD With the goal of creating effective, tolerable, and scalable interventions for the prevention of adolescent depression, we have fielded three randomized clinical trials, centered in health care delivery organizations that use a whole-of-society approach: (a) Path 2 Purpose (N = 664), comparing the Competent Adulthood Transition with Cognitive Behavioral, Humanistic, and Interpersonal Training (CATCH-IT; B. W. Van Voorhees et al., 2015), guided digital health intervention to a synchronous mental health specialist-led group cognitive behavioral intervention, Coping with Depression Course-Adolescent; (b) PATHway (N = 400), examining the efficacy of the CATCH-IT components; and (c) Behavioral Health Stratified Treatment (N = 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).

Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression prevention trials and examine how cognitive‐behavioral (CB) interventions and baseline predictors relate to trajectory membership.

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Depression is a prevalent, distressing, and often recurrent disorder. Adolescence represents a vulnerable developmental period when rates of depression surge and many people experience their first episode. Some professional agencies now recommend universal screening starting at age 12. In this article, I advocate for a risk-based approach to screening for adolescent depression that can improve on current approaches and facilitate more seamless connections to enable personalizing the prevention of depression on the basis of risk-group classification. I review empirical examples for screening based on established risk factors that predict later depression and provide evidence that risk groups can reliably and validly classify adolescents at risk for future development of depression based on cognitive and interpersonal vulnerabilities. These risk groups inform one approach to personalizing prevention of depression by matching youths’ risk to established, evidence-based prevention programs (cognitive or interpersonal). Promising data from a randomized trial suggest that this personalized depression-prevention strategy can reduce depression better than a one-size-fits-all approach.

Several adolescent depression prevention programs have demonstrated effects on depressive symptoms and overall functioning. Yet, despite an increasing emphasis on elucidating mechanisms of change in interventions, few studies have identified mediators of these preventive interventions. In this study, we examined interpersonal mediators of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), an evidence-based depression prevention program. The Depression Prevention Initiative is a school-based randomized controlled trial in which 186 adolescents (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were assigned to receive either IPT-AST (n = 95) or Group Counseling (GC) (n = 91). We examined whether change in interpersonal conflict, social support, or social functioning from baseline to midintervention mediated the effects of IPT-AST on depressive symptoms and overall functioning at postintervention. At postintervention, youth in IPT-AST had lower depressive symptoms (d = −.31) and higher overall functioning scores (d = .32) than youth in GC. Improvements in adolescent romantic functioning, reductions in peer conflict, and improvements in a factor score reflecting mother–adolescent conflict and difficulties in family functioning emerged as significant mediators. However, the effects of the intervention on change in the mediators were not statistically significant. These findings add to the sparse literature on mediators of psychosocial interventions, provide partial support for the theoretical mechanisms underlying change in IPT-AST, and highlight important directions for future prevention and intervention research.

BACKGROUND Given the prevalence and consequences of adolescent depression, depression prevention has become an important area of research. While prevention programs like Interpersonal Psychotherapy - Adolescent Skills Training (IPT-AST) have demonstrated effectiveness, little research to date has studied the relationship between maternal depression and adolescent outcomes in these programs. METHOD The current study investigated the relationship between maternal and adolescent depressive symptoms in 167 mother-adolescent dyads who were enrolled in the Depression Prevention Initiative (DPI), a randomized controlled trial that compared IPT-AST to group counseling (GC). First, the study examined the relationship between initial levels of adolescent and maternal depressive symptoms. The study then investigated whether maternal depressive symptoms improved over the two-year study period. Finally, the study assessed whether maternal and adolescent symptoms changed concurrently across time. RESULTS Results indicated that initial levels of maternal and adolescent symptoms were positively associated. Additionally, maternal symptoms improved across the two-year period. Maternal and adolescent outcomes were related across time: as adolescents improved in our study, their mothers also improved. LIMITATIONS The study utilized self-report data only and did not allow for the testing of causality in the relationship between mother-youth depression. CONCLUSIONS These findings add to the literature demonstrating that as one part of the mother-child dyad improves, the other improves as well. These findings extend the current understanding of the relationship between maternal and adolescent depressive symptom outcomes, and have important implications for the prevention and treatment of depression.

Understanding the mechanisms of change has recently been emphasized as crucial for advancing research on preventive interventions. This study, embedded within a pilot trial, aimed to explore the mediating effects of resilience for three preventive interventions focusing on reducing the risk of adolescent depression and anxiety in Nepal. We hypothesized that the self-regulation, economic, and combined interventions would differentially increase internal and external resilience, which in turn would reduce adolescent depressive and anxiety symptoms among adolescents in Nepal, supporting to development of a testable, replicable mediation model of prevention intervention pathways. Data were collected as part of a feasibility cluster-randomized controlled trial. A total of 229 adolescents aged 13–15, identified as living in poverty and at risk of depression or anxiety, were cluster-randomized by school into three intervention arms (self-regulation, economic, combined) and a control group. Assessments for depression and anxiety symptoms, and external and internal resilience were performed at three timepoints, with a six-month interval between each. Twenty school-based group intervention sessions were conducted weekly post-baseline. Linear mixed modeling explored changes in resilience within groups. Exploratory mediation analyses were performed to examine the association between interventions (as predictors), resilience at 6 months (as mediator), and symptoms of depression and anxiety at 12 months as outcomes, through two separate parallel mediation models. While no significant sensitivity to change effects for resilience was found, hypothesized directional time-related improvements were observed in external resilience for males in self-regulation and economic arms, and for females in the self-regulation arm; internal resilience showed positive trends for males in economic and combined arms, and for both males and females in the self-regulation arm. No significant effects of the interventions through resilience on mental health outcomes were detected, though internal resilience at 6 months predicted lower anxiety at 12 months, and for males in all intervention arms, higher internal resilience was significantly associated with lower depression. The findings warrant the testable conceptual mediation model with resilience as a mechanism in larger, fully powered prevention trials for adolescents. Trial registration: ISRCTN14601588 https//doi.org/10.1186/ISRCTN14601588.

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is an evidence-based indicated depression prevention program that has been shown to reduce depression symptoms. Research is needed to identify moderators of IPT-AST’s effects. Although trauma history has emerged as a moderator of depression treatment outcomes, the impact of trauma on short- and long-term outcomes in the context of preventive interventions for adolescent depression is unknown. This study examines the impact of trauma on prevention outcomes in a school-based randomized controlled trial (RCT) in which 186 adolescents (mean age = 14.01 years, SD = 1.22; 67% female) were randomly assigned to IPT-AST delivered by research staff or to group counseling (GC) provided by school counselors. Trauma history significantly moderated intervention outcomes during the active phase of the intervention but not during long-term follow-up. During the active phase, youth in IPT-AST with low or no trauma exposure experienced significantly greater reductions in depression symptoms than youth in GC with low or no trauma exposure, but there were no significant differences in rates of change between the two interventions for youth with high or any trauma exposure. These findings highlight the importance of assessing trauma and investigating whether these interventions can be tailored or supplemented to enhance the effects for youth with trauma exposure.

Suicide is one of the most devastating, yet preventable, health disparities for African American adolescents. African American adolescent suicidal ideation and behavior may have different manifestations and risk factors relative to those of adolescents from other ethnic backgrounds that impact prevention efforts. For example, in addition to more common manifestations of suicidal ideation and behavior, African American youth may engage in violent or high-risk behaviors, use more lethal means, or report ideation at lower depression levels. The Adapted-Coping with Stress Course (A-CWS), an adaptation of Gregory Clarke and colleagues' Coping with Stress Course, was developed to address the cultural nuances of African American adolescents. The A-CWS is a 15-session cognitive-behavioral, group-based preventive intervention that aims to enhance adaptive coping skills and reduce suicidal ideation, by incorporating strategies that counter stressors associated with systemic racism that burden African American adolescents. This study evaluated the feasibility and acceptability of the A-CWS intervention, using a sample of predominantly African American ninth-grade students. Results indicated that the adolescents were very favorable and receptive to the A-CWS intervention and that the intervention could be conducted feasibly. The A-CWS intervention serves as a model to advance culturally-grounded, evidence-based preventive intervention, for an underserved sector of adolescents.

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The role of the perceived social support in prevention of depression in adolescence still remains an insufficiently explored problem. By integrating the results of the previous studies of moderator role of perceived social support between negative life events and depression in adolescence we set up two goals. One is to determine whether perceived social support has moderator role in the sample consisted of clinical, subclinical, and control respondents. Another goal is to identify in which group the interaction effect is significant, i.e. the perceived social support acts as moderator. The sample consisted of 412 adolescents (61.7% female and 38.3% male) aged 13–17 years (mean = 15.70, SD = 1.22). We applied: Data sheet for all respondents; Mini International Neuropsychiatric Interview; Multidimensional Scale of Perceived Social Support; Adolescent Life Events Questionnaire; Centre for Epidemiological Depression Scale. We have shown that the association between levels of depressive symptoms and negative life events changes as the value of the moderator variable perceived social support changes. The finding that the moderating interaction effect was significant only in the subclinical group is particularly interesting. Taking into account that perceived social support moderates the association between negative stress events and levels of depression, we can propose a model for the prevention of depression, which will include perceived social support. However, future research with longitudinal design is required to verify the results.

Meta-analyses of school-based CBT have shown that prevention for anxiety symptoms typically report small but significant effects. There is limited knowledge regarding which youths may benefit most and least from such programs, and characteristics of youth who respond differentially to interventions of different intensity. The present study examined predictors of school-based CBT outcomes among 302 youths (mean age 14.0 years, SD 0.8, 84% female) who participated in a randomized waitlist-controlled trial comparing a 10-session and a 5-session group intervention. Potential predictors included youth and parental factors, and credibility and expectancy of the interventions. Pre-intervention anxiety and depression levels, and clinician rated severity were examined as moderators of intervention effects. Outcomes were youth-, and parent-reported youth anxiety and depressive symptoms at post-intervention and 1-year follow-up. Higher parent-reported impairment from youth anxiety predicted larger parent-reported anxiety and depressive symptom change, whereas higher caregiver strain was associated with less symptom change. Higher parent rated credibility and expectancy was associated with improved outcomes at post-intervention. At 1-year follow-up, no predictors of outcome were identified. No moderators were identified. Families with high levels of caregiver strain associated with youth anxiety may need extra support regardless of length of intervention program. Parents' credibility and expectancy of interventions should be targeted to optimize school-based CBT.

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Abstract Virtual reality (VR) for mental health promotion remains understudied in low-income humanitarian settings. We examined the effectiveness of VR in reducing depression with urban refugee youth in Kampala, Uganda. This randomized controlled trial assessed VR alone (Arm 1), VR followed by Group Problem Management Plus (GPM+) (Arm 2) and a control group (Arm 3), with a peer-driven and convenience sample of refugee youth aged 16–25 in Kampala. The primary outcome, depression, was measured with the Patient Health Questionnaire-9. Secondary outcomes included: mental health literacy, mental health stigma, self-compassion, mental well-being and adaptive coping. Analyses were conducted at three time points (baseline, 8 weeks, 16 weeks) using generalized estimating equations. Among participants (n = 335, mean age: 20.77, standard deviation: 3.01; cisgender women: n = 158, cisgender men: n = 173, transgender women: n = 4), we found no depression reductions for Arms 1 or 2 at 16 weeks compared with Arm 3. At 16 weeks, mental health literacy was significantly higher for Arm 2 compared with Arm 3, and self-compassion was significantly higher in Arm 1 and Arm 2 compared with Arm 3. VR alongside GPM+ may benefit self-compassion and MHL among urban refugee youth in Kampala, but these interventions were not effective in reducing depression.

Objective: The main objective of this study was to test the efficacy of a Multi-component intervention program (strategies) over emotional and behavioural problems (EBPs) among school adolescents.Methods: This research uses Pretest- Posttest Control Experimental Group. The outcome measurement used was Youth Self-ReportTM –Narrow-Band Scale (Achenbach and Rescorla, 2001). The sample of 50 students with age range 14 to18 years was administered on YSRTM. From these 50 20 students who fall into clinical consideration were selected for experimental (n=10) and control group (n=10). The intervention is mainly tailored to Internalizing (anxiety, depression and somatic complaint) as well as externalizing ( rule breaking and aggressive behaviour), including other (Cognitive & Social) problems.Results: The findings showed significant improvements in posttest measures of EBPs namely anxiety, withdrawal depression, social problems, thought problems, offending behaviour, aggressive behaviour, and other problems. The finding supports multi component intervention for EBPs among school adolescents. The finding could facilitate the adaptation of the intervention in other settings, potentially amplifying its impact.

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Introduction Depression is a common psychiatric disorder characterized by persistent low mood, reduced interest, and slowed thinking. Young adults are the main first-onset group for depression in all categories of the population. Program for education and enrichment of relational skills (PEERS) training, a program for the Education and Enrichment of Relational Skills, has been used in Europe and America for people with various types of social disorders with good results. A Chinese adaptation of the PEERS training program may be a new approach to help youth with depression return to society as soon as possible. This study aimed to construct and optimize a social skills training program for Chinese young adults with depression and to validate the impact of the program. Materials and methods and analysis The aim of this trial protocol is to evaluate the efficacy of the localized PEERS training program on social competence, depressed mood in a Chinese young adult population with depression. The primary outcome will be a change in self-reported depressive symptoms from baseline to week 3 post-randomization to week 6 post-randomization measured using the Liebowitz social anxiety scale (LSAS). Secondary outcomes include the rate of decline in severe social anxiety, the Social Avoidance and Distress Scale (SAD), the Social Self-Efficacy Scale (PSSE), and the Hamilton Depression Scale (HAMD-17). Data for each assessment will be collected at baseline, week 3 of the trial, and week 6 of the trial. Ethics and dissemination Ethics approval was obtained from the Hospital Ethics Committee. Findings will be disseminated through scientific journals, conferences, and university courses. Trial registration number [http://www.chictr.org.cn/], identifier [ChiCTR2100046050].