One-day mental health workshop improves teenagers’ mood for six months

Teenagers can gain long-lasting mental health benefits from CBT

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A one-day school workshop based on cognitive behavioural therapy (CBT) led to small improvements in teenagers’ mood and stress levels for at least six months, a trial has found.

The result contrasts with several other recent trials of mental health interventions for schools, which found they slightly worsened children’s well-being.

In the past decade, CBT has become one of the most common kinds of talking therapy offered to people with depression or anxiety. Unlike more open-ended kinds of talking therapy, such as psychoanalysis, CBT is structured with the aim of encouraging people to change unhelpful ways of thinking or behavioural patterns, like focusing on upsetting events or avoiding social situations.

CBT also has the most supporting evidence from randomised trials involving adults with depression, anxiety or other mental health problems. Participants usually see a therapist for 1 hour a week for two or three months.

The latest trial was designed to assess whether a one-day course could have benefits for teenagers, in this case aged 16 to 18. The workshop was offered to students who felt they were experiencing stress, worries or low mood.

Three therapists delivered the course to groups of 16 pupils. It involved teaching them about CBT and techniques for relaxation and mindfulness – brief meditative practices – and offering practical tips about time management and getting enough sleep.

In 57 schools in England, 900 pupils were randomly selected to attend one of the workshops or to use existing mental health systems, such as being directed to health services.

After the workshops, the pupils were allowed up to three further phone calls with the therapists for support.

Those who took part in the workshops saw a decline in their symptoms of depression, compared with the control group, of just over 2 points on a 67-point scale, which is classed as a small effect.

But among the one-third of participants who had the highest depression scores to begin with, those who attended the workshops saw about a 4-point reduction in symptoms on average, which is classed as a moderate impact, says Ben Carter at King’s College London. “We found an effect that was far higher than we were expecting.”

The workshops also led to small improvements across the whole group in tests for anxiety and well-being, which lasted for at least six months.

June Brown, another member of the team at King’s, says there may be several reasons why this format seems more beneficial than other mental health interventions in schools. Some previous schemes involved teachers giving training on mindfulness to whole classes, rather than using therapists and focusing on teens who really are having problems, as in this trial, she says. Mindfulness also has less supporting evidence for its use in adults than CBT.

Jack Andrews at the University of Oxford says the findings are welcome. “The trial was very well designed,” he says. “These results are very promising.”

The therapists running the workshops are part of a new initiative that began in 2018 to have mental health professionals work within English schools. They are currently operating in schools that teach about a third of pupils in England, with coverage eventually planned for all schools.

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