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School-based depression and anxiety prevention programs: An updated systematic review and meta-analysis
Aliza Werner-Seidler1, Samantha Spanos1, Alison L Calear2
1Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
Clinical Psychology Review
|September 27, 2021
Summary
School-based psychological prevention programs show small but significant effects in reducing childhood and adolescent depression and anxiety. Targeted interventions and external providers may enhance effectiveness for broader population impact.
Area of Science:
- Psychology
- Public Health
- Education
Background:
- Childhood and adolescent depression and anxiety are prevalent, necessitating effective prevention strategies.
- School settings offer a crucial platform for delivering psychological interventions to young people.
- Previous reviews highlighted the need for updated evidence on school-based prevention program efficacy.
Purpose of the Study:
- To systematically review and update the evidence on the effectiveness of school-based psychological prevention programs for depression and anxiety.
- To assess the impact of program type (universal vs. targeted) and delivery (school staff vs. external providers).
Main Methods:
- Systematic search of three electronic databases for randomized controlled trials (RCTs) published up to October 2020.
- Inclusion of 130 articles representing 118 unique trials with 45,924 participants.
- Meta-analysis and subgroup analyses to determine effect sizes and identify moderators.
Main Results:
- Small between-group effect sizes were observed for depression (g=0.21) and anxiety (g=0.18) immediately post-intervention.
- Targeted prevention programs demonstrated significantly greater effect sizes for depression compared to universal programs.
- External providers showed some benefit over school-staff delivered programs, though study quality was moderate.
Conclusions:
- School-delivered psychological prevention programs yield modest reductions in depression and anxiety symptoms.
- Further refinement of programs and strategies for sustainable school-based delivery are essential for population-level impact.
- Future research should focus on optimizing program content and implementation for long-term preventive effects.
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