Two universal school-based prevention programs for depression and anxiety: 24-Month follow-up of an RCT

Area of Science:

• Child and adolescent mental health
• Preventive psychology
• School-based interventions

Background:

• Transdiagnostic approaches target interconnected pathology in depression and anxiety.
• Universal school-based programs aim to maximize preventative effects across multiple mental health issues.
• Emotion Regulation (ER) and Behavioral Activation (BA) programs targeted worry to promote resilience.

Purpose of the Study:

• Investigate long-term effects of ER and BA programs on depression and anxiety.
• Assess the impact of these interventions on resilience and worry.
• Examine resilience as a potential mediator of intervention effects.

Main Methods:

• Follow-up study of 162 students (aged 8-13) from six Australian schools.
• Cluster randomized controlled trial with BA, ER, and control groups.
• Interventions included 8 weekly 50-minute sessions; outcomes measured at 24-month follow-up.

Main Results:

• No significant effects of ER or BA on depression, anxiety, worry, or resilience at 24 months.
• Fewer participants in ER and BA groups met clinical thresholds for separation anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) at follow-up.
• No mediation effects of resilience were found.

Conclusions:

• ER and BA interventions may offer limited, short-term protective effects on SAD and OCD symptoms.
• Program effects on SAD and OCD appear to have a shelf-life shorter than 24 months.
• Refresher sessions at shorter intervals may be necessary to maintain intervention effects.