Qualitative Process Evaluation of a School-Based Group Intervention (DISCOVER) for Depression and Anxiety for Older...

DISCOVER is a Cognitive Behavioural Therapy based intervention for anxiety and depression in 16-18-year-olds delivered in schools, shown to be clinically and cost-effective by the Brief Educational workshops in Secondary Schools Trial (BESST). DISCOVER comprises pre-workshop 1:1 meeting, a group workshop, and 1:1 follow-up phone call. A qualitative process evaluation investigated intervention delivery and outcome generation within BESST.

Thematic analysis of interviews with an ethnically diverse sample of male and female students (n = 22) and focus groups with DISCOVER practitioners (n = 21) in 4 English regions.

Practitioners valued the pre-workshop student meetings and workshop materials. However, they felt uncomfortable with the scripted delivery, and found delivery of all content difficult in the time available. Time constraints and variable adherence to follow-up phone calls limited provision of goal-attainment support. Students preferred relatable, interactive workshop elements more than didactic teaching. They found group discussions 'normalising', but often reported fatigue by the workshop end. Some reported beneficial use of thought challenging, mindfulness and sleep hygiene techniques, particularly during exams, but reported variable experience of follow-up calls. The DISCOVER app was rarely accessed. Male and female students provided similar accounts.

Students valued DISCOVER and perceived it as effective. Practitioners expressed support for implementation in routine practice. Findings suggest enhanced effectiveness may be achieved by (a) reviewing the parameters for modification of scripted material; (b) streamlined delivery of workshop content, and (c) enhancing support for goal-attainment by providing extra practitioner training and using more digital and telecommunication resources to boost student engagement.