Development and validation of a Solution-Focused Group Therapy program for interpersonal relationships in adolescents...

To develop and validate a standardized, de-pathologized Solution-Focused Group Therapy (SFGT) program specifically designed to address interpersonal dysfunctions among Chinese adolescents with anxiety and depression.

A two-round Delphi method was employed to integrate multidisciplinary perspectives. An initial set of intervention components was developed based on the systematic literature review and semi-structured interviews with 10 frontline practitioners. This was followed by two iterative evaluation rounds involving a purposive panel of 20 experts in psychiatry, clinical psychology and education, all situated within the context of the high-pressure educational system in central China. Consensus was quantified using the expert positivity coefficient, authority coefficient (Cr) and Kendall's coefficient of concordance (W), with refinements guided by the principles of clinical safety, cognitive adaptation and ethical boundaries.

Both consultation rounds achieved a 100% response rate, yielding a high expert authority coefficient (Cr = 0.90). The consensus trajectory showed improvement, with Kendall's W increasing from 0.211 to 0.251 (P < 0.001) and all final-round coefficients of variation (CV) falling below the 0.25 threshold. Key qualitative modifications included the exclusion of competitive tasks to mitigate acute rejection sensitivity and the reframing of the Miracle Question into the Small Change Hypothesis to accommodate the diminished cognitive processing speed characteristic of depressive states. The final protocol comprises eight functional units structured to foster interpersonal resilience.

The developed SFGT program demonstrates preliminary content validity and theoretical plausibility. The protocol is hypothesized to activate therapeutic factors such as universality and corrective emotional experiences, which may contribute to reducing learned helplessness and mitigating social stigma among adolescents in the Chinese cultural context. However, empirical validation of these hypothesized mechanisms-including clinical efficacy, dose-response relationships, and long-term interpersonal outcomes-requires rigorous testing through multi-center randomized controlled trials and implementation studies.