Reducing Barriers to Evidence-Based Services: A High School-University Partnership to Adapt the Unified Protocol for...

Rates of depression and anxiety in adolescents are rising and access to effective treatment remains limited. Public schools are instrumental in reducing barriers to treatment.

The present study describes a community-engaged approach to the adaptation and open trial of The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al. 2018) delivered as a group-based intervention in a Chicago Public High School among predominantly low-income Black and Latine adolescents experiencing elevated depression symptoms (i.e. "Healthy Minds, Happy Lives program;" HMHL).

This study utilized qualitative and quantitative analyses to evaluate: (1) the systematic adaptation process that aimed to balance fidelity (to the original UP-A intervention) and flexibility (e.g. the school-based group delivery, and community partner input), (2) the initial feasibility and acceptability of the HMHL intervention by analyzing salient themes from focus groups, and (3) pre- to post-intervention changes in symptoms, in order to inform intervention refinement and methodological considerations for a pilot clinical trial. Our adaptation process utilized the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions and relied on the engagement of key school-staff partners (N = 8) and student-trial participants with elevated depression symptoms (N = 16). Focus group content was coded and thematically analyzed. Outcome trends were evaluated using reliable change indices.

Preliminary feasibility was promising, with participants attending an average of 7 out of 8 hMHL sessions and retention was excellent with 100% of participants completing the program. Additionally, most trial participants demonstrated a clinically meaningful reduction in depression symptoms and increased emotional state awareness following the intervention.

HMHL may be a feasible and acceptable intervention for increasing access to care for youth who may otherwise not have access to evidence-based services. Recommendations are provided for enhancing both the content and delivery of the intervention.