Teens can gain long-term mental health benefits from CBT
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A one-day school workshop based on cognitive behavioral therapy (CBT) produced modest improvements in teens' mood and stress levels for at least six months, a trial found.
The results contrast with several other recent trials of school-based mental health interventions, which found children's well-being was slightly worse.
Over the past decade, CBT has become one of the most common types of talk therapy offered to people with depression and anxiety. Unlike more open-ended types of talking therapy, such as psychoanalysis, CBT encourages people to change unhelpful patterns of thinking and behavior, such as focusing on upsetting events or avoiding social situations. It is configured for the purpose of
CBT also has the most supporting evidence from randomized trials in adults with depression, anxiety, and other mental health problems. Participants typically see a therapist for one hour a week for two to three months.
The latest trial was designed to assess whether the one-day course is effective for teenagers, in this case 16 to 18 years old. This workshop was offered to students who felt they were experiencing stress, worry, or low mood.
Three therapists delivered the course to a group of 16 students. It included teaching about CBT and relaxation and mindfulness techniques (short meditation practices), and providing practical tips on time management and getting enough sleep.
Across 57 schools in England, 900 students were randomly selected to attend one of the workshops or access existing mental health systems, including referrals to health services.
After the workshop, students were allowed to make up to three additional phone calls with their therapist for support.
People who took part in the workshop had just over 2 points less in depressive symptoms out of 67 compared to the control group, but this was classified as a small effect.
However, among the one-third of participants who originally had the highest depression scores, those who attended the workshop experienced an average decrease in symptoms of about 4 points, which would be classified as a moderate impact. Ben Carter of King's College London said. . “The results were much better than expected.”
The workshop also led to small improvements on tests of anxiety and well-being across the group. The test lasted for at least 6 months.
June Brown, another member of the Kings team, says there may be several reasons why this format may be more beneficial than other mental health interventions in schools. Some previous plans, like the current trial, have involved teachers teaching entire classes about mindfulness, rather than using therapists and focusing on the teens who are actually having problems. Some offered training, she said. Mindfulness also has less supporting evidence than CBT for its use in adults.
Jack Andrews from the University of Oxford said the findings were welcome. “The trial was very well designed,” he says. “These results are very promising.”
The therapists running the workshops are part of a new initiative launched in 2018 to bring mental health professionals to work within English schools. They are currently working in schools that teach around a third of pupils in England and will eventually be rolled out to all schools.
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