Research > School-Based Intervention Study
Teaching Middle-School Youth Coping Skills for Depression: A School-Based Intervention Study
Funded by the National Institute of Mental Health
Network Director: John R. Weisz, PhD, ABPP
Project Directors: Ana M. Ugueto, Ph.D., Sarah Kate
Bearman, PhD, Jane Gray, PhD, and Alisha Alleyne, Ph.D.
About the Network Director
John
Weisz is President and CEO of the Judge Baker Children’s Center. Previously,
he was Professor in the Departments of Psychology and Psychiatry and Biobehavioral
Sciences at the University of California at Los Angeles, where he served
for a term as Director of the Graduate Program in Clinical Psychology and
Director of the Psychology Clinic. He studied at Yale University, where
he received a PhD in clinical and developmental psychology. His written
work includes books and articles focused primarily on youth problem behavior
and disorders, cultural factors in development and dysfunction, and psychotherapy
for children and adolescents.
Project Description
Youth depression is a serious condition that causes genuine impairment and is an archenemy of school performance. It undermines concentration on classwork, saps the energy and motivation needed to do homework, causes significant school absenteeism, and threatens the social connections boys and girls need for emotional well-being. Rates of depression increase sharply following puberty, highlighting the public health significance of treatment in early adolescence. Thus, the middle school years may be an ideal time to help boys and girls build coping skills to ward off depression.
Our long-term goal is to develop and refine treatment for youth depression that is effective and deployable in a variety of youth settings. Here we focus on the setting in which evidence suggests that depression may be most likely to be detected and in which a great deal of everyday youth mental health care occurs: the school. Efforts to disseminate empirically supported cognitive behavioral therapies (CBTs) to schools have not been very successful to date, perhaps for at least 2 reasons:
- the design of most CBT programs may make them difficult for school counseling personnel to learn and use, and the design of most programs places a heavy burden on the counselors in terms of preparation and engagement of children., and
- CBT programs have not yet been shown to outperform current school-based interventions, so there is not yet a compelling logical case for change. In this project, we address both potential problems.
To address the user appeal issue, we have drawn from the literature on robust design to restructure our own CBT program--Primary and Secondary Control Enhancement Training (PASCET) as a video-guided treatment program. The program is designed to be efficient and engaging; it teaches coping skills through the use of videotaped vignettes and group discussion. Through the tapes, youngsters learn nine coping skills that can be used to gain control of their mood when stressful events make them feel sad or upset. A multicultural group of young actors in the videos illustrate the use of these skills in situations involving school, family, and peer stressors. In each group session, co-leaders play video clips and pause periodically to lead group discussion. The full program is organized into twelve 90-minute group meetings.
To address the case for change issue, we are carrying out a trial of our video-guided treatment with a commonly used school-based treatment approach as the comparison condition. That comparison condition is a counselor-led program, designed by the counselors to reflect their usual ways of working with depressed youths in their school. We provide funding to the counselors for the time and materials they need to prepare their group program, and for them to pay an expert clinical consultant to assist them in this process.
In this clinical trial, 6th and 7th graders who show significant levels of depressive symptoms and those who meet criteria for a depressive disorder are randomly assigned to the two conditions (PASCET or Counselor Intervention), matched for group format and treatment dose. All treatment takes place in the middle schools. We assess levels of depression and other outcomes immediately after the end of treatment, and again at a one-year follow-up, to assess the long-term holding power of the effects. The project was located in Los Angeles and Santa Monica, California, during the 2003-4 and 2004-5 school years. Beginning in the 2005-6 school year, the project will be carried out concurrently in Los Angeles and in Boston, with middle schools in both cities participating.
At the end of the project, we will offer the staff in each participating school the full videotape series for the PASCET program, so that the program can be continued even after the project has ended.
