Long-term Results from the Empowering a Multimodal Pathway Toward Healthy Youth Program, a Multimodal School-Based Approach, Show Marked Reductions in Suicidality, Depression, and Anxiety in 6,227 Students in Grades 6-12 (Aged 11-18) (original) (raw)
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PLOS ONE, 2015
We describe initial pilot findings from a novel school-based approach to reduce youth depression and suicidality, the Empowering a Multimodal Pathway Towards Healthy Youth (EMPA-THY) program. Here we present the findings from the pilot cohort of 3,244 youth aged 11-18 (Grades 6-12). They were screened for depression, suicidality, anxiety, use of drugs, alcohol, or tobacco (DAT), quality-of-life, and self-esteem. Additionally, all students in Grades 7 and 8 (mean ages 12.3 and 13.3 respectively) also received an 8-session cognitive-behavioural therapy (CBT) based program designed to increase resiliency to depression. Following screening there were rapid interventions for the 125 students (3.9%) who were identified as being actively suicidal, as well as for another 378 students (11.7%) who were felt to be at higher-risk of self-harm based on a combination of scores from all the scales. The intervention consisted of an interview with the student and their family followed by offering a guided internet-based CBT program. Results from the 2,790 students who completed scales at both baseline and 12-week follow-up showed significant decreases in depression and suicidality. Importantly, there was a marked decrease in the number of students who were actively suicidal (from n=125 at baseline to n=30 at 12-weeks). Of the 503 students offered the CBT program 163 (32%) took part, and this group had significantly lower depression scores compared to those who didn't take part. There were no improvements in self-esteem, qualityof-life, or the number of students using DAT. Only 60 students (2% of total screened) required external referral during the 24-weeks following study initiation. These results suggest that a multimodal school-based program may provide an effective and pragmatic approach to help reduce youth depression and suicidality. Further research is required to determine longerterm efficacy, reproducibility, and key program elements.
Cognitive Behavioural Therapy Approach on Adolescent Social and Emotional Well-being and Resilience, 2023
People with strong cognitive skills and resources will likely develop into autonomous, productive citizens in a rapidly changing world. Unfortunately, children's mental health issues have increased dramatically due to the global mental health crisis. Researchers must look at more essential and consequential approaches to building mental health literacy to assist with resilience and social and emotional learning development. Therefore, this study's Cognitive Behavioural Therapy (CBT) intervention aims to help build mental health education and understanding and provide techniques and coping skills to manage adolescent mental health struggles. CBT can reduce stigma and improve social and emotional learning (SEL) and resilience (Klim-Conforti et al., 2022). The SEL and resilience competencies were measured for this study using the Emotion Awareness Questionnaire-Revised or EAQ-R (Rieffe et al., 2008) and the Child and Youth Resilience Measure-Revised or CYRM-R (Jefferies et al., 2018). The results indicated a 30% increase in their total SEL scores and a 13% increase in their resilience scores at the end of the Cognitive Behavioural Therapy intervention. The findings add to the accumulating empirical evidence about the favourable impact of SEL programs. Students who get instruction in social and emotional competencies and resilience show improved resilience and increased awareness of differentiating emotions. These improved competencies result in differentiating feelings between sadness, anger, fear or sometimes unawareness of their feelings and how to process them healthily and react accordingly. Integrating evidence-based SEL programming into standard educational practice is one method policymakers and educators may assist in the development of mentally healthier children. Adolescents exhibiting these qualities are likelier to succeed in their future occupations, health, and overall well-being (Durlack et al., 2011). 3 Literature Review The compelling inspiration for this study is the increasing number of adolescents facing various emotional and mental health challenges that negatively impact their lives. According to the Centre for Addiction and Mental Health (CAMH), seventy percent of children and adolescents experience mental health issues (CAMH, 2022). As a result, mental health has become a significant concern for adolescents. CAMH (2022) statistics indicate that adolescents between 15 and 24 years are further prone to encounter mental illness, substance use disorders, self-harm, and impulse control issues than any other age group. The World Health Organization (WHO, 2021) reports that 14% of mental health conditions worldwide are attributed to 10-19-year-old adolescents, with depression, anxiety, and other mental health and behavioural disorders, among the primary causes of impairment in young people. In addition, 1 in 3 adolescents will experience an anxiety disorder over their lifespan (O'Connor et al., 2020). Mental health issues are the most significant reason adolescents drop out of school or struggle to obtain an education (Klim-Conforti et al., 2022). Furthermore, 70% to 80% of cases of mental health disorders in adolescents go undiagnosed. (Mei et al., 2020). Adolescents are experiencing sadness, hopelessness, or suicidal thoughts resulting from unrealistic societal expectations such as social media comparison, educational or career expectations or a lack of mental health knowledge. Consequently, after accidents, the second leading cause of death was suicide among 10 to 14-year-olds in 2018 (CAMH, 2022). Furthermore, due to the Covid-19 pandemic, the rates of adolescent mental illness have increased dramatically (Elharake et al., 2021). Adolescents spent months in seclusion during the Covid-19 quarantine, during which they were physically separated from their friends, family, and teachers. (Yurt, 2018). Students who did not possess adequate technology for virtual learning and staying in touch with friends and family faced increased isolation, boredom, and frustration, putting them on a path to experience further mental and physical health issues as adults (Elharake et al., 2021). Denean (2019) remarked that 70 years of mental health neglect for children, in addition to all these issues, led to the
Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality
Child and Adolescent Psychiatric Clinics of North America, 2011
Depression is one of the most common reasons adolescents seek treatment. Although there are several treatment options available, cognitive-behavioral therapy (CBT) has been the most widely researched psychotherapy approach for treating depression in adolescents. Among depressed adolescents, it is common for these youths to experience suicidal thoughts or engage in suicidal behaviors. Although it is evident that such symptoms require psychological treatment, there is some debate about the best means of targeting these distressing thoughts and behaviors. Some clinical researchers have postulated that if the underlying depressive disorder is treated adequately, suicidal ideation and behavior will remit along with the disorder. However, there has been some evidence with adults 1 that suggests this is not the case. That is, suicidal thoughts and behavior need to be directly addressed if these problems are to improve. This article first reviews the rationale underlying the use of CBT for the treatment of depression and suicidality (defined as suicidal thoughts and suicide attempts) in adolescents. The literature supporting the efficacy of CBT for depressed adolescents is then briefly reviewed. Because there are many excellent recent reviews of the efficacy of CBT for adolescent depression (see later discussion), the review of the depression literature is brief. Instead, the article focuses primarily on whether
Evidence-Based Interventions for Youth Suicide Risk
Current Psychiatry Reports, 2020
Purpose of Review To review and discuss recent advances in evidence-based interventions (EBIs) for youth suicide risk. Recent Findings There is a growing body of research on the effectiveness of interventions targeting suicidal ideation and behavior among adolescents. Dialectical Behavioral Therapy-Adolescent has shown effectiveness across two independent randomized controlled trials (RCTs). Several other interventions have shown effectiveness in only one trial and are in need of replication. New interventions are also being developed that incorporate developments in technology and adaptive intervention designs. It is recommended that future research focus on strategies for engaging underserved youth with interventions, consider the broader needs of youth living in poverty, and further tailor interventions to subgroups with distinct risk profiles. Limited EBIs exist for preadolescents, despite evidence for an increasing rate of suicidal behavior for these youth. Summary Several interventions for youth suicide risk are highly promising, but further investigation is necessary. EBIs that are effective for preadolescents are needed, and greater efforts to tailor interventions for distinct subgroups of youth at risk are recommended.
Cognitive Behavioral Therapy for Depressed Suicidal Adolescents (CBT--TASA)
PsycEXTRA Dataset
Adolescent major depressive disorder (MDD) is a highly prevalent, incapacitating and costly illness. Many depressed teens do not improve with cognitive behavioral therapy (CBT), a first-line treatment for adolescent MDD, and face devastating consequences of increased risk of suicide and many negative health outcomes. "Who will improve with CBT?" is a crucial question that remains unanswered, and treatment planning for adolescent depression remains biologically unguided. The purpose of this study was to utilize machine learning applied to patients' brain imaging data in order to help predict depressive symptom reduction with CBT. Methods: We applied supervised machine learning to diffusion MRI-based structural connectome data in order to predict symptom reduction in 30 depressed adolescents after three months of CBT. A set of 21 attributes was chosen, including the baseline depression score, age, gender, two global network properties, and node strengths of brain regions previously implicated in depression. The practical and robust J48 pruned tree classifier was utilized with a 10-fold cross-validation. Results: The classification resulted in an 83% accuracy of predicting depressive symptom reduction. The resulting tree of size seven with only three attributes highlights the role of the right thalamus in predicting depressive symptom reduction with CBT. Additional analysis showed a significant negative correlation between the change in the depressive symptoms and the node strength of the right thalamus. Conclusions: Our results demonstrate that a machine learning algorithm that exclusively uses structural connectome data and the baseline depression score can predict with a high accuracy depressive symptom reduction in adolescent MDD with CBT. This knowledge can help improve treatment planning for adolescent depression.
Suicide Interventions Targeted toward At-Risk Youth
Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves as a qualitative review of existing interventions for adolescent suicide. Long-term outcome data on existing programs are relatively scarce. However, promising current interventions include strategies to help youth tolerate intense negative affect and maintain emotional regulation. Individual psychotherapy for suicide prone youth is often conducted in conjunction with pharmacological treatments. Other noteworthy suicide interventions address the family dynamics surrounding suicidal youth, often by including the family in treatment. Interventions that increase the adolescent's motivation for treatment and likelihood of treatment compliance are also under current investigation. Modes of delivery for suicide interventions may also be changing with the inclusion of technology in service access and provision. Essential elements of effective suicide prevention programs and concerns with existing suicide-related interventions are also summarized.
A Wrap Around Approach to Suicide Prevention in Schools: It’s not just School Counselors…
Teaching and supervision in counseling, 2022
Suicide prevention is an important issue for K-12 education. A recent report issued by the Office of the Surgeon General (2021) highlights the significant mental health challenges that children and adolescents face. Prior to the COVID-19 pandemic, nearly 20% of U.S. children between the ages of 3 and 17 had some type of mental, emotional, developmental, or behavioral disorder. At the high school level, the number of students reporting feelings of sadness or hopelessness increased by 40% between 2009 and 2019. The COVID-19 pandemic has further exacerbated these mental health issues.