Extrait

Background and study aims Adolescence is an important time for mental health prevention and treatment, with one in nine adolescents having a mental disorder. However, less than a quarter of young people in the UK are in touch with mental health services. Common obstacles for those who do not seek help range from inconvenient appointment times to fear of stigmatisation. Even if adolescents do reach services, they are unlikely to access cognitive behavioural therapy (CBT) treatment, a proven therapy that helps people to change how they think and behave. CBT workshops have been developed for delivery in schools, targeting anxiety and depression in 16 – 18 year olds. The workshops are based on ‘Wellbeing Workshops’ for adults, developed by Brown and colleagues. These workshops are delivered in a one-off, day-long group format based on CBT principles and methods. The adult workshops have been successfully delivered in local community settings with evidence suggesting relatively high rates of uptake among traditionally hard-to-reach groups and improvement in depression and anxiety. A recent study has also provided evidence for how possible it is to run CBT workshops in schools for 16-18 year olds and the potential impact of being able to do so. We want to test the possibility of running a full trial of the school-based workshops. We will work in 10 schools to see if we can develop appropriate measures to show how well they work, whether they are acceptable to the children and whether they are value for money. We will also explore whether teachers and students can work with us on a potentially complex research study. Who can participate? Young people aged between 16 and 18, attending a recruited school or college in Southwark or Lambeth, who are fluent in English, are able to attend the workshops and would like psychological help for managing emotional difficulties. What does the study involve? Schools participating in the trial are randomly allocated into one of two groups, an experimental group or a waitlist group. Between 12-15 children from each school are recruited into the study. Those children that attend one of the schools in the experimental group attend a day-long ‘How to Handle Stress’ workshop straight away. Those children attending a school in the waitlist group attend the workshop three months later. Assessments are made of all the children in both schools before the study begins. Those children in the experimental group are then interviewed three months later and asked about their experiences of the workshop, what they got out of it, whether they felt any stigmatisation and what they thought of participating in a research project. Those students in the waitlist attend the same interview three months after they have attended their own workshop. All students are also invited to attend a focus group 6 months later. What are the possible benefits and risks of participating? The 'How to Handle Stress' workshops are adapted from the adult 'Wellbeing' workshops, which has been proven to alleviate anxiety and depression. In the pilot study, the workshops for adolescents were found to be an effective intervention, whereby students reported significantly reduced depression and anxiety and were very satisfied with the workshops. The ‘How to Handle Stress’ workshops are based on theory and principles from cognitive behavioural therapy, which has increasing evidence to support its effectiveness with adolescents for anxiety and depression. The theory and strategies provided aim to provide the 16-18 year olds with the ability to build resilience to stress and build their capacity to resolve problems. There are few risks or burdens anticipated for participants. We work in close partnership with schools in order to allow students day release from classes in order to attend the South London and Maudsley NHS Foundation trust (SLaM) provided workshop intervention. Workshops are not run during exam periods, in order to reduce potentially stressful timetable clashes. It may be that some students with literacy problems find it difficult and potentially stressful to complete the self-report questionnaires throughout the study. A research worker is available in order to assist with the completion of these forms and explain any problematic terms. Students who remain troubled and wish for further mental health support over the course of the research project receive clear and accurate information regarding accessing local services. The research team also make direct referrals to the adolescent mental health teams in Southwark and Lambeth if this help is required. Young people may also experience some stress if they feel stigmatised by expressing an interest in and/or attending the workshops. Several methods have been employed in order to reduce potential stigma. Although the workshop intervention is provided by SLaM and comprises of CBT techniques targeting anxiety and depression, the workshops are entitled 'How to Handle Stress' in order to normalise the experience and the content of the workshop aims to normalise stress. Participants are reassured that what is said in the workshops is kept confidential. Teachers are advised on how to discuss the possibility of enrolling for the workshops with students sensitively. Finally, the open access approach, compared to a targeted approach also helps to avoid students feeling stigmatised, as it avoids only those being assessed as the most distressed being targeted. Where is the study run from? King's College London (UK) When is the study starting and how long is it expected to run for? October 2014 to June 2016 Who is funding the study? National Institute for Health Research (UK) Who is the main contact? Dr June Brown

Critère d'inclusion

• Topic: Mental Health; Subtopic: Anxiety, Depression; Disease: Depression, Anxiety

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