Coping Kids: a randomized controlled study of a new indicated preventive intervention for children with symptoms of anxiety and depression

The primary aim of the Coping Kids study was to examine if a new group and school based program, Coping Kids, is more effective than treatment as usual (TAU) in reducing high levels of symptoms of both anxiety and depression among 8-12 year old schoolchildren, and further examine relevant variables for the implementation of the intervention. 266 children have received the intervention Coping Kids, with 428 children at post-test in the control group (total 36 schools). The response rate for children and teachers was close to 100%. The response rate for parents, where at least one parent has provided data for the participating children, was 75%. The results revealed significant reductions of anxious and depressive symptoms as reported by the children, where children in the intervention condition had almost twice the reduction in symptoms compared to the control condition. Parents reported in general lower symptom levels than did the children, however parents also reported significant decrease in child depressive symptoms. Various municipal services have expressed great interest in the intervention and the assessment tools we used. Concurrently, four PhD students connected to the project are producing publications of study results together with researchers and supervisors from UiO, NTNU, UiT, RBUP East and South, RKBU central and RKBU north.

Prosjektet har vist en rekke positive effekter. For eksempel har kompetansen i forskningsbaserte tiltak til forebygging og behandling av angst og depresjon økt hos deltakende tjenester. I tillegg har et stort antall fagpersoner utenfor forskningsstudiet deltatt i opplæringen. Vedvarende tilgjengeligheten av intervensjonen gjør det mulig at førstelinje tjenester også etter studiens slutt kan fortsette å anvende intervensjonen. I noen tjenester førte prosjektet til en vedvarende forandring av deres praksis og en politisk forankring av forebyggende arbeid og bruk av intervensjonen i kommunalpolitisk vedtak. Samtidig ble det gjennom prosjektarbeidet initiert eller styrket samarbeid mellom forskjellige tjenester, kunnskapssentrene i prosjektet samt relevante forskningsmiljø i USA. Prosjektet hadde stor betydning for de deltakende tjenester. Mange fikk for første gang opplæring og veiledning i mer avanserte forskningsbaserte intervensjoner og mange familier og barn fikk tilgang til disse.

Background: High levels of anxiety and depression are common psychological symptoms among children and adolescents that often affect them negatively in multiple life domains, and are possible precursors of disorders. Despite high prevalence rates, relati vely few children with emotional problems are referred for treatment, indicating the need for preventive approaches. Aims: Evaluation of a new indicated preventive program in schools: Coping Kids, to reduce high levels of anxiety and depressive symptoms among children aged 8 to 10 years. The program is based on empirically supported treatments, The Coping Cat program and the ACTION program, and developed in collaboration with the program owners. Methods: This is a clustered randomized controlled trial . The unit of allocation is 23 schools which are assigned to one of two conditions; The group cognitive behavioral intervention Coping Kids or Treatment as usual (TAU). Assessments will be undertaken at base-line, post treatment, using self-reports questi onnaires for the children (n = 559), and reports on children by parents and teachers. The participants will be reassessed 12 months after the intervention. The primary outcome will be changes in depressive symptoms as measured by MFQ and anxiety symptoms by MASC. Secondary outcomes will be changes in self-esteem, Life Quality, school and daily functioning. Ethnicity and gender will be studied as moderating factors. Collaboration: Active collaboration is established nationally between the three regional c enters in Norway responsible for work with children and adolescents: RKBU-North, RKBU-Mid, and RBUP South and East and with schools/municipalitites in these regions. Internationally P. Kendall and K. Stark will be actively involved in the study. Conclus ion: This research aims to evaluate a preventive program in school children with high levels of anxiety and depressive symptoms; early intervention with these children will have important public health implications