EARLY INTERVENTIONS FOR ANXIOUS YOUTHS
Anxiety disorders are among the most prevalent mental health problems in adolescents. It is essential for anxious youths, his/her family, as well as for society that anxiety problems are treated at an early stage to avoid the risk of developing chronic anxiety disorders, other psychological disorders (e.g. substance abuse or depression), school drop-outs, or future disability benefits. The majority of youths with anxiety problems, are not in contact with mental health services and do not receive effective help. We need to offer young people easily available, effective help in their everyday context. The school health service is a low-threshold service for young people. School health nurses, however, are generally not trained in evidence based interventions for youth anxiety, and furthermore have limited access to evidence based programs. The present project evaluates the effect of two low-threshold schoolbased group-interventions for adolescents (12-16 years) with anxiety symptoms. The programs are administered in groups of 6-8 adolescents at the schools and with school health nurses as group leaders. At some Schools the groups have been conducted in collaboration with community psychologists or representatives from specialist health care services. Both interventions are based on cognitive behavioural theory (CBT), but differ in scope and intensity. The interventions are compared to a waitlist control group. The first intervention is a standard, program that has previously been evaluated internationally (CHILLED), while the other is a new, shorter, low-intensity program, based on self-help material (VÅG). Both programs aim to ameliorate symptoms of anxiety and to increase the quality of life for the participants. Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health (RKBU vest) is running the study in collaboration with researchers at Sørlandet Hospital and Modum Bad. Nine municipalities, comprising nineteen secondary schools, in Western, Southern and Eastern Norway participate in the study. The school nurses receive training and supervision from experienced CBT therapists. In addition to evaluating the two low-threshold interventions, a survey has been conducted among adolescents and parents at the 19 participating schools, to learn more about anxiety and correlates of anxiety in general among Norwegian youths. Hopefully the study will contribute to the implementation of effective low-threshold interventions for anxious youths in primary health services. Results from the study will be published in internationally journals and communicated through different Norwegian channels of dissemination.
Anxiety and depression are among our major mental health problems, with regard to prevalence and long-term economic consequences. Youth internalizing problems are associated with decreased levels of functioning. However, the majority of youth with these p roblems do not recieve help from mental health services. Developing effective low intensity, easily available, early intervention programs targeting youth with internalizing problems are considered to be of value for the youth themselves, their families a nd society. In this multisite RCT-study a newly developed low-intensity cognitive behavioural treatment (CBT) Psykologisk Førstehjelp (PF) will be compared to an established CBT early intervention program and a waitlist-control group (WLC). The interventi ons will be delivered by school nurses/primary health workers. Anxious youth (13-16 years)with or without depressive symptoms will be randomized to three conditions; PF, standard CBT and WLC. The interventions aim towards symptom-relief and increased qual ity of life. Assessments will be made prior to the interventions,during and after the interventions, and one year follow-up. PF and standard CBT will be delivered at schools. Adolescents will be recruited through their contact with the school nurses or by self-recruitment. The study is targeting the question whether low-intensity CBT is as effective as a standard, more extensive CBT program, and better than no-intervention. Furthermore we need to know what works for whom, comparing low versus high-intensi ty CBT. All students in the included schools will be assessed with regard to internalizing problems and life quality one year apart, in order to evaluate the long-term effects of CBT with the natural course of internalizing problems in youth. The study is a collaboration between researchers at RKBU/Uni Health/Uni Research, Modum Bad, ABUP/Sørlandet Sykehus and University of Agder.