LARS&LISA: a universal school-based cognitive-behavioral program to prevent adolescent depression

Adolescent depression is a prevailing international mental health concern as up to 27% of adolescents experience either subsyndromal depression or a major depressive episode by the age of 18. Depression in adolescence has been found to negatively impact current and future academic achievement, functioning, mental health, and quality of life. Accordingly, the authors emphasize the importance of proactively preventing depression (and its negative outcomes) instead of waiting and having to "fix" the problems after they have already developed. The current article begins with a discussion of the various types of prevention, including their respective advantages and disadvantages. Further and more importantly, the article's primary focus is to provide a summary of the theoretical basis, development of, empirical support for, and content of a universal school-based cognitive-behavioral program to prevent adolescent depression entitled LARS&LISA (Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag). As the program exists within the overlapping realms of universal prevention, school-based programs, and cognitive-behavioral interventions, the content of this article is relevant to all three areas and offers insight into the development of depression prevention in general. Finally, empirical support for the positive effects of the program is presented and some ideas for further research are discussed.

The Prevention of Mental Disorders has a Bright Future

This article takes four looks at the status of prevention in psychiatry. The first glance is critical, shaped by disappointment at the slow progress in the understanding of psychiatric diseases and the lack of promise in prevention. The second look is less humble. It characterizes and acknowledges the efforts made so far. The third and the fourth perspectives optimistically announce a new age in research and prevention. Breakthroughs, whose contours are already appearing on the horizon today, will transform the prevention of psychiatric diseases into a success story within the next 10–15 years.

Teachers or psychologists: who should facilitate depression prevention programs in schools?

The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls’ depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects.

Indizierte Prävention internalisierender Störungen

Die vorliegende Studie überprüft die Wirksamkeit eines kognitiv-verhaltenstherapeutischen Präventionsprogramms für Kinder mit internalisierenden Symptomen. Eine modifizierte Version der deutschen Bearbeitung des australischen Programms FRIENDS wurde im indizierten Präventionskontext angewendet und unter Verwendung eines Wartelistendesigns mit Eigenkontrollgruppe evaluiert. 81 Kinder (42 Jungen, 39 Mädchen) im Alter von acht bis 12 Jahren nahmen teil. Sowohl das Elternurteil (CBCL), als auch das Selbsturteil der Kinder (SCAS, DIKJ) wurden zur Wirksamkeitsüberprüfung herangezogen. Die Datenerhebungen erfolgten zu drei Zeitpunkten (drei Monate vor Beginn sowie unmittelbar vor und nach der Intervention). Die Ergebnisse sprechen für die Effektivität des Programms; die internalisierenden Symptome der Kinder reduzierten sich während der Intervention signifikant stärker als während der Wartezeit. Mittlere Effektstärken zeigten sich sowohl aus Elternsicht (d = .72), als auch aus Kindersicht (d = .55).

Promoting adaptive emotion regulation and coping in adolescence: a school-based programme

Particularly in adolescence, fostering adaptive emotion regulation is an important aim in health promotion. Expressive writing in combination with psycho-education on emotion regulation seems especially appropriate to serve this aim. In this study, school classes were randomly assigned either to a prevention (N = 208) or to a non-treatment control group (N = 151). The prevention group showed significant improvements regarding negative affect, grades, and days absent compared to the control-group. A combination of expressive writing with elements of psycho-education of emotion regulation might be an effective preventive tool, as it seems to improve psychosocial adjustment by establishing functional emotion regulation strategies.