Study supported by Anna Freud reveals day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

New research supported by Anna Freud and led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that providing 16-18 year olds with a day-long course in Cognitive Behavioral Therapy (CBT) was both a clinically and cost-effective means of improving their mental health. 

The trial, known as Brief Educational workshops in Secondary Schools Trial (BESST) and published in The Lancet Psychiatry, was successfully adapted from the DISCOVER program, which was designed to help adults manage their feelings of stress. The study has been funded by the National Institute for Health and Care Research (NIHR).  

Around one in 12 young people in England currently experience anxiety or depression¹. Despite this, the large majority remain untreated, and almost a quarter (24%) have no contact with specialist Child and Adolescent Mental Health Services (CAMHS)^2.   

This study recruited 900 students from 57 schools in England. Half were provided with signposting to mental health services and the standard care their school would usually provide. The other half were invited to a day-long workshop on CBT coping techniques for managing mood, anxiety, and stress, and provided with follow up phone calls to help incorporate those skills into real-life situations.   

Researchers found that participants who attended the workshop showed significant improvements in their depression, anxiety, wellbeing and resilience after a six-month follow up.    

Dr June Brown, Associate Professor in Clinical Psychology at King’s IoPPN and the study’s lead author said: 

“More than half of adult mental disorders start before the age of 15³, and when we approached schools, we found that there was overwhelming number of young people actively seeking support. There is clearly an urgent need for early intervention to ensure that symptoms of poor mental health don’t persist and worsen. Our study set out to establish if there was a clinically and cost-effective way to do that at scale.   

“One of our main challenges was to adapt an adult therapeutic intervention which would be attractive and engaging for teenagers. In addition, previous studies have either been aimed at all students, some of whom aren’t necessarily in need of assistance, while others have taken a more targeted approach that potentially stigmatises those who might need support. Giving students the opportunity to self-refer means that we work with students who recognise that they’d like help.  

“Our study shows that this intervention can be delivered at low cost by mental health professionals who can bridge the gap between schools and CAMHS.”  

Professor Ben Carter, Professor of Medical Statistics at King’s IoPPN and the study’s senior author said: 

“Since the pandemic there is an increased need to support schools and adolescents with their mental health. While we found improvements in depression; anxiety; wellbeing; and resilience, the largest effect was seen in those students that had higher symptoms of depression at the start of the study, meaning that we reached and improved those students most vulnerable to depression.  

“The ultimate success of this has laid the groundwork for these workshops to be rolled out nationwide to provide an early intervention against depression and anxiety.”  

The trial was supported by Anna Freud researchers including Professor Jess Deighton, Director of Applied Research and Evaluation and Professor in Child Mental Health and Wellbeing at UCL, who led study’s North West site. She said:  

“This research underscores the importance of early mental health interventions for young people, particularly for those already showing signs of experiencing problems. The trial gave cohorts of young people access to a CBT workshop that took just day but offered long-term benefits, providing many with valuable tools to better manage their own mental wellbeing.  

"Prevention and early intervention should be the cornerstone of mental health care for children and young people, and we look forward to seeing this approach rolled out more widely across the UK.”  

Karen Crowe, Senior Tutor for the Sixth Form & Curriculum Leader for Psychology at St Nicholas Catholic High School in Cheshire said: 

“Our school seeks to prioritise mental wellbeing and promote strategies that improve students’ mental health.  We believe it is important to teach students how to become self-regulating individuals who can manage their own stress, which is why the school fully supported the BESST trial.  We value techniques that provide students with skills to resolve problems, cope better with expectations, and build confidence, so the trial’s aims perfectly complement our school’s mission and ethos.”  

Olivia Black, a student at St Nicholas Catholic High School who took part in the BESST trial, said: 

“The study gave me new ways to manage my stress and remain productive during my studies. It was such a helpful process that allowed me to develop my personal strategies for maintaining good mental health.  The skills and confidence gained from this trial motivated me to help start up our 'breathing space' initiative where sixth formers support younger students with their mental health.”  

Find out more  

Anna Freud is a mental health charity and we’ve been supporting children and young people for over 70 years. 

Through our Thinking Differently manifesto we’re asking political parties, policy makers and funders to close the gap in children and young people’s mental health through a renewed focus on prevention and early intervention.  

We believe schools have an important part to play in this by embedding a whole-school approach to mental health and wellbeing – read James’ story on why this matters.