School-based cognitive-behavioural interventions: A systematic review of effects and inequalities

Josephine Kavanagh
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Sandy Oliver
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Theo Lorenc
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Jennifer Caird
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Helen Tucker
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Angela Harden
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Adele Greaves
Social Science Research Unit, Institute of Education, University of London, United Kingdom

James Thomas
Social Science Research Unit, Institute of Education, University of London, United Kingdom

Ann Oakley
Social Science Research Unit, Institute of Education, University of London, United Kingdom

PP: 61 - 78

Abstract

Little is known about the impact of preventive interventions on inequalities in young people's mental health. We conducted a systematic review of mental health promotion interventions based on cognitive behavioural therapy (CBT) delivered in schools to young people aged 11-19.

Meta-analysis of 17 high quality randomised controlled trials (RCTs) showed a reduction in symptoms of depression, which was generally short term. Interventions for people with clinical risk factors or existing symptoms were more effective, with benefits lasting up to six months. We also found that CBT may be more effective for young people from families with middle to high socioeconomic status (SES) than for those from low SES backgrounds. However, this finding was based on a meta-regression with only six studies.

A lack of long-term follow-up data and a failure to report subgroup analyses prevented further conclusions being drawn about the effect of these types of interventions on mental health inequalities.

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Keywords

sociology, health inequalities, mental health, young people, systematic review, research methods


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