Taylor John A, Phillips Rhiannon, Cook Ellen, Georgiou Lucy, Stallard Paul, Sayal Kapil
Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK.
Wales School for Primary Care Research, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, 5th Floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
Int J Environ Res Public Health. 2014 Jun 5;11(6):5951-69. doi: 10.3390/ijerph110605951.
Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030) randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628). The views of young people (n = 42), teachers (n = 12) and facilitators (n = 16) involved in the Resourceful Adolescent Programme (RAP) were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing.
小规模试验表明，针对青少年的课堂认知行为疗法（CBT）覆盖面广，有助于预防抑郁症。然而，在更多样化的日常环境中，此类项目往往不会显示出如此积极的效果。本研究考察了将一项基于课堂的CBT抑郁症预防项目作为一项在英国八所中学开展的大型随机对照试验（n = 5,030）的一部分进行实施的过程，该试验未发现该项目有效（“有办法的青少年”项目，ISRCTN19083628）。通过焦点小组和访谈收集了参与“有办法的青少年”项目（RAP）的青少年（n = 42）、教师（n = 12）和辅导员（n = 16）的意见，并进行了主题分析。该项目被认为结构良好，包含有用的内容，特别是对低年级学生而言。然而，与实施相关的挑战包括该项目对所有年级的年龄适宜性、其灵活性不足、授课质量的一致性、对教师时间的竞争性需求以及一种将学术目标置于个人、社会和健康教育之上的文化。虽然学校是引入此类项目的便利场所，且覆盖面广，但学校中改善青少年幸福感、提高教师与青少年的参与度以及维持此类项目的文化氛围等问题仍需解决。
