Abstract
The present study examined the benefit of a transdiagnostic prevention program, Super Skills for Life (SSL), among adolescents with internalizing and/or externalizing problems in two types of school settings (mainstream school and pupil referral unit) using a randomized waitlist-controlled trial (RCT). The main aims were to examine the effects of the SSL-A in reducing internalizing and externalizing problems in adolescents, and to identify the moderating role of gender, age, and school type on the intervention outcome. The RCT involved 112 adolescents aged 11 to 14 years old, randomly allocated to either an SSL intervention group or a waitlist-control group (WLC). Adolescents in the intervention group participated immediately in the SSL-A, whereas adolescents in the WLC group received the intervention after the intervention group completed the 6 months follow-up assessment. Results showed that internalizing and externalizing problems were significantly reduced from pre-test to follow-up assessments. Gender, age and school setting moderated the intervention outcome. Specifically, males, younger adolescents and adolescents from mainstream schools showed a significant reduction over time on both internalizing and externalizing problems.
 This study provides evidence for the benefits of a transdiagnostic prevention program for internalizing and externalizing problems in two types of school settings.
Highlights
Internalizing problems such as anxiety and depression occur commonly among adolescents
The present study examined the benefit of a transdiagnostic prevention program, Super Skills for Life – adolescent version (SSL-A), among adolescents with internalizing and externalizing problems in two types of school settings using a randomized waitlist-controlled trial (RCT)
Over half (64.3%) of the participants were from the Pupil Referral Unit (PRU) and 35.7% were from the mainstream school
Summary
Internalizing problems such as anxiety and depression occur commonly among adolescents. It is estimated that up to 30% of adolescents in the general population are affected by anxiety and depression which cause significant distress and impairment in major areas of life (Essau, Lewinsohn, et al, 2014). Individuals with comorbid disorders tend to experience higher level of psychosocial impairment (Kessler et al, 2005) and have worse quality of life (Rapaport et al, 2005) compared to those with only one disorder. Studies have reported that internalizing and externalizing problems that occur early in life, if left untreated, tend to have a negative course and outcome (Essau, Lewinsohn, et al, 2014)
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