Abstract
BackgroundEmotional problems such as anxiety and low mood in children are common, impair everyday functioning and increase the risk of severe mental health disorders in adulthood. Relatively few children with emotional health problems are identified and referred for treatment indicating the need to investigate preventive approaches.Methods/DesignThe study is designed to be a pragmatic cluster randomized controlled trial evaluating the effectiveness of an efficacious school-based cognitive behavior therapy (CBT) prevention program (FRIENDS) on symptoms of anxiety and low mood in children 9 to 10 years of age. The unit of allocation is schools which are assigned to one of three conditions: school-led FRIENDS, health-led FRIENDS or treatment as usual. Assessments will be undertaken at baseline, 6 months and 12 months. The primary outcome measure is change on the Revised Child Anxiety and Depression Scale. Secondary outcome measures assess changes in self-esteem, worries, bullying and life satisfaction. An economic evaluation will be undertaken.DiscussionAs of September 2011, 41 schools have been recruited and randomized. Final 12-month assessments are scheduled to be completed by May 2013.Trial RegistrationISRCTN23563048
Highlights
Emotional problems such as anxiety and low mood in children are common, impair everyday functioning and increase the risk of severe mental health disorders in adulthood
Many more children experience severe anxiety or depressive symptoms that fall below criteria required for a formal diagnosis but have a significant impact upon everyday functioning
Comparison between children aged 9 and 10 years and those aged 14 to16 years showed that both age groups benefited from FRIENDS, the younger group demonstrated the greatest changes in anxiety symptoms [21]
Summary
Emotional problems in children are common with community surveys in the United States and in the United Kingdom indicating that at any one time up to 8% of children aged 5 to 16 years will fulfill DSM diagnostic criteria for a severe anxiety disorder with accompanying significant impairment. [1,2]. Of the school-based CBT preventive programs that have been developed, the FRIENDS program appears successful [15] This was noted by the World Health Organization, which identified FRIENDS as having strong evidence of being effective as a schoolbased intervention for anxiety [16]. Comparison between children aged 9 and 10 years and those aged 14 to years showed that both age groups benefited from FRIENDS, the younger group demonstrated the greatest changes in anxiety symptoms [21] These results are promising, most trials have been undertaken by the program developers in Australia and no RCTs of FRIENDS have been undertaken in the United Kingdom
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