Afterschool Mentoring Program for Depression

Overseen By Katherine Hendel

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Minnesota

Disqualifiers: Substantial cognitive impairment

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

209 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment After School Plus for depression?

Research shows that school-based programs using cognitive behavioral therapy (CBT) can effectively reduce depressive symptoms in students, with effect sizes ranging from 0.21 to 1.40. Additionally, group mentoring programs that include CBT techniques have been shown to improve social problem-solving skills and reduce behavior problems in children. ^{1 2 3 4 5}

How does the Afterschool Mentoring Program for Depression differ from other treatments for depression?

The Afterschool Mentoring Program for Depression is unique because it focuses on building supportive mentoring relationships to help reduce depressive symptoms in youth, rather than using traditional methods like medication or cognitive behavioral therapy (CBT). This program emphasizes the quality of the mentor-mentee relationship and provides personalized support, which can be particularly beneficial for adolescents experiencing depression. ^{1 6 7 8 9}

What is the purpose of this trial?

Coming out of the COVID-19 pandemic many youth are experiencing declines in physical activity and worsening mental health (e.g., depression symptoms). These declines are exacerbated among underserved youth who experience greater barriers to health services and exposure to life stressors that put them at increased risk for impaired mental, emotional, and behavioral health. School-based afterschool programming is an important strategy to reach this population of youth and provides intervention at a time when youth are likely to otherwise be in environments not supportive of health. Further participation in extracurricular activities has been shown to be a protective factor for youth mental health. However, consistent with the Behavioral Theory of Depression, youth who are currently inactive and who have depression symptoms are unlikely to participate in afterschool programming on their own and likely require heightened positive reinforcement when they do attend to encourage retention. Given the high prevalence of youth who experience symptoms of depression and resource and staffing challenges faced by many schools, the level of support needed to engage students to consistently participate and benefit from afterschool programming is often beyond the capacity of school-based afterschool programs. In partnership with a local afterschool program for middle school students in a low resource community, we developed an augmented version of the current afterschool program in which college students are trained to mentor and assist in the afterschool program, expanding the capacity of the afterschool program to engage students. The mentoring intervention uses behavioral activation principles to help youth connect their behaviors with their mood and support youth to engage in behaviors that improve their mood, including physical activity. The main purpose of this study is to pilot the feasibility of the newly developed intervention.

Research Team

Katherine Hendel

Principal Investigator

University of Minnesota

Eligibility Criteria

This pilot study is for middle school students in a low-resource community who may be experiencing symptoms of depression and declines in physical activity, especially following the COVID-19 pandemic. The program aims to engage these youth through an augmented afterschool initiative.

Inclusion Criteria

Parent of a student enrolled in the study

Mentor in the after school plus program

Staff member affiliated with the after school program at a participating middle school

Exclusion Criteria

I do not have significant cognitive issues that prevent me from completing study tasks.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Program Phase

Middle school students participate in the after school program as usual

4 months

Regular after school sessions

Enhanced Program Phase

Middle school students participate in the augmented after school program with mentoring

4 months

Regular after school sessions with mentoring

Follow-up

Participants are monitored for attendance, depression symptoms, and activity levels

8 months

Treatment Details

Interventions

• After School Plus

Trial Overview The trial tests 'After School Plus', a mentoring-based afterschool program designed to improve adolescent mental health and increase physical activity using behavioral activation principles, with college students as mentors.

Participant Groups

Group I: School B Experimental Treatment 1 Intervention

Middle school students at School B who participate in the after school program. They will receive after school plus in months 1-4, followed by after school as usual in months 5-8.

Group II: School A Experimental Treatment 1 Intervention

Middle school students at School A who participate in the after school program. They will receive after school as usual in months 1-4, followed by after school plus in months 5-8.

Who Is Running the Clinical Trial?

University of Minnesota

Lead Sponsor

Trials

1,459

Recruited

1,623,000+

Findings from Research

A systematic review of 42 randomized controlled trials found that school-based programs, particularly those using cognitive behavioral therapy (CBT), are effective in reducing depressive symptoms in students, especially those already showing elevated levels of depression.

The effectiveness of these programs varied widely, with effect sizes ranging from 0.21 to 1.40, and programs led by teachers or those using attention control conditions showed fewer significant effects, highlighting the need for further research in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review of school-based prevention and early intervention programs for depression. Calear, AL., Christensen, H.[2022]

Screening for depression in schools can identify students in need of help, with a 'numbers-needed-to-screen' of 31, meaning that for every 31 students screened, one successfully receives treatment.

Psychological interventions for treated students showed a moderate effect size of 0.55, indicating that these interventions can effectively reduce depressive symptoms in children and adolescents, although more research is needed to assess the long-term effects and compare different types of therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening and early psychological intervention for depression in schools : systematic review and meta-analysis. Cuijpers, P., van Straten, A., Smits, N., et al.[2018]

A study involving 151 teachers across eight high schools in Scotland found that a psychoeducational intervention did not improve teachers' ability to recognize clinical depression in their adolescent students, despite all teachers receiving training on the topic.

The research involved reporting on 2262 pupils who were independently screened for depression, highlighting the ongoing challenges in effectively identifying depressive symptoms in adolescents within educational settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving the recognition of depression in adolescence: can we teach the teachers? Moor, S., Maguire, A., McQueen, H., et al.[2015]

The group mentoring program significantly improved social problem-solving skills in children aged 8 to 12 and reduced both externalizing and internalizing behavior problems, based on reports from parents.

With only a 7% dropout rate, the study suggests that integrating cognitive behavioral techniques into community mental health services can enhance the effectiveness of existing treatments for children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Behavioral Principles Within Group Mentoring: A Randomized Pilot Study. Jent, JF., Niec, LN.[2021]

An 8-week school-based coping skills program significantly reduced depressive symptoms and academic stress in 120 Indian adolescents with subclinical depression, showing lasting effects at a 3-month follow-up.

The program also improved social problem-solving and coping skills, indicating its potential as an effective intervention for addressing mental health issues in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of an indicated intervention program for Indian adolescents with subclinical depression. Singhal, M., Munivenkatappa, M., Kommu, JVS., et al.[2019]

The study involved 255 middle and high school students from low-income families in South Korea and found that parental neglect is linked to increased depression among these adolescents.

Satisfaction with a mentorship program was shown to moderate the relationship between neglect and depression, suggesting that effective mentorship can help improve mental health outcomes for low-income students, especially in the aftermath of COVID-19.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of a Mentorship Program on the Relationship between Neglect and Depression among Adolescents in Low-Income Families. Lee, J., Allen, J., Lim, H., et al.[2021]

An 8-week cognitive-behavioral group intervention led by school nurses significantly reduced depressive symptoms among high school students, particularly in females, compared to a control group.

The program not only helped decrease depression but also enhanced the range of coping strategies among students, demonstrating the effectiveness of school-based mental health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

School-based intervention to promote coping in rural teens. Lamb, JM., Puskar, KR., Sereika, SM., et al.[2022]

A systematic review identified eight studies of internet-based programs for treating anxiety and depression in children and adolescents, with most interventions based on cognitive behavior therapy.

Six out of eight studies reported reductions in symptoms of anxiety and/or depression after the interventions, indicating early support for the effectiveness of these online programs, although more rigorous research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Review of internet-based prevention and treatment programs for anxiety and depression in children and adolescents. Calear, AL., Christensen, H.[2022]

Participation in mentoring programs significantly reduced depressive symptoms among 2003 youth, indicating that mentoring can be beneficial for mental health.

The quality of the mentoring relationship was linked to changes in depressive symptoms, suggesting that mentors should be trained to build strong relationships, especially with youth who have higher baseline depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mentoring and depressive symptoms of youth: Examining prospective and interactive associations with mentoring relationship quality. Browne, R., Jarjoura, GR., Keller, TE., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Systematic review of school-based prevention and early intervention programs for depression. [2022]

2. Germany pubmed.ncbi.nlm.nih.gov

Screening and early psychological intervention for depression in schools : systematic review and meta-analysis. [2018]

3. England pubmed.ncbi.nlm.nih.gov

Improving the recognition of depression in adolescence: can we teach the teachers? [2015]

4. United States pubmed.ncbi.nlm.nih.gov

Cognitive Behavioral Principles Within Group Mentoring: A Randomized Pilot Study. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Efficacy of an indicated intervention program for Indian adolescents with subclinical depression. [2019]

6. Switzerland pubmed.ncbi.nlm.nih.gov

The Role of a Mentorship Program on the Relationship between Neglect and Depression among Adolescents in Low-Income Families. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

School-based intervention to promote coping in rural teens. [2022]

8. Australia pubmed.ncbi.nlm.nih.gov

Review of internet-based prevention and treatment programs for anxiety and depression in children and adolescents. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Mentoring and depressive symptoms of youth: Examining prospective and interactive associations with mentoring relationship quality. [2023]