Skip to main content

Table 1 Intervention characteristics

From: Universal, school-based transdiagnostic interventions to promote mental health and emotional wellbeing: a systematic review

Study quality

Study design

Measures

Follow-up

Conductor

Intervention

Effects/Outcomes

General study aim

School level

Berry et al. [71] (68.8%)

Cluster Randomized Control Trial; Randomized on a 1:1 ratio stratified with binary classification of school size and eligible children proportion for free school meal; 29 schools "PATHS" intervention × 27 schools WL control

SDQ

PTRS

T-POT

TBQ

Baseline, 1-year follow-up, 2-year follow-up,

Teacher

SEL

12 months follow-up: No difference on SDQ, some significant differences on PTRS (social competence: d = 0.09, aggressive behaviour:d = − 0.14,inattention: d = − 0.06, Impulsivity: d = − 0.06, peer relations: d = − 0.10, learning behaviours: d = 0.10); 6 months follow-up: Significant difference on T-POT (Total teacher positive behaviours: d = − 0.304, Class negative behaviour to teacher: d = 0.307, Class off-task behaviour:d = 0.227)

Promotion

Primary school

Bradshaw et al. 2013 (68.8)

Open cohort 4-year RCT:new students to intervention school can participants while those who left intervention schools would not be traced; 21 schools randomized to intervention group, 16 schools randomized to control group

TOCA-C

5 times of evaluation over the four years: Baseline in the fall of the first year, and follow-up in the spring of the following four years.No particular time point reported

Teacher

CBT

Significant effect on the general sample: disruptive behaviors (d = 0.12), concentration problems (d = 0.08), prosocial behavior (d = − 0.17), emotion regulation (d = − 0.11), IG children are 33% likely to receive an ODR (AOR = 0.67),IG girls less likely to receive an ODR than CG girls (AOR = 1.27); Significant effect on the participants who are at kindergarten at the onset of the trial than CG: prosocial behavior (γ = 0.08), emotion regulation (γ = 0.05); no significant differences between SWPBIS and comparison schools on suspensions

Promotion

Elementary school

Burckhardt et al. [72] (43.4%)

Quasi-randomised controlled trial with cluster randomization. 1: 1 ratio of intervention and control group number (n = 4);disproportionate participants number to intervention (n = 63) and control group (n = 61).After follow-up, intervention was also delivered to the control group for evaluation

DASS-21

FS

Baseline, Post-intervention, 5-month follow-up

Teacher

ACT

No significant difference between IG and CG on baseline;no significant differences between post-intervention completers and dropouts;no differences were found between follow-up dropouts and completers.No significant differences between the ACT and control conditions for the DASS-21 or FS on different time points.Baseline-post effect size on (non-significant): depression: d = 0.31, anxiety: d = 0.28, stress: d = 0.63; DASS-total: 0.44, FS: d = 0.20. General positive effect of ACT reported by both groups: agreeing over 50%, except exercising more

Prevention

High school

Cook et al. [73] (34%)

A matched quasi-randomized design was used to equate groups at baseline. A quasi-experimental procedure and not pure random assignment were conducted, producing four pairs of classes were assigned to differentt experimental conditions

SIBS

SEBS

Baseline, Post-test (5 months after baseline collection)

Teacher

SEL and PBIS

Externalizing: SEL Only (d = − 0.24), PBIS Only (d = − 0.26), SEL/PBIS COMBO (d = − 0.62), Control (d = 0.00); Internalizing: SEL Only (d = − 0.16), PBIS Only (d = − 0.02), SEL/PBIS COMBO (d = − 0.37), Control (d = 0.00). The significance of all data was not reported

Promotion

Elementary school

Dowling et al. [74] (59%)

Cluster Randomized Control Trial; 1: 1 ratio of intervention and control group number (n = 17);disproportionate participants number to intervention (n = 345) and control group (n = 330)

RSS

ERQ

TMMS

CSI-15

SEQC

AICQ

MDELS

DASS-21. WEMWBS

ATSS

SAMRS

Baseline, Post-intervention

Teacher

SEL

Significant increase of Social Support Copings (d = 0.15), Significant reduction of suppressing emotions (d = − 0.19), Significant reduction of stress (d = − 0.06) and depression (d = − 0.07)

Promotion

High school

Dvořáková et al. [75] (50%)

Pilot randomized control trial. Gender stratification was conducted in the randomization to assure a balanced gender ratio in the intervention (n = 55, n of female = 35) and control (n = 54, n of female = 37)

GAD

SWL

MAAS

SCS

SCC-R. CS

PSQI

YAAPST

Baseline, post-intervention

Psychologist

Mindfulenesss

Significant effect on anxiety (d = − 0.48), depression (d = − 0.34), and satisfaction with life (d = 0.41)

Promotion

University

Flynn et al. [76] (37.5%)

Quasi-experimental design with opportunistic sampling. No blinding or randomization was reported. DBT STEPS-A (n = 26) × control group (n = 45)

DBT-WCCL. BASC-2

Baseline, post-intervention

Teacher

SEL

Significant effect on emotion symptom index (d = − 0.32) and internalizing (d = − 0.41)

Promotion

All-female high school

Garcia-Escalera et al. 2020 (46.9%)

Two-arm cluster randomized control trial. UP-A group (n = 90) × waitline control group (n = 61)

RCADS-30

CDN

EAN

DPDSQ

CKQ

SPOQ

Baseline, postintervenion, 3-months follow-up

Psychologist

UP

Significant main effect of time on the RCADS total score (d = − 0.22), Separation Anxiety Disorder (SAD, d = − 0.32), Generalized Anxiety Disorder (GAD, d = − 0.18), Obsessive Compulsive Disorder (OCD, d = − 0.21). Significant decreases for those with severe baseline symptoms in the UP-A group between the following time points: T1 and T3 (d = 0.96, n = 9) and T2 and T3 (d = 0.88, n = 9)

Prevention

High school

Johnson and Wade, 2019 (56.3%)

Cluster (class based) controlled trial. Mindfulness intervention group (n = 71) × Control group (n = 75)

DASS-21

GAD-7

EDE-Q. WEMWBS

Baseline, post-intervention, 4-months follow-up

Teacher

Mindfulenesss

No significant effect was reported on post-intervention. High medium significant effect reported on the anxiety (d = 52) and depression (0.61) among all intervention group students in follow-up. Moderation effect: only significant effect on anxiety (d = 0.81) and depression (d = 0.95) among year ten students

Promotion

Secondary school

Johnson and Wade, [63] (59%)

Cluster (class based) controlled trial. Mindfulness intervention group (n = 237) × Control group (n = 239)

CHIME-A. DASS-21

GAD-7

EDE-Q. WEMWBS

Baseline, post-intervention, 3-months follow-up, 9-months follow-up

Teacher

Mindfuleness

Significant effect on Decentering and Nonreactivity (d = − 0.20) among the general sample in 3 month follow-up. Year 8 at 3 month follow-up: Awareness of External Experiences (d = − 0.30), Decentering and Nonreactivity (d = − 0.39), wellbeing (d = − 0.25)

Promotion

Secondary

Kishida et al. [77] (81.3%)

No randomization was conducted

JSDQ

GSESC_x005f-R

Short CAS. DSRS-C

ASCA

Baseline, post-intervention

Teacher

CBT

Study 1: Significant time effects for general difficulties [F (1, 52.78) = 4.88, p < 0.05], general difficulties (SDQ) decreased with small effect sizes (g =  − 0.20). For subclinical samples in study 1, no significant time effects for the primary and secondary outcomes; general difficulties, internalizing problems, and externalizing problems decreased with medium effect sizes (g =  − 0.79, g =  − 0.52, and g =  − 0.60, respectively). Study 2: no significant time effects or meaningful effect sizes for all outcomes. subclinical sample: Significant time effects for depression as a secondary outcome [F (1, 9) = 6.45, p < 0.05], General difficulties and internalizing problems, anxiety, and depression decreased with medium effect sizes (g =  − 0.69, g =  − 0.55, g =  − 0.63, and g =  − 0.63, respectively)

Prevention

Primary

Knight et al. [78] (75%)

Conductor (teacher) randomization, and student control trials. Teachers aligned to different classes in the first year. In the second year, students may be alligned with different teachers and classmates, while they will remain in the same group (intervention or control)

SEARS

Baseline, post-intervention

Teacher

CBT and SEL

Significant effect on Self-regulation (d = 1.04), Social competence (d = 0.65), Empathy (d = 0.70), Responsibility (d = 0.81), SEARS-T (d = 0.89). No significant effect reported on SEARS-C/A

Promotion

Secondary

Kuyken et al. [64] (50%)

Non-randomised controlled parallel group study. MiSP group (n = 256) × Control group (n = 266)

WEMWBS

PSS

CES-D

Baseline, post-intervention, 3 months follow-up

Teacher and psychologist

Mindfulness

Significant fewer depressive symptoms post-treatment and at follow-up and lower stress and greater well-being at follow-up

Promotion

Secondary

Lam and Seiden [79] (34%)

Controlled trial, no randomization was reported

BRIEF-SR

DERS

RRS

Baseline, post-intervention

Psychologist

ACT, SEL, and Mindfulness

Significant effect on general YSR (η2 = 0.05) and EF (η2 = 0.11) score, specifically on anxiety/depression (η2 = 0.09), emotion (η2 = 0.06), monitor (η2 = 0.06), and memory (η2 = 0.11)

Promotion

Primary

Mendelson et al. [80] (43.3%)

Randomized control trial. RAP group (n = 29) × Control group (n = 20)

SDQ

ACES

SCS

SMFQ

CCSC

EAQ

Baseline, post-intervention

Psychologist and a community member

CBT and Mindfulness

Significant effect on SCS Dysregulation (d = 0.85), SCS Social Competence (d = 0.87), SCS Authority Acceptance (d = 0.69), ACES Academic Competence (d = 0.76)

Prevention

Secondary

Sawyer et al. [81] (78.1%)

Cluster randomized controlled trial. Intervention group (n = 3037) × Control group (n = 2597)

CES-D

OTSS

AICQ

CAS

MSPS

APSC. Interpersonal Competence Questionnaire, Coping Actions Scale. School-level protective and risk factors:Multidimensional Scale of Perceived Support, Adolescents’ perceptions of school climate

Baseline, 1-year follow-up, 2-year follow-up

Not reported

CBT

Multi-level modelling indicated significant effect on both intervention and control groups: CES-D scores (coefficient = 0.517, SE = 0.222), Positive Coping Strategies (coefficient = -0.496, SE = 0.147), Negative Coping Strategies (coefficient = − 0.248, SE = 0.100), Optimistic Thinking Style (coefficient = − 0.716, SE = 0.115), Family Relationships (coefficient = − 0.838, SE = 0.068), Friends Relationships (coefficient = − 0.188, SE = 0.077), Significant Other Relationships (coefficient = − .178, SE = 0.063), School Climate (coefficient = − 1.849, SE = 0.247); Significant coefficient for the group × time rating on teacher rated school climate (coefficient = 0.600, SE = 0.290). Students with mild to severe CES-D baseline scores: reduction in Negative Coping Strategies (coefficient = − 0.708, SE = 0.129), Relationships (coefficient = − 0.765, SE = 0.117) and student-rated School Climate (coefficient = − 1.392, SE = 0.252). Significant increase in Interpersonal Competence (coefficient = 0.352, SE = 0.164)

Promotion

Secondary

Shum et al. [82] (50%)

Non-randomized controlled trial. Intervention group (n = 264) × Control group (n = 195)

SCARED

ATS-N/P. C-IRI

RSES

Baseline, post-intervention, 6-months follow-up

Students

CBT

Significant effect on the knowledge of mental health in post-intervention (coefficients = 0.46) and follow-up (coefficients = 0.66), and perspective-taking (empathy, coefficients = 1.50). Online program: compared with lower completion group, significant improvement on higher completion group on the knowledge of mental health (coefficients = 0.51) and positive thoughts (coefficients = 3.32)

Prevention and promotion

Primary

Skryabina et al. [83] (59%)

Cluster randomized control trial. Health-led FRIENDS (n = 478) × School-led FRIENDS (n = 467) × Usual PSHE (n = 398)

RCADS

PSWQC

RSES

Baseline, 12 months follow-up

Teacher and psychologist respectively

CBT

Significant reductin on Sep anxiety: Health-led FRIENDS group × Usual PSHE group (d = − 0.11), School-led FRIENDS group × Usual PSHE group (d = − 0.17)

Prevention and promotion

Primary

Stallard et al. [65] (75%)

Cluster randomised controlled trial. Health-led FRIENDS (n = 509) × School-led FRIENDS (n = 497) × Usual PSHE (n = 442)

RCADS-30. PSWQC

RSC

OBVQ

SDQ

RCADS-30-P

Baseline, 6-months follow-up, 12-months follow-up

Teacher and psychologist respectively

CBT

All groups: Significant difference in the mean of RCADS at 12 month for health-led FRIENDS, comparing school-led FRIENDS (interaction coefficient − 3.91) and usual school provision (interaction coefficient = − 2.66). High risk group: signficant 12 month within group reduction, without effect difference across groups. Low risk group: Significant difference in the mean of RCADS at 12 month for health-led FRIENDS, comparing school-led FRIENDS ((adjusted difference = − 3.78) and usual school provision (adjusted difference = − 3.13). Low anxiety group: significant effect on health-led FRIENDS, than usual school provision (d = 0.22) and school-led FRIENDS (d = 0.25), reflected by child-completed total RCADS

Prevention

Primary

Takahashi et al. [66] (56.3%)

Non-randomized controlled trial. Intervention group (n = 69) × Control group (n = 230), alligned on teacher's decision

VOYAGE, SDQ

Baseline, post-intervention

psychologist

ACT

Significant group × time interaction effect on Continuation of Avoidance subscale (CA, β =  − 0.97), the ACT group showed significant reductions in CA between pre- and post-intervention periods (β = 0.86). Significant reduction in CA in ACT group between pre- and post-intervention periods (β = 2.02), while not in the WLC group (β =  − 0.58). Significant interaction effect for the Hyperactivity/Inattention subscale on the SDQ in the whole sample (β =  − 0.69). Both WLC (β = 0.22) and ACT group (β = 0.92) showed significant reduction in Hyperactivity/Inattention

Promotion

Secondary

Torok et al. [84] (34%)

Non-experimental pilot examination with pre and post-test

Teacher-rated SDQ

Baseline, post-intervention

Teacher

SEL

Significant effect on SDQ global difficulties (d = 0.44), Externalising difficulties (d = 0.30), Internalising difficulties (d = 0.36), Emotional (d = 0.30), Conduct (d = 0.21), Hyperactivity (d = 0.29), Peer relationships (d = 0.30), Prosocial behaviour (d = 0.26)

Promotion

Primary

Volkaert et al. [85] (68.8%)

Cluster randomized control trial, without blinding participants. Intervention group (n = 139) × Control group (n = 208)

DERS

FEEL-KJ. SPPA

HRQoL

CDI

CESD

STAI-C

SSRPH

OBVQ

ARSP

CBCL

BRIEF

Baseline, post-intervention, 3-month follow-up, 6-month follow-up

Psychologist

Locally Designed Transdiagnostic

Significant group × time interaction effect on depressive symptoms***, CDI*, anxiety symptoms***, negative affect***, self-esteem***, quality of life***

Promotion

Primary