Abstract
Anxiety and depressive disorders may pose a long-term, deleterious impact on youth, prompting a need for early and effective prevention of such concerns. A growing body of research has examined universal prevention programs targeting these emotional disorders in childhood. While most universal prevention programs are offered within the school setting, there is also a rationale for developing and investigating prevention programs within novel settings, including a recreational context. This initial investigation utilized the Emotion Detectives Prevention Program (EDPP), a universal prevention protocol focusing on anxiety and depression symptoms within a recreational summer camp. The aims of this pilot study were to assess the EDPP’s feasibility and participant satisfaction following its initial administration in a camp setting. Forty children (ages 7–10 years, 70.7% male) were recruited from an existent recreational sports camp and participated in a non-randomized, open trial of the EDPP. The EDPP, a 15-session program, presents cognitive-behavioral strategies in a manner that emphasizes strategy applicability across a range of emotional experiences. Participating children reported a significant decrease in anxiety symptoms at post–prevention. No significant change in depression symptoms or other emotion regulation indices were reported. Moderate to high participant satisfaction was indicated. The EDPP appears to be a feasible program for the prevention of child-reported anxiety symptoms in a camp setting. Given the novelty of the prevention context, issues inherent in the conduct of research in a recreational camp setting and future directions for research in this setting are discussed.
Similar content being viewed by others
References
Albano, A., Chorpita, B. F., & Barlow, D. H. (2003). Childhood anxiety disorders. In E. J. Mash, R. A. Barkley, E. J. Mash, & R. A. Barkley (Eds.), Child psychopathology (2nd ed., pp. 279–329). New York, NY US: Guilford Press.
Allen, L. B., Ehrenreich, J. T., & Barlow, D. H. (2005). A unified treatment for emotional disorders: Applications with adults and adolescents. Japanese Journal of Behavior Therapy, 31, 3–31.
Altman, D. G., Schulz, K. F., Moher, D., Egger, M., Davidoff, F., Elbourne, D., et al. (2001). The revised CONSORT statement for reporting randomized trials: Explanation and elaboration. Annals of Internal Medicine, 134(8). 663–694.
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: The Guilford Press.
Barlow, D. H., Ellard, K. K., Fairholme, C. P., Farchione, T. J., Boisseau, C. L., Allen, L. B., et al. (2010). The unified protocol for transdiagnostic treatment of emotional disorders, therapist guide. New York: Oxford University Press.
Barrett, P. M., Farrell, L. J., Ollendick, T. H., & Dadds, M. (2006). Long-term outcomes of an australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program. Journal of Clinical Child and Adolescent Psychology, 35(3), 403–411. doi:10.1207/s15374424jccp3503_5.
Barrett, P. M., & Pahl, K. M. (2006). School-based intervention: examining a universal approach to anxiety management. Australian Journal of Guidance & Counselling, 16(1), 55–75. doi:10.1375/ajgc.16.1.55.
Barrett, P., & Turner, C. (2001). Prevention of anxiety symptoms in primary school children: Preliminary results from a universal school-based trial. British Journal of Clinical Psychology, 40(4), 399–410. doi:10.1348/014466501163887.
Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. Journal of American Academy Child Adolescent Psychiatry, 38, 1230–1236.
Cantwell, D. P., Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1997). Correspondence between adolescent report and parent report of psychiatric diagnostic data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(5), 610–619. doi:10.1097/00004583-199705000-00011.
Cole, P. M., Martin, S. E., & Dennis, T. A. (2004). Emotion regulation as a scientific construct: Methodological challenges and directions for child development research. Child Development, 75(2), 317–333. doi:10.1111/j.1467-8624.2004.00673.x.
Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: Problems, progress, and potential in theory and research. Psychological Bulletin, 127(1), 87–127.
Craske, M. G. (1997). Fear and anxiety in children and adolescents. Bulletin of the Menninger Clinic, 61, A4–A36.
Dadds, M. R., Spence, S., Holland, D. E., Barrett, P. M., & Laurens, K. R. (1997). Prevention and early intervention for anxiety disorders: A controlled trial. Journal of Consulting and Clinical Psychology, 65, 627–635.
Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25(2), 115–152. doi:10.1023/A:1024654026646.
Dynarski, M., Moore, M., Mullens, J., Gleason, P., James-Burdumy, S., Rosenberg, L., et al. (2003). When schools stay open late: The national evaluation of the 21st-century community learning centers program. First year findings. Retrieved from EBSCOhost.
Ehrenreich, J. T., Buzzella, B. A., Trosper, S. E., Bennett, S. M., Wright, L. A. & Barlow, D. H. (2008). Unified protocol for the treatment of emotional disorders in youth. University of Miami and Boston University. Unpublished treatment manual.
Ehrenreich-May, J. & Bilek, E. L. (2009). Emotion detectives prevention program. University of Miami (unpublished treatment manual).
Ehrenreich-May, J. & Bilek, E. L. (in press). The development of a transdiagnostic, cognitive behavioral group intervention for childhood anxiety disorders and co-occurring depression symptoms. Cognitive and Behavioral Practice.
Ehrenreich-May, J., & Remmes, C. (2010, November). The unified protocol for the treatment of emotional disorders in youth: Preliminary outcomes from a randomized, clinical trial. In C. Suveg (Chair), Emotion and psychopathology: Conceptual foundations and clinical applications. Presented at the annual meeting of the Association for Behavioral and Cognitive Therapies, San Francisco, CA.
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101. doi:10.1016/j.cbpra.2009.06.002.
Farrell, L. J., & Barrett, P. M. (2007). Prevention of childhood emotional disorders: Reducing the burden of suffering associated with anxiety and depression. Child and Adolescent Mental Health, 12(2), 58–65.
Gordon, R. (1987). An operational classification of disease prevention. In J. A. Steinberg, M. M. Silverman, J. A. Steinberg, & M. M. Silverman (Eds.), Preventing mental disorders: A research perspective (pp. 20–26). Rockville, MD: National Institute of Mental Health.
Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19(5), 629–645. doi:10.1007/s10826-009-9350-2.
Izard, C. E., Woodburn, E. M., Finlon, K. J., Krauthamer-Ewing, E., Grossman, S. R., & Seidenfeld, A. (2011). Emotion knowledge, emotion utilization, and emotion regulation. Emotion Review, 3(1), 44–52. doi:10.1177/1754073910380972.
Jellinek, M. S., & Snyder, J. B. (1998). Depression and suicide in children and adolescents. Pediatric Review, 19, 255–264.
Kessler, R. C., Anthony, J. C., Blazer, D. G., Bromet, E., Eaton, W. W., Kendler, K., et al. (1997a). The US national comorbidity survey: Overview and future directions. Epidemiologia e Psichiatria Sociale, 6(1), 4–16.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 617–627.
Kessler, R. C., & Greenberg, P. (2002). The economic burden of anxiety and stress disorders. In K. L. Davis, D. Charney, J. T. Coyle, & C. Nemeroff (Eds.), Neuropsychopharmacology: The fifth generation of progress. American College of Neuropsychopharmacology.
Kessler, R. C., Ruscio, A., Shear, K., & Wittchen, H. (2010). Epidemiology of anxiety disorders. In M. B. Stein, T. Steckler, M. B. Stein, & T. Steckler (Eds.), Behavioral neurobiology of anxiety and its treatment (pp. 21–35). New York, NY US: Springer. Retrieved from EBSCOhost.
Kessler, R. C., Zhao, S., Blazer, D. G., & Swartz, M. (1997b). Prevalence, correlates, and course of minor depression and major depression in the national comorbidity survey. Journal of Affective Disorders, 45(1–2), 19–30.
Kirschman, K., Roberts, M. C., Shadlow, J. O., & Pelley, T. J. (2010). An evaluation of hope following a summer camp for inner-city youth. Child & Youth Care Forum, 39(6), 385–396. doi:10.1007/s10566-010-9119-1.
Levitt, J. T., Brown, T. A., Orsillo, S. M., & Barlow, D. H. (2004). The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder. Behavior Therapy, 35(4), 747–766.
Lock, S., & Barrett, P. M. (2003). A longitudinal study of developmental differences in universal preventive intervention for child anxiety. Behaviour Change, 20, 183–199.
Lowry-Webster, H. M., Barrett, P. M., & Dadds, M. R. (2001). A universal prevention trial of anxiety and depressive symptomatology in childhood: Preliminary data from an Australian study. Behaviour Change, 18(1), 36–50. doi:10.1375/bech.18.1.36.
MacDermott, S. T., Betts, J., Gullone, E., & Allen, S. J. (submitted for publication). Emotion regulation in childhood and adolescence: A revised version of the Emotion Regulation Questionnaire (ERQ-CA).
McKay, M. M., Hibbert, R., Hoagwood, K., Rodriguez, J., Murray, L., Legerski, J., et al. (2004). Integrating evidence-based engagement interventions into ‘real world’ child mental health settings. Brief Treatment and Crisis Intervention, 4(2), 177–186. doi:10.1093/brief-treatment/mhh014.
Moher, D., Schulz, K. F., & Altman, D. G. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel group randomized trials. Annals of Internal Medicine, 134(8), 657–662.
Muris, P., Merckelbach, H., Mayer, B., & Prins, E. (2000). How serious are common childhood fears? Behaviour Research and Therapy, 38(3), 217–228. doi:10.1016/S0005-7967(98)00204-6.
Neil, A. L., & Christensen, H. (2009). Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clinical Psychology Review, 29(3), 208–215. doi:10.1016/j.cpr.2009.01.002.
New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Retreived from www.mentalhealthcommission.gov .
Owens, J., & Murphy, C. E. (2004). Effectiveness research in the context of school-based mental health. Clinical Child and Family Psychology Review, 7(4), 195–209. doi:10.1007/s10567-004-6085-x.
Pelham, W. R., & Hoza, B. (1996). Intensive treatment: A summer treatment program for children with ADHD. In E. D. Hibbs, P. S. Jensen, E. D. Hibbs, & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (pp. 311–340). Washington, DC, US: American Psychological Association. doi:10.1037/10196-013.
Penza-Clyve, S., Zeman, J., & Sim, L. (1999). Mother and child report of asthmatic children’s emotional expressiveness. Presented at the annual meeting of the American Psychological Association, Boston, MA.
Pini, S., Cassano, G. B., Simonini, E., Savino, M., Russo, A., & Montgomery, S. A. (1997). Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. Journal of Affective Disorders, 42, 145–153.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. doi:10.1177/014662167700100306.
Rambaldo, L. R., Wilding, L. D., Goldman, M. L., McClure, J. M., & Friedberg, R. D. (2001). School-based interventions for anxious and depressed children. In L. VandeCreek, T. L. Jackson, L. VandeCreek, & T. L. Jackson (Eds.), Innovations in clinical practice: A source book (Vol. 19, pp. 347–358). Sarasota, FL, US: Professional Resource Press/Professional Resource Exchange.
Rapee, R. (2009). Perceived stigma and consumer satisfaction in school-based programs for anxiety and depression. Symposium presented at the annual meeting of the Anxiety Disorders of America Association, Baltimore, MD.
Roberts, R. E., Andrews, J. A., Lewinsohn, P. M., & Hops, H. (1990). Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(2), 122–128. doi:10.1037/1040-3590.2.2.122.
Santucci, L. C., Ehrenreich, J. T., Trosper, S. E., Bennett, S. M., & Pincus, D. B. (2009). Development and preliminary evaluation of a one-week summer treatment program for separation anxiety disorder. Cognitive and Behavioral Practice, 16, 317–331.
Suveg, C., Sood, E., Comer, J., & Kendall, P. C. (2009). Changes in emotion regulation following cognitive-behavioral therapy for anxious youth. Journal of Clinical Child and Adolescent Psychology, 38(3), 390–401.
The City of Coral Gables, Demographic Data. (2010). Report of Nielsen Claritas, Inc. Retrieved from http://www.coralgables.com/CGWeb/documents/CG_DadeTbl_10_box.pdf.
Trosper, S. E., Buzzella, B. A., Bennett, S. M., & Ehrenreich, J. T. (2009). Emotion regulation in youth with emotional disorders: Implications for a unified treatment approach. Clinical Child and Family Psychology Review, 12(3), 234–254. doi:10.1007/s10567-009-0043-6.
Walker, A., Barry, T. D., & Bader, S. H. (2010). Therapist and parent ratings of changes in adaptive social skills following a summer treatment camp for children with autism spectrum disorders: A preliminary study. Child & Youth Care Forum, 39(5), 305–322. doi:10.1007/s10566-010-9110-x.
Weissman, M. M., Sholomskas, D., Potternger, M., Prusoff, B. A., & Locke, B. Z. (1977). Assessing depressive symptoms in five psychiatric populations: A validation study. American Journal of Epidemiology, 106(3), 203–214.
Whittal, M. L. (2008). Prevention of mental disorders. Cognitive and Behavioral Practice, 15(1), 1–2.
Wittchen, H., Nelson, C. B., & Lachner, G. G. (1998). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 28(1), 109–126. doi:10.1017/S0033291797005928.
Wittchen, H. U., Stein, M. B., & Kessler, R. C. (1999). Social fears and social phobia in a community sample of adolescents and young adults: Prevalence, risk factors and comorbidity. Psychological Medicine, 29, 309–323.
Wu, Y. P., Prout, K., Roberts, M. C., Parikshak, S., & Amylon, M. D. (2011). Assessing experiences of children who attended a camp for children with cancer and their siblings: A preliminary study. Child & Youth Care Forum, 40(2), 121–133. PsycINFO, EBSCOhost (accessed June 10, 2011).
Zeman, J., Shipman, K., & Penza-Clyve, S. (2001). Development and initial validation of the Children’s Sadness Management Scale. Journal of Nonverbal Behavior, 25, 187–205.
Acknowledgments
The authors would like to acknowledge the contributions of Krystyna Ahlers, Jessica Alvarez, Rhonda DuBord, Ashley Falcon, Sara Klaben, Ryan Landoll, Elizabeth Penela, Alexander Queen, Nicole Schoenherr, Gregory Simpson, Thomas Soria, Carolyn Snell, Tanya Tran and Rita Zeiden regarding the conduct of this investigation and Lindsay Stewart for her comments on a previous draft of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ehrenreich-May, J., Bilek, E.L. Universal Prevention of Anxiety and Depression in a Recreational Camp Setting: An Initial Open Trial. Child Youth Care Forum 40, 435–455 (2011). https://doi.org/10.1007/s10566-011-9148-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10566-011-9148-4