Clinical Child and Family Psychology Review

, Volume 21, Issue 4, pp 466–481 | Cite as

A Meta-Analysis of Universal School-Based Prevention Programs for Anxiety and Depression in Children

  • Kristy M. JohnstoneEmail author
  • Eva Kemps
  • Junwen Chen


Anxiety and depression are among the most common mental health issues experienced in childhood. Implementing school-based prevention programs during childhood, rather than adolescence, is thought to provide better mental health outcomes. The present meta-analysis aimed to investigate the efficacy of universal school-based prevention programs that target both anxiety and depression in children (aged 13 years or below), and examine three moderators (i.e., program type, primary target of program, and number of sessions) on prevention effects. PsycINFO, PubMED, and Google Scholar were systematically searched for relevant articles published up to and including January 2018. Fourteen randomised controlled trials, consisting of 5970 children, met eligibility criteria. Prevention programs led to significantly fewer depressive symptoms at post-program (g = 0.172) and at long-term follow-up periods (g = 0.180), but not at short-term follow-up. Programs were not found to prevent anxiety symptoms across any time point. Considerable heterogeneity was observed for all effects. Program type and length were found to moderate the relationship between prevention program and outcomes. Prevention programs were effective in preventing depressive symptoms at post-program and long-term follow-up, while no significant preventative effect on anxiety symptoms was observed. The FRIENDS Program and programs which contained a greater number of sessions showed beneficial effects on anxiety and depressive symptoms. Universal programs aimed at preventing both anxiety and depression in children are limited. Future research should investigate the long-term evaluation of school-based prevention programs for anxiety and depression in children.


Meta-analysis Prevention Anxiety Depression School children 



The authors would like to thank Inessa Harpas for her assistance in conducting the literature search.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

10567_2018_266_MOESM1_ESM.docx (24 kb)
Supplementary material 1 (DOCX 23 KB)


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Authors and Affiliations

  1. 1.School of PsychologyFlinders UniversityAdelaideAustralia

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