Journal of Youth and Adolescence

, Volume 48, Issue 9, pp 1668–1685 | Cite as

A Systematic Review and Meta-Analysis of School-Based Stress, Anxiety, and Depression Prevention Programs for Adolescents

  • Robyn FeissEmail author
  • Sarah Beth Dolinger
  • Monaye Merritt
  • Elaine Reiche
  • Karley Martin
  • Julio A. Yanes
  • Chippewa M. Thomas
  • Melissa Pangelinan
Empirical Research


Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11–18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.


Anxiety Depression Stress Health policy Meta-analysis 


Authors Contributions

RF conceived of the study, participated in the design, data collection, and analysis for the study, and drafted the manuscript; SBD participated in the design and data collection and drafted the manuscript; MM participated in the design and data collection and drafted the manuscript; ER participated in the design and data collection and drafted the manuscript; KM participated in the design and data collection and drafted the manuscript; JAY participated in the analysis for the study and drafted the manuscript; CMT participated in the design and drafted the manuscript; MP conceived of the study, participated in the design, data collection, and analysis for the study, and drafted the manuscript. All authors read and approved the final manuscript.

Data Sharing and Declaration

The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Authors and Affiliations

  1. 1.College of Education School of Kinesiology, Auburn UniversityAuburnUSA
  2. 2.Department of Psychology, Auburn UniversityAuburnUSA
  3. 3.Auburn University Magnetic Resonance Imaging Research Center, Auburn UniversityAuburnUSA
  4. 4.Department of Special Education, Rehabilitation and Counseling, Auburn UniversityAuburnUSA
  5. 5.Office of Faculty Engagement—University Outreach, Auburn UniversityAuburnUSA

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