Effectiveness Trial of Brief Indicated Cognitive-Behavioral Group Depression Prevention in French-Canadian Secondary Schools

Abstract

Most adolescent depression prevention programs have been tested in the USA and other Anglo-Saxon countries. Their effects in other contexts are less clear. We conducted a pilot trial aimed at testing the effectiveness of the Blues program, a brief indicated cognitive-behavioral (CB) group program to prevent depression originally developed in the USA, in French-Canadian secondary schools. CB group facilitators were endogenous school clinicians. A total of 74 students (mean age= 15.50; 66% female) with elevated depressive symptoms were randomized to CB group (n = 37) or educational brochure control (n = 37). Participants completed diagnostic interviews and surveys at pretest, posttest, and 6-month follow-up. Results showed that CB group had a large, statistically significant effect on MDD onset at 6-month follow-up. CB group also had a positive effect on depressive symptoms, intermediate outcomes (pleasant activities, negative thoughts), and one secondary outcome (improved interaction with parents) at posttest. These effects were not maintained at follow-up. This trial replicates results from a previous US effectiveness trial. The clinically meaningful effects of brief indicated CB group prevention, at least with regard to the prevention of MDD onset, hold in French-Canadian students when the intervention is implemented by school clinicians. Work is still needed to augment and maintain CB effects in real-world practice.

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Acknowledgements

This study was supported by a research grant from the Fonds de Recherche Québécois sur la Société et la Culture (FRQSC 2016-NP-191870) and an evaluation contract the not-for-profit organization Boscoville. Thanks go to Paul Rohde, as well as the project research assistants and the participants who made this study possible. This RCT was registered on clinicaltrials.gov (FRQSC2016-NP-191870).

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Correspondence to Frédéric N. Brière.

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Brière, F.N., Reigner, A., Yale-Soulière, G. et al. Effectiveness Trial of Brief Indicated Cognitive-Behavioral Group Depression Prevention in French-Canadian Secondary Schools. School Mental Health 11, 728–740 (2019). https://doi.org/10.1007/s12310-019-09316-2

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Keywords

  • Major depression
  • Prevention
  • Adolescents
  • Cognitive-behavioral
  • Effectiveness
  • French