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Abstract
Objective: Mental health disorders affect many children in South Africa, where vulnerability is high, and treatment is limited. We sought to determine the feasibility and acceptability of a universally delivered classroom-based programme for the promotion of mental health in young adolescents.
Method: We pilot tested an 8 session, cognitive-behavioural therapy-based programme, 4 Steps To My Future (4STMF) in two schools. Participants were grade 5 learners (n = 222; Mean age = 10.62 (Standard deviation = 0.69)). 4STMF was delivered in class time by trained psychology postgraduates. Feasibility (rates of parental opt-out, child assent, assessment completion at baseline and follow-up, programme completion, session attendance and programme fidelity), acceptability (teacher feedback and focus groups with learners), as well as demographic data and data on a battery of a psychological measures were collected at baseline, postintervention and at one-month follow-up.
Results: Most eligible learners at both schools agreed to participate (85% – school 1; 91% – school 2) with more than 80% completing postintervention measures. Learner session attendance and programme fidelity were high. Teachers rated facilitators highly on confidence, preparedness, enthusiasm and classroom management and observed children to be enjoying the programme. Focus group data suggest that learners liked the programme, could recall the content and had shared some of the content with their family. An exploratory analysis of outcomes showed significant pre–post differences on self-esteem at school 1 and on emotion regulation at school 1 and school 2, maintained at follow-up.
Conclusions: This pilot study has shown that 4STMF can acceptably and feasibly be delivered, at classroom level, as a universal school-based prevention programme to young adolescent learners in South African primary schools. The programme could fit in with school context, could be delivered by nonspecialists, showed significant improvements on self-esteem and emotion regulation and was liked by the learners.
| Original language | English |
|---|---|
| Pages (from-to) | 22-32 |
| Number of pages | 11 |
| Journal | Child and Adolescent Mental Health |
| Volume | 29 |
| Issue number | 1 |
| Early online date | 18 Jan 2024 |
| DOIs | |
| Publication status | Published - 29 Feb 2024 |
Funding
This research was funded in whole by the Wellcome Trust (213987/Z/18/Z). The authors would like to thank both schools for hosting them and to all of their participants; they learned so much from you. The authors would also like to thank Prof Helene Loxton, Dr Naomi Myburgh and the NGO staff members for their continuous guidance and support. M.L. (NIHR Doctoral Research Fellowship, DRF-2016-09-021; Development and Skills Enhancement Award, 302367; Advanced Fellowship 302929) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. The authors have declared that they have no competing or potential conflicts of interest.
| Funders | Funder number |
|---|---|
| The Wellcome Trust | 213987/Z/18/Z, 302929, 302367, DRF‐2016‐09‐021 |
| National Institute for Health and Care Research | |
| Department of Health and Social Care |
Keywords
- LMIC
- Mental health
- South Africa
- school-based
- universal intervention
- young adolescents
ASJC Scopus subject areas
- Psychiatry and Mental health
- Pediatrics, Perinatology, and Child Health
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