Examination of an indicated prevention program targeting emotional and behavioural functioning in young adolescents

The current study is an evaluation of the Life Skills Program, an indicated prevention program developed by a team of clinicians within the Child and Adolescent Health Services (CAHS; government run specialist mental health service) in Western Australia. Typically, young people who meet criteria to access CAHS are those who are on the more extreme end of the spectrum of mental disorders. This access pattern is mainly due to resource limitations and, therefore, complex and high needs clients are prioritised first. The Life Skills program, developed as a way of revising the traditional model of service delivery, aims to reduce the incidence of mental health disorders among adolescents, by targeting sub-clinical populations, thereby averting severe mental health dysfunction. The program content draws upon various therapeutic techniques from Cognitive- Behavioural, Dialectical Behaviour, and Acceptance- and Mindfulness-based models of therapy intervention, with an overall primary focus across these techniques on emotional regulation as a target for intervention. The program consists of eight weekly sessions of group therapy, designed to be delivered over the course of one school term. The current study was aimed at gaining a better understanding of how the Life Skills program impacted the behavioural and emotional functioning of young adolescents, aged 12 to 14 years, who had been identified as being at-risk for developing clinical disorder. Groups were run seven times within six different high schools in the Perth Metropolitan area and questionnaires were administered pre- and post-intervention. It was hypothesised that participants assigned to receive the Life Skills program, when compared to participants assigned to the no-intervention control group, would experience (a) significant reductions on measures of psychological indicators including depression, internalising and externalising symptoms and (increases in) self-esteem and (b) significant improvements on measures of process skills including coping skills, acceptance and mindfulness and (a reduction of) fear of emotions. Results showed that there were significant intervention effects for productive coping (subscale of the Adolescent Coping Scale), acceptance and mindfulness, symptoms of depression, and fear of anxiety (subscale of the Modified Affective Control Scale for Adolescents-Revised). However, there were non-significant results for the remaining coping subscales, the remaining fear of emotions sub-scales, self-esteem, and internalising and externalising symptoms. Structural Equation Modelling (Path Analysis) revealed that the changes in the participants’ psychological indicator measures (depression symptoms and emotional symptoms), based on their assignment to either prevention or control group, was partially mediated through their acquisition of acceptance and mindfulness skills, a decrease in their fear of emotions and increased productive coping skills. The current findings inform best practice in terms of models of service delivery within CAHS and also make an important contribution to knowledge generation in prevention science. In particular, the findings support etiological theories that highlight the role of emotion regulation as an underlying mechanism for the development of psychopathology