Reducing anxiety and depression in Chinese adolescents through group behavioral activation: a pilot study with school-based implementation

TL;DR

A school-based therapy called GBAT reduced anxiety and depression in Chinese teens, with effects lasting three months.

Contribution

This study demonstrates the effectiveness of implementing GBAT in schools for adolescent mental health.

Findings

GBAT significantly reduced anxiety symptoms in adolescents immediately after the intervention.

Improvements in anxiety and depression were maintained at the 3-month follow-up.

GBAT showed moderate to large effect sizes in reducing mental health symptoms.

Abstract

Anxiety and depression are increasingly prevalent public health concerns among adolescents. Group Behavioral Activation Therapy (GBAT), a structured school-based intervention, has shown promise as a potential approach for alleviating these conditions.

This quasi-experimental trial evaluated the efficacy of school-implemented GBAT in reducing anxiety and depressive symptoms among Chinese adolescents. Participants (N = 139; aged 12–17 years; 44.6% male) were assigned to either a GBAT group (n = 72) or a waitlist control group (n = 67). The GBAT protocol consisted of eight weekly 90-minute sessions. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Depression Self-Rating Scale for Children (DSRSC).

A total of 93.06% of students completed all eight GBAT sessions. Post-intervention SCARED scores decreased significantly, t (135) = 2.44, MD = 4.20, 95% CI [0.79, 7.60], p = 0.016, Cohen’s d = 0.42. Linear mixed-model analysis revealed a significant group effect (F (1,397) = 10.60, p = 0.001), indicating lower anxiety scores in the GBAT group compared with the waitlist control. A significant time effect was also observed, F (1,397) = 7.64, p < 0.001. At 3-month follow-up, GBAT maintained significant improvement in anxiety (SCARED: MD = 8.69, 95% CI [3.58, 13.80], p < 0.001 Cohen’s d = 0.82) and depressive symptoms (DSRSC: MD = 2.28, 95% CI [0.10, 4.46], p = 0.037, Cohen’s d = 0.43), indicating moderate to large effect sizes.

These preliminary findings suggest that GBAT may be a promising primary prevention strategy for adolescent mental health. This study provides a foundation for future research exploring its potential integration into school-based mental health frameworks.

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