Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools

Behav Res Ther. 2020 Jul:130:103439. doi: 10.1016/j.brat.2019.103439. Epub 2019 Jul 30.

Abstract

Background: The PRIDE programme aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. This paper describes the development of a low-intensity, first-line component of the PRIDE model.

Method: Contextual and global evidence informed an intervention 'blueprint' with problem solving as the primary practice element. Successive iterations were tested and modified across two pilot cohort studies (N = 45; N = 39). Participants were aged 13-20 years and presenting with elevated mental health symptoms in New Delhi schools.

Results: The first iteration of the intervention, based on a guided self-help modality, showed promising outcomes and user satisfaction when delivered by psychologists. However, delivery was not feasible within the intended 6-week schedule, and participants struggled to use materials outside 'guidance' sessions. In Pilot 2, a modified counsellor-led problem-solving intervention was implemented by less experienced counsellors over a 3-4 week schedule. Outcomes were maintained, with indications of enhanced feasibility and acceptability. High demand was observed across both pilots, leading to more stringent eligibility criteria and a modified sensitisation plan.

Discussion: Findings have shaped a first-line intervention for common adolescent mental health problems in low-resource settings. A forthcoming randomised controlled trial will test its effectiveness.

Keywords: Adolescents; India; Mental health; Psychological intervention; Schools; Transdiagnostic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Anxiety / psychology
  • Anxiety / therapy*
  • Cohort Studies
  • Conduct Disorder / psychology
  • Conduct Disorder / therapy*
  • Depression / psychology
  • Depression / therapy*
  • Evidence-Based Practice
  • Female
  • Humans
  • India
  • Male
  • Pilot Projects
  • Problem Solving
  • Program Development
  • Psychosocial Intervention*
  • School Mental Health Services*
  • Schools
  • Young Adult