The Impact of a Harry Potter-Based Cognitive-Behavioral Therapy Skills Curriculum on Suicidality and Well-being in Middle Schoolers: A Randomized Controlled Trial

Paula Klim-Conforti; Rabia Zaheer; Anthony J Levitt; Amy H Cheung; Russell Schachar; Ayal Schaffer; Benjamin I Goldstein; Mark Fefergrad; Thomas Niederkrotenthaler; Mark Sinyor

doi:10.1016/j.jad.2021.02.028

The Impact of a Harry Potter-Based Cognitive-Behavioral Therapy Skills Curriculum on Suicidality and Well-being in Middle Schoolers: A Randomized Controlled Trial

J Affect Disord. 2021 May 1:286:134-141. doi: 10.1016/j.jad.2021.02.028. Epub 2021 Feb 10.

Authors

Affiliations

¹ Member of the College of Psychologists of Ontario, Toronto, Ontario, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada.
² Sunnybrook Health Sciences Centre, Toronto, Canada.
³ Department of Psychiatry, University of Toronto, Psychiatrist, Sunnybrook Health Sciences Centre, Toronto, Canada.
⁴ The Hospital for Sick Children. Professor, Department of Psychiatry, University of Toronto, Canada.
⁵ Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Professor, Department of Psychiatry, University of Toronto, Canada.
⁶ Department of Psychiatry, University of Toronto, Psychiatrist, The Centre for Addiction and Mental Health, Toronto, Canada.
⁷ Medical University of Vienna, Centre for Public Health, Department of Social and Preventive Medicine, Unit Suicide Research and Mental Health Promotion.
⁸ Department of Psychiatry, University of Toronto, Psychiatrist, Sunnybrook Health Sciences Centre, Toronto, Canada. Electronic address: mark.sinyor@sunnybrook.ca.

PMID: 33721740
DOI: 10.1016/j.jad.2021.02.028

Abstract

Objective: To evaluate the impact of a Harry Potter-based mental health literacy curriculum, imparting cognitive behavioral therapy (CBT) skills, on suicidality and well-being in middle-schoolers.

Methods: Students (aged 11-14; grades 7-8) who received a 3-month teacher-delivered intervention embedded in the language arts curriculum (N=200) were compared to a wait-list control group (N=230) in the largest urban school board in Canada. Suicidality defined as a composite measure of self-reported suicidal ideation and attempts [primary outcome], self-reported emotion dysregulation, interpersonal chaos, confusion about self, and impulsivity [Life Problems Inventory (LPI)] and self-reported depression and anxiety symptoms [Revised Child Anxiety and Depression Scale (RCADS)] were the outcomes of interest. Measurements occurred prior to and after curriculum delivery with independent t-tests used to compare mean change scores between groups clustered by class.

Results: Thirty-seven English teachers in 46 classes across 15 schools comprised the planned study cohort. Composite suicidality scores were significantly worse in the control than intervention group at endpoint (0.05±0.54 vs. 0.17±0.47, t= -2.60, df=428, p=0.01). There were also significant improvements in LPI and RCADS scores in the intervention group compared to controls (LPI:-3.74±7.98 vs. 1.16±10.77 t=5.28, df=428, p<.001; RCADS: (-3.08±5.49 vs. -1.51±6.53 t=2.96, df=429, p=0.01). Sub-analyses revealed that these improvements were largely driven by a significant difference in scores in girls.

Limitations: Sample size constraints as study terminated prematurely during COVID pandemic.

Conclusions: This study demonstrates significant improvement in suicidality, emotional regulation, self-concept, interpersonal difficulties, depression and anxiety in youth, particularly girls following this intervention. Replication studies in larger samples are needed to confirm these results.

Keywords: Anxiety; Depression; School-based; Suicide; Universal Prevention.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
COVID-19*
Canada
Child
Cognitive Behavioral Therapy*
Curriculum
Depression / therapy
Female
Humans
SARS-CoV-2
Suicide Prevention*