Evaluating the effectiveness of a transdiagnostic universal prevention program for both internalizing and externalizing problems in children: two feasibility studies

Abstract

Background The present study examined the effectiveness of the Universal Unified Prevention Program for Diverse Disorders (Up2-D2) for internalizing and externalizing problems for children aged 9–11 years. Methods We used two feasibility studies. The Up2-D2 entailed 12 sessions delivered by teachers; each session was developed based on cognitive-behavioral and positive psychological interventions. In Studies 1 and 2, 58 elementary school children aged 9–11 and 73 elementary school children aged 10–11 attended the Up2-D2. The teachers in Study 1 received 1.5 h of on-site teacher training for learning rationales for interventions, how to run the program, and received ongoing supervision by professionals with mental health expertise. In contrast, the teachers in Study 2 were given self-learning DVD materials in place of on-site training and ongoing supervision. Results Mixed models revealed that general difficulties, which is total score of both internalizing and externalizing problems, decreased in Study 1 but not in Study 2. Additional analyses for children with subclinical general difficulties revealed that general difficulties, internalizing problems, and externalizing problems decreased in Study 1, whereas in Study 2, general difficulties and internalizing problems decreased, except for externalizing problems. Conclusions These results suggest that on-site teacher training and ongoing supervision are imperative for improving general difficulties in children at a universal level. In addition, universal preventive interventions by classroom teachers without on-site training and continuous supervision might be efficacious for reducing general difficulties and internalizing problems for children with subclinical difficulties.

Implementation of a Transdiagnostic Universal Prevention Program on Anxiety in Junior High School Students After School Closure During the COVID-19 Pandemic

“…Therefore, students came back to school after school closure might have more anxiety at the moment and it might be associated with the outcome of this study. Besides, Kishida et al’s ( 2022 ) analysis of feasibility studies using the Up2-D2 for whole students in elementary schools indicated significant improvements for general difficulties which include both internalizing and externalizing problems, but no significant improvements in anxiety, depression, and anger. Although this program was developed to aim preventive effects for anxiety, depression, and anger as a transdiagnostic intervention, pragmatic trials in schools supported that anxiety or general difficulties might be highly likely to be improved.…”

“…Specifically, a teacher manual (teaching plan) was created and distributed so that teachers could implement the program without intensive training and supervision by mental health experts. Kishida et al, ( 2022 ) confirmed that the program could be feasible when implemented without on-site training and ongoing supervision by mental health experts. However, the program has been shown to be more effective when training and supervision was provided by experts rather than schoolteachers who have not been trained (Kishida et al, 2022 ).…”

“…Kishida et al, ( 2022 ) confirmed that the program could be feasible when implemented without on-site training and ongoing supervision by mental health experts. However, the program has been shown to be more effective when training and supervision was provided by experts rather than schoolteachers who have not been trained (Kishida et al, 2022 ). Therefore, the participating teachers received two hours of teacher training before implementing the program, which included an overview of the program, the flow of each session, and how to run the program in class.…”

“…The Universal Unified Prevention Program for Diverse Disorders (Up2-D2; Ishikawa et al, 2019 ; Hida et al, 2020 ; Kishida et al, 2022 ; Oka et al, 2021 ) is a newly developed school-based transdiagnostic universal preventive intervention program that addresses both internalizing and externalizing problems in children and adolescents. Moreover, the Up2-D2 aims not only to prevent children’s mental health problems, but also to improve children’s strengths and self-efficacy.…”

Universal, school-based transdiagnostic interventions to promote mental health and emotional wellbeing: a systematic review

“…WEMWBS Baseline, post-intervention, 3-months follow-up, 9-months follow-up Teacher Mindfuleness Significant effect on Decentering and Nonreactivity (d = − 0.20) among the general sample in 3 month follow-up. Year 8 at 3 month follow-up: Awareness of External Experiences (d = − 0.30), Decentering and Nonreactivity (d = − 0.39), wellbeing (d = − 0.25) Promotion Secondary Kishida et al [ 77 ] (81.3%) No randomization was conducted JSDQ GSESC_x005f-R Short CAS. DSRS-C ASCA Baseline, post-intervention Teacher CBT Study 1: Significant time effects for general difficulties [F (1, 52.78) = 4.88, p < 0.05], general difficulties (SDQ) decreased with small effect sizes (g = − 0.20).…”