Preliminary investigation of the feasibility of a long‐term but low‐frequency preventive intervention for depression in Japanese high schools

Abstract

Aim We explored the feasibility of a long‐term but low‐frequency psychological preventive intervention in a high school setting. Background High school students may experience depression; psychological interventions to improve social and cognitive skills may be useful to decrease such depression. A long‐term but low‐frequency intervention may be feasible in this setting because of its minimal time demands and lack of need for specialist human resources Design We conducted a single‐arm longitudinal descriptive study with an intervention applied six times over 2 years in one high school. Method We conducted a psychological preventive intervention with 94 high school students in one school for 2 years (April 2014 to March 2016). This intervention aimed to improve social and cognitive skills. We measured social skills, cognitive distortion, and depression five times during the 2‐year period, through a self‐report scale. Results/Findings Scores for maintaining relationship skills tended to increase over the 2 years. However, depression did not decrease over the intervention period. Conclusion Although our research did not include control conditions and the intervention did not decrease depression, the six‐session programme for high school adolescents improved an aspect of social skills that is a preventive factor against depression.

Implementation and Effectiveness of a Sustained Depression Prevention Program for High School Students in Japan

“…We adopted a long-term but low-frequency approach for implementing the sustained depression prevention program. This approach is easy to implement into the school curriculum and can have a booster effect [13,16]. However, a new nding from the results of this study is that it may take time for the effects of this approach to appear.…”

“…According to previous studies, the trajectory of change may differ depending on gender [29] as well as between the intervention and follow-up periods [13,29]. Therefore, we compared the simple change model, including the entire population and period (Model A), the different intercept and slope for each gender (Model B), the different slope for the intervention and follow-up periods (Model C), as well as the intercept and slope differed by gender and follow-up period (Model D) using the likelihood ratio tests.…”

“…Among the implementation innovations based on curricular issues, a long-term (over one year) but low-frequency preventive intervention that divides the program content into several grades has been proposed [13]. For this method, the sessions are distributed over several school years, which reduce the need to conduct several sessions in a short period of time.…”

“…However, the prevalence of such interventions for high school students is lower than that for elementary and junior high school students, especially in Asian countries [12]. This is because the high school curriculum is time-consuming [13,14], and Asian countries are in a erce competition for entrance exams; most of the time, high school is dedicated to acquiring knowledge necessary for entrance exams [15]. Therefore, to implement a method that will sustain implementation in high schools, it is necessary to integrate universal depression prevention intervention programs into the curricula and demonstrate their effectiveness over time.…”

“…In addition, the vast separation of sessions allows for a booster effect that maintains the effectiveness of the preventive intervention [9,16]. However, it is unclear whether such an implementation would have a signi cant effect, since the number of subjects in the previous study [13] was small and only students enrolled in a particular year were included. Therefore, we have also introduced a psychological schoolbased universal depression prevention program into the school curriculum of a Japanese high school using this strategy.…”