(RxWiki News) Whether in their schools, families or social circles, teenagers can face a range of pressures. School-based programs are among those aiming to ease challenges to young people's overall well-being.
Projects that work to keep teens mentally healthy may also have the added benefits of helping them maintain a good body weight and avoid severe depression and substance abuse, according to a new study.
"Search for tools to help boost teens' mental health. "
Bernadette Melnyk, PhD, RN, who is dean of Ohio State University College of Nursing, was lead author of the study.
For this research, Dr. Melnyk and her team compared the impact on teenagers of taking what researchers labeled as standard health courses or a health course that also included cognitive behavioral therapy.
The researchers divided a total of 779 14- through 16-year-olds from 11 high schools in the southwestern United States into two groups of roughly the same size. One group was enrolled in 15 consecutive weeks of a 50-minute health class only exploring such topics as road safety, dental and skin care and vaccinations against disease. They also had homework assignments on those topics.
The other half spent 15 consecutive weeks in a 50-minute weekly course, called Creating Opportunities for Personal Empowerment (COPE), that included 20 minutes of physical exercises, instruction on good nutrition and cognitive behavioral therapy.
The cognitive behavioral therapy consisted of having teens consider and record their thoughts about self-esteem and personal emotions, and how they coped with stress and other challenges. It also instructed them on how to practice positive thinking and positive self-talk.
At the end of the study, the researchers found that COPE students had better outcomes in several areas than did the students in the more traditional health course.
The researchers concluded that, compared to students in the traditional course, the COPE students had less excess body weight, behaved better socially and drank less alcohol. The COPE group also made better grades in the health class than did the first group.
These were among the main findings:
- 12.9 percent of COPE students were drinking alcohol at the end of the 15-week course, compared to 19.9 percent of students in the traditional health course.
- Six months after their health courses ended, 97.3 percent of COPE students who began the class at a healthy weight had kept that healthy weight, while 2.7 percent had become overweight. In the traditional health course, 91.2 precent of students who began at a healthy weight maintained that weight, while 7.3 percent had become overweight and 1.5 percent had become obese.
- The number of steps both groups walked per day was about the same at the start of the study — roughly 9,990 steps per day. By the end of study, the COPE students were taking an average of 4,061 more steps per day than students in the traditional health class.
"Less than 25 percent of adolescents who have mental health problems get any help, and here we have an intervention that addresses that suffering and also can prevent or reduce obesity," said Dr. Melnyk, also a professor of pediatrics and psychiatry.
"We teach kids how to monitor [events that trigger bad thoughts] and show them that instead of embracing a negative belief, they can turn that around to a positive belief about themselves," Dr. Melnyk said.
This study was conducted from January 2010 to December 2012. It was prompted by certain hard facts about the general well-being of youth and young adult life in the United States, the researchers wrote. They cited, as examples, the fact that suicide is the third leading cause of death among people aged 10 to 24 living in the United States and that more than a third of the nation's youth are obese.
Yet school-based interventions don't go far enough in addressing those youth concerns or measuring how far school programs go to help alleviate some of the problems teens face, Dr. Melnyk argued.
Dr. Melnyk created COPE about 20 years ago. She began developing COPE while she was a nurse practitioner at an inpatient psychiatric center for teens.
This study marked the first time that the researcher tried to measure how effective COPE is when health teachers, who are not trained therapists, are groomed to teach COPE.
Of the students in the study, 67.5 percent said they were Latino, 14.1 percent said they were white, 9.9 said they were black, 4 percent said they were Asian and 3.5 percent said they were Native American.
"As an educator and child psychiatrist, the presented findings are compelling. From an education standpoint, the increased activity and engagement promoted in the cope curriculum is appealing. And from a mental health standpoint, the integration of physical and mental health in a user-friendly, positive, and evidence-based format represents an important innovation that merits consideration throughout the public education system," Aaron Krasner, MD, a board certified child/adolescent and adult psychiatrist at Silver Hill Hospital in New Canaan, CT, told dailyRx News.
"I support this type of integration of mental health topics and strategies into core state-mandated curriculum with the caveat that such curricular development cannot be a surrogate for appropriate psychiatric treatment when indicated," said Dr. Krasner.
“One well-known but often-ignored aspect of being an adolescent is the desire to have ‘tools’ for solving problems, rather than just listening passively about risks and dangers. From that perspective, cognitive-behavioral therapy (CBT) is an appealing approach, because it focuses on what teens can do for themselves. As this article nicely demonstrates, a well-constructed, brief intervention even with minimally trained instructors potentially can have life-altering effects. Behaviorally informed interventions tailored to adolescent thought processes can be both inexpensive and effective,” Glen R. Elliott, MD, PhD, a clinical professor at the Stanford University Department of Psychiatry and Behavioral Sciences, told dailyRx News.
This study was published online September 10 in the American Journal of Preventive Medicine.
The National Institutes of Health National Institute of Nursing Research funded the study.