Intervention: Psychoeducation in the form of a Comprehensive, Developmental Guidance Lesson
Theoretical Approach: Cognitive-Behavioral
Modality of Intervention: Group, Primary Prevention
Setting: School
Psychoeducation is a cognitive-behavioral therapy technique that can be applied to helping adolescents with Major Depressive Disorder. Psychoeducational interventions are methods in which education is offered to individuals with psychological disorders or physical illnesses. Counselors educate students about the nature of their problems and how treatment is likely to succeed. A major strength of this technique is the emphasis on education and prevention (Corey, 2009).
According to Donker, Griffiths, Cuijpers, and Christensen (2009), “Psychoeducation interventions can vary from the delivery of 'passive' materials such as single leaflets, emails or information websites to active multi-session group-intervention with exercises and therapist-guidance. Examples of passive interventions are interventions that offer psychoeducational information about disorders or feedback to individuals based on test results or screening tests.” In addition, there is evidence from systematic reviews that psychoeducational interventions are effective in treating or preventing mental disorders (Donker et al, 2009).
The American Foundation for Suicide Prevention (AFSP) developed More Than Sad: Teen Depression to show young people and those close to them what depression looks like in adolescents and how it can be treated. The key aims of the 26-minute film are to help teens recognize depression in themselves or their friends, and to encourage them to seek help.
More Than Sad was designed to be used as an educational tool to achieve several specific goals:
•To educate high school students and other teens to recognize the signs and symptoms of depression in themselves and others;
•To convey the de-stigmatizing notion that depression is an illness that, just like any other medical illness, responds to specific treatments;
•To promote the importance and acceptability of seeking help for oneself or a friend and to demystify the treatment process by showing how teens can get help for depression, what treatment involves and what it can achieve.
**Counselors who show this film are encouraged to review the guide thoroughly to ensure that the film will be an effective and safe resource. Doing this will increase your confidence as a facilitator and enhance the likelihood that the film will have a positive impact on your viewers.
(LINK TO THE FACILITATOR'S GUIDE: http://www.morethansad.org/facilitatorguide.pdf)**
Developmental Learning Activity: one-50 minute class
Introduction (3 min): “Today we will be watching a film about depression in teenagers. Most of us probably think we know what it means to be depressed, but in this film you’re going to meet four quite different teenagers, each of whom struggled with depression. After watching the film, we’ll have a chance to talk about what we've seen and the messages we can draw from these teens’ experiences. First, though, I’d like for you to take a few minutes to answer some brief questions about teen depression. Whether or not you think you know the right answers, you’ll want to keep these questions in mind as you watch the film and listen for the correct answers.”
Theoretical Approach: Cognitive-Behavioral
Modality of Intervention: Group, Primary Prevention
Setting: School
Psychoeducation is a cognitive-behavioral therapy technique that can be applied to helping adolescents with Major Depressive Disorder. Psychoeducational interventions are methods in which education is offered to individuals with psychological disorders or physical illnesses. Counselors educate students about the nature of their problems and how treatment is likely to succeed. A major strength of this technique is the emphasis on education and prevention (Corey, 2009).
According to Donker, Griffiths, Cuijpers, and Christensen (2009), “Psychoeducation interventions can vary from the delivery of 'passive' materials such as single leaflets, emails or information websites to active multi-session group-intervention with exercises and therapist-guidance. Examples of passive interventions are interventions that offer psychoeducational information about disorders or feedback to individuals based on test results or screening tests.” In addition, there is evidence from systematic reviews that psychoeducational interventions are effective in treating or preventing mental disorders (Donker et al, 2009).
The American Foundation for Suicide Prevention (AFSP) developed More Than Sad: Teen Depression to show young people and those close to them what depression looks like in adolescents and how it can be treated. The key aims of the 26-minute film are to help teens recognize depression in themselves or their friends, and to encourage them to seek help.
More Than Sad was designed to be used as an educational tool to achieve several specific goals:
•To educate high school students and other teens to recognize the signs and symptoms of depression in themselves and others;
•To convey the de-stigmatizing notion that depression is an illness that, just like any other medical illness, responds to specific treatments;
•To promote the importance and acceptability of seeking help for oneself or a friend and to demystify the treatment process by showing how teens can get help for depression, what treatment involves and what it can achieve.
**Counselors who show this film are encouraged to review the guide thoroughly to ensure that the film will be an effective and safe resource. Doing this will increase your confidence as a facilitator and enhance the likelihood that the film will have a positive impact on your viewers.
(LINK TO THE FACILITATOR'S GUIDE: http://www.morethansad.org/facilitatorguide.pdf)**
Developmental Learning Activity: one-50 minute class
Introduction (3 min): “Today we will be watching a film about depression in teenagers. Most of us probably think we know what it means to be depressed, but in this film you’re going to meet four quite different teenagers, each of whom struggled with depression. After watching the film, we’ll have a chance to talk about what we've seen and the messages we can draw from these teens’ experiences. First, though, I’d like for you to take a few minutes to answer some brief questions about teen depression. Whether or not you think you know the right answers, you’ll want to keep these questions in mind as you watch the film and listen for the correct answers.”
Activities
Worksheet (3 min): Distribute worksheet. The purpose of the quiz is to alert viewers to some of the topics that will be covered in the film, rather than to test their knowledge, so it is helpful to let students know that they will be asked the questions again after the film, and encourage them again to listen carefully to the film for the right answers.
Movie (26 mins): Distribute a blank sheet of paper to each student prior to the start of the movie. Instruct the students to jot down any questions they may have during the short film.
This clip from the movie below shows one high school aged boy suffering from irritability and drinking to try to make himself feel better. This is an example that some high school students will be able to relate to and provides students with another symptom of depression. He is also speaking to a counselor in the clip and is modeling that help is possible!
This clip from the movie below shows one high school aged boy suffering from irritability and drinking to try to make himself feel better. This is an example that some high school students will be able to relate to and provides students with another symptom of depression. He is also speaking to a counselor in the clip and is modeling that help is possible!
Discussion (10 mins): Encourage students to ask questions they may have and answer them to the best of your ability. Additionally, pose questions like:
· Which of the four students in the film would you have been most likely to recognize as being depressed?
· Why? Were there any you would not think of as being depressed?
· What differences did you notice about the ways that depression was expressed in the four students shown in the film?
· What does the film say about the causes of depression in teens?
During the discussion, educate students on depression. The American Foundation for Suicide Prevention provides an information on depression in teens handout so that you may educate the students on symptoms, statistics, normalize how they might feel, remove stigma, and make depression less "scary."
· Which of the four students in the film would you have been most likely to recognize as being depressed?
· Why? Were there any you would not think of as being depressed?
· What differences did you notice about the ways that depression was expressed in the four students shown in the film?
· What does the film say about the causes of depression in teens?
During the discussion, educate students on depression. The American Foundation for Suicide Prevention provides an information on depression in teens handout so that you may educate the students on symptoms, statistics, normalize how they might feel, remove stigma, and make depression less "scary."
Finishing up the lesson
Repeat worksheet and distribute handouts (3 mins): Have
students repeat the worksheet and go over briefly the handout they were given. The handout provides facts about depression that the students can take with them. A copy of this handout can be retrieved from: http://www.morethansad.org/factsaboutdepression.pdf.
Conclusion (2 min): Summarize key points that were discussed both in the film and throughout the discussion. Mention:
- Like other illnesses, depression sometimes doesn’t seem to have a clear cause. It can be triggered by chemicals in the brain becoming unbalanced, and thus can affect teens who don’t seem to have any particular reason to be unhappy or upset.
·Like many other illnesses, depression usually doesn’t go away on its own. Treatments are available and they work.
·If someone you know seems to be depressed, encourage them to talk to their parents, counselors, doctors, or another adult about getting help.
Brief Assessment of the Activity: The handout completion will assess what students learned during the lesson. This handout will allow students to demonstrate their knowledge of depression before and after the movie.
*Multicultural Consideration: Counselors who use psychoeducation and CBT often function as teachers and have students who focus on learning skills to deal with the problems students face. This type of intervention is collaborative but also structural, individualized to the student, active in nature, emphasizes learning, and generally, is brief.
*Developmental Consideration: Adolescents are developing their sense of self and are still trying to fit in with their peers This video shows students of the same age expressing feelings of depression. For students who are viewing this movie, their feelings will be normalized. Additionally, the video shows students needing help and asking for it which might encourage viewers to do the same. Again, this video normalizes their feelings and allows students to discover who they are ad what they can be by reaching out for help.
*Accommodation for Visual Impairment: Preferential seating for this student close to the SMARTboard, chalkboard, etc. For this lesson, students will be accommodated with large print handouts, magnifier, and closed captioning will be used with the video.
ASCA National Standards:
Academic Standard A: Students will acquire the attitudes, knowledge and skills that contribute to effective learning in school and across the life span.
Competencies: A:A2 Acquire Skills for Improving Learning
A:A2.2 Demonstrate how effort and persistence positively affect learning
A:A2.3 Use communications skills to know when and how to ask for help when needed
A:A2.4 Apply knowledge and learning styles to positively influence school performance
A:A3 Achieve School Success
A:A3.1 Take responsibility for their actions
A:A3.3 Develop a broad range of interests and abilities
A:A3.5 Share knowledge
Standard B: Students will complete school with the academic preparation essential to choose from a wide range of substantial post-secondary options, including college.
Competencies: A:B1 Improve Learning
A:B1.1 Demonstrate the motivation to achieve individual potential
A:B1.2 Learn and apply critical-thinking skills
A:B1.4 Seek information and support from faculty, staff, family and peers
A:B2 Plan to Achieve Goals
A:B2.5 Use problem-solving and decision-making skills to assess progress toward educational goals
Personal/Social Standard A: Students will acquire the knowledge, attitudes and interpersonal skills to help them understand and respect self and others.
Competencies: PS:A1 Acquire Self-knowledge
PS:A1.1 Develop positive attitudes toward self as a unique and worthy person
PS:A1.4 Understand change is a part of growth
PS:A1.5 Identify and express feelings
PS:A2 Acquire Interpersonal Skills
PS:A2.7 Know that communication involves speaking, listening and nonverbal behavior
PS:C1 Acquire Personal Safety Skills
PS:C1.6 Identify resource people in the school and community, and know how to seek their help
PS:C1.7 Apply effective problem-solving and decision-making skills to make safe and healthy choices
References
American Foundation for Suicide Prevention. (2009). More than sad: Teen depression [Web]. Retrieved from http://www.morethansad.org/facilitatorguide.pdf
American Foundation for Suicide Prevention (2009). More than sad: Teen depression (Clip 4 of 5). Retrieved from http://www.youtube.com/watch?feature=player_embedded&v=uiOjmfaxhdE
American School Counselor Association. (2004). ASCA National Standards for Students. Alexandria, VA: Author.
Corey, G. (2009). Theory and Practice of Counseling & Psychotherapy. Cengage Learning.
Donker, T., Griffiths, K. M., Cuijpers, P., & Christensen, H. (2009). Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC medicine, 7(1), 79.
Neil, A. L., & Christensen, H. (2009). Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clinical Psychology Review, 29(3), 208-215.
- Like other illnesses, depression sometimes doesn’t seem to have a clear cause. It can be triggered by chemicals in the brain becoming unbalanced, and thus can affect teens who don’t seem to have any particular reason to be unhappy or upset.
·Like many other illnesses, depression usually doesn’t go away on its own. Treatments are available and they work.
·If someone you know seems to be depressed, encourage them to talk to their parents, counselors, doctors, or another adult about getting help.
Brief Assessment of the Activity: The handout completion will assess what students learned during the lesson. This handout will allow students to demonstrate their knowledge of depression before and after the movie.
*Multicultural Consideration: Counselors who use psychoeducation and CBT often function as teachers and have students who focus on learning skills to deal with the problems students face. This type of intervention is collaborative but also structural, individualized to the student, active in nature, emphasizes learning, and generally, is brief.
*Developmental Consideration: Adolescents are developing their sense of self and are still trying to fit in with their peers This video shows students of the same age expressing feelings of depression. For students who are viewing this movie, their feelings will be normalized. Additionally, the video shows students needing help and asking for it which might encourage viewers to do the same. Again, this video normalizes their feelings and allows students to discover who they are ad what they can be by reaching out for help.
*Accommodation for Visual Impairment: Preferential seating for this student close to the SMARTboard, chalkboard, etc. For this lesson, students will be accommodated with large print handouts, magnifier, and closed captioning will be used with the video.
ASCA National Standards:
Academic Standard A: Students will acquire the attitudes, knowledge and skills that contribute to effective learning in school and across the life span.
Competencies: A:A2 Acquire Skills for Improving Learning
A:A2.2 Demonstrate how effort and persistence positively affect learning
A:A2.3 Use communications skills to know when and how to ask for help when needed
A:A2.4 Apply knowledge and learning styles to positively influence school performance
A:A3 Achieve School Success
A:A3.1 Take responsibility for their actions
A:A3.3 Develop a broad range of interests and abilities
A:A3.5 Share knowledge
Standard B: Students will complete school with the academic preparation essential to choose from a wide range of substantial post-secondary options, including college.
Competencies: A:B1 Improve Learning
A:B1.1 Demonstrate the motivation to achieve individual potential
A:B1.2 Learn and apply critical-thinking skills
A:B1.4 Seek information and support from faculty, staff, family and peers
A:B2 Plan to Achieve Goals
A:B2.5 Use problem-solving and decision-making skills to assess progress toward educational goals
Personal/Social Standard A: Students will acquire the knowledge, attitudes and interpersonal skills to help them understand and respect self and others.
Competencies: PS:A1 Acquire Self-knowledge
PS:A1.1 Develop positive attitudes toward self as a unique and worthy person
PS:A1.4 Understand change is a part of growth
PS:A1.5 Identify and express feelings
PS:A2 Acquire Interpersonal Skills
PS:A2.7 Know that communication involves speaking, listening and nonverbal behavior
PS:C1 Acquire Personal Safety Skills
PS:C1.6 Identify resource people in the school and community, and know how to seek their help
PS:C1.7 Apply effective problem-solving and decision-making skills to make safe and healthy choices
References
American Foundation for Suicide Prevention. (2009). More than sad: Teen depression [Web]. Retrieved from http://www.morethansad.org/facilitatorguide.pdf
American Foundation for Suicide Prevention (2009). More than sad: Teen depression (Clip 4 of 5). Retrieved from http://www.youtube.com/watch?feature=player_embedded&v=uiOjmfaxhdE
American School Counselor Association. (2004). ASCA National Standards for Students. Alexandria, VA: Author.
Corey, G. (2009). Theory and Practice of Counseling & Psychotherapy. Cengage Learning.
Donker, T., Griffiths, K. M., Cuijpers, P., & Christensen, H. (2009). Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC medicine, 7(1), 79.
Neil, A. L., & Christensen, H. (2009). Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clinical Psychology Review, 29(3), 208-215.
Intervention: Mental Health Screening
Theoretical Approach: Behavioral Theory
Modality of Intervention: Group, Primary Prevention
Setting: School
Primary prevention systems of behavior support that schools conduct a screening for identifying students who may be at risk for developing emotional or behavioral disorders. Using a universal mental health screening can offer extremely helpful information about students. According to Gould, Greenberg, Velting, and Shaffer (2003), self-report and individual interviews are used to identify youngsters at risk for suicidal behavior. School-wide screenings, involving multistage assessments, have focused on depression, substance abuse problems, recent and frequent suicidal ideation, and past suicide attempts.
In another study, D'Esposito, Blake, Riccio (2011), explored how to minimize peer aggression. In their research, they offer implications for school counselors. They offer this, “Universal screenings, in the form of brief rating scales that can be administered school-wide, could be used as one tool by school counselors to identify students who display characteristics that place them at risk for victimization. Such screenings could also provide a method to identify children with general psychological adjustment difficulties who are in need of counseling (e.g., children who are experiencing grief after loss of loved one.” Screening is typically linked to the concept of preventing problems or developing early intervention strategies to prevent long-term negative outcomes (Levine, Perkins, & Perkins, 2005).
Theoretical Approach: Behavioral Theory
Modality of Intervention: Group, Primary Prevention
Setting: School
Primary prevention systems of behavior support that schools conduct a screening for identifying students who may be at risk for developing emotional or behavioral disorders. Using a universal mental health screening can offer extremely helpful information about students. According to Gould, Greenberg, Velting, and Shaffer (2003), self-report and individual interviews are used to identify youngsters at risk for suicidal behavior. School-wide screenings, involving multistage assessments, have focused on depression, substance abuse problems, recent and frequent suicidal ideation, and past suicide attempts.
In another study, D'Esposito, Blake, Riccio (2011), explored how to minimize peer aggression. In their research, they offer implications for school counselors. They offer this, “Universal screenings, in the form of brief rating scales that can be administered school-wide, could be used as one tool by school counselors to identify students who display characteristics that place them at risk for victimization. Such screenings could also provide a method to identify children with general psychological adjustment difficulties who are in need of counseling (e.g., children who are experiencing grief after loss of loved one.” Screening is typically linked to the concept of preventing problems or developing early intervention strategies to prevent long-term negative outcomes (Levine, Perkins, & Perkins, 2005).
One universal screening measure: BASC-2 Behavioral and Emotional Screening System
BASC-2 is a brief measure, with parent, teacher, and child forms, for use with grades preschool through 12. It takes approximately 5-10 minutes to administer, is available in Spanish, and can be hand scored, computer scored, or scored via scantron. One benefit of this screening is the software that is included which provides both individual and group reporting options. This software can define multiple groups within a location and generate summary reports for each of the levels within a group (e.g. classroom, district, region). In addition, a roster listing students and their scores can be generated for any of the group variables that have been defined.
Link for more information on: BASC-2 and pricing.
Link for more information on: BASC-2 and pricing.
Once students are identified as being at risk for exhibiting mental health problems or experiencing victimization, the school counselor could interview these students to determine whether additional counseling services are needed, such as group or individual counseling, or general social skills training is required (D'Esposito, Blake, & Riccio, 2011). |
According to Severson, Walker, Hope-Doolittle, Kratochwill, & Gresham (2007), "Schools are increasingly embracing models of prevention to deal with the large number of students who need services. Multi-tiered models of prevention are being considered, and screening is linked to initial identification of students who may profit from more intense services in the school and community," (Severson & Walker, 2002). |
Universal screening data indicates which students need additional instruction.
Screening data is not diagnostic but can provide information about the starting point for
students who need additional help.
Screening data is not diagnostic but can provide information about the starting point for
students who need additional help.
**The ultimate success of this screening strategy is dependent on the effectiveness of the referral. Considerable effort must be made to assist the families and adolescents in obtaining help if it is needed (Gould et al., 2003). Research suggests that early identification followed by effective education and treatment improves the school, community and life outcomes for children and families.**
*Multicultural Consideration: Screenings can be used in different languages. Additionally, in the example above, the BASC-2 applies a triangulation method for gathering information. By analyzing the child’s behavior from three perspectives—Self, Teacher, and Parent—you get a more complete and balanced picture of the student. Finally, the BASC-2 is normed based on current U.S. Census population characteristics.
*Developmental Consideration: The screening that is used needs to be written in a format and use language that students can understand. As mentioned in the Assessments section of this website, children and adolescents do not have the same ability as adults to understand and report strong internal emotions. Therefore, the limitations of self-report measures should be considered during the interpretation of results of the screening process. Thus, a screening instrument such as the BASC-2 allows multiple raters to get a more comprehensive and accurate view of the student.
*Accommodation for students with learning disability: Screening tool can be read aloud to students (and repeated, if needed) and answers can be noted by a teacher, counselor, or other school personnel.
ASCA National Standards:
Academic Standard A: Students will acquire the attitudes, knowledge and skills that contribute to effective learning in school and across the life span.
Competencies: A:A1 Improve Academic Self-concept
A:A1.5 Identify attitudes and behaviors that lead to successful learning
A:A2 Acquire Skills for Improving Learning
A:A2.2 Demonstrate how effort and persistence positively affect learning
A:A2.3 Use communications skills to know when and how to ask for help when needed
Personal/Social Standard A: Students will acquire the knowledge, attitudes and interpersonal skills to help them understand and respect self and others.
Competencies: PS:A1 Acquire Self-knowledge
PS:A1.2 Identify values, attitudes and beliefs
PS:A1.5 Identify and express feelings
PS:A1.10 Identify personal strengths and assets
References
American School Counselor Association. (2004). ASCA National Standards for Students. Alexandria, VA: Author.
D'Esposito, S. E., Blake, J., & Riccio, C. A. (2011). Adolescents' vulnerability to peer victimization: Interpersonal and intrapersonal predictors. Professional School Counseling, 14(5), 299-309.
Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: a review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42(4), 386-405.
Levine, M., Perkins, D. D., & Perkins, D. V. (Eds.). (2005). Prevention. Principles of community psychology: Perspectives and applications (pp. 271–325)., 3rd ed. New York: Oxford University Press.
Severson, H. H., Walker, H. M., Hope-Doolittle, J., Kratochwill, T. R., & Gresham, F. M. (2007). Proactive, early screening to detect behaviorally at-risk students: Issues, approaches, emerging innovations, and professional practices. Journal of School Psychology, 45(2), 193-223.
*Multicultural Consideration: Screenings can be used in different languages. Additionally, in the example above, the BASC-2 applies a triangulation method for gathering information. By analyzing the child’s behavior from three perspectives—Self, Teacher, and Parent—you get a more complete and balanced picture of the student. Finally, the BASC-2 is normed based on current U.S. Census population characteristics.
*Developmental Consideration: The screening that is used needs to be written in a format and use language that students can understand. As mentioned in the Assessments section of this website, children and adolescents do not have the same ability as adults to understand and report strong internal emotions. Therefore, the limitations of self-report measures should be considered during the interpretation of results of the screening process. Thus, a screening instrument such as the BASC-2 allows multiple raters to get a more comprehensive and accurate view of the student.
*Accommodation for students with learning disability: Screening tool can be read aloud to students (and repeated, if needed) and answers can be noted by a teacher, counselor, or other school personnel.
ASCA National Standards:
Academic Standard A: Students will acquire the attitudes, knowledge and skills that contribute to effective learning in school and across the life span.
Competencies: A:A1 Improve Academic Self-concept
A:A1.5 Identify attitudes and behaviors that lead to successful learning
A:A2 Acquire Skills for Improving Learning
A:A2.2 Demonstrate how effort and persistence positively affect learning
A:A2.3 Use communications skills to know when and how to ask for help when needed
Personal/Social Standard A: Students will acquire the knowledge, attitudes and interpersonal skills to help them understand and respect self and others.
Competencies: PS:A1 Acquire Self-knowledge
PS:A1.2 Identify values, attitudes and beliefs
PS:A1.5 Identify and express feelings
PS:A1.10 Identify personal strengths and assets
References
American School Counselor Association. (2004). ASCA National Standards for Students. Alexandria, VA: Author.
D'Esposito, S. E., Blake, J., & Riccio, C. A. (2011). Adolescents' vulnerability to peer victimization: Interpersonal and intrapersonal predictors. Professional School Counseling, 14(5), 299-309.
Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: a review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42(4), 386-405.
Levine, M., Perkins, D. D., & Perkins, D. V. (Eds.). (2005). Prevention. Principles of community psychology: Perspectives and applications (pp. 271–325)., 3rd ed. New York: Oxford University Press.
Severson, H. H., Walker, H. M., Hope-Doolittle, J., Kratochwill, T. R., & Gresham, F. M. (2007). Proactive, early screening to detect behaviorally at-risk students: Issues, approaches, emerging innovations, and professional practices. Journal of School Psychology, 45(2), 193-223.