Program

Oct 23, 2014

OVERVIEW

Op Volle Kracht (OVK) is a school-based program intended to prevent depression in adolescents between the ages of 11 and 16 who are at high risk for developing depressive symptoms.  At the one-year follow-up, the program had no statistically significant impact on depressive symptoms; impacts were found, though, for a subgroup of students with parents receiving treatment from a psychiatrist.  However, OVK had an unexpected and unintended impact in that, at the one-year follow-up, with clinical levels of depressive symptoms, a higher proportion of students in the OVK group reported symptoms compared to students in the control group.

DESCRIPTION OF PROGRAM

Target population:  Adolescents with risk factors (low income) to develop depressive symptoms.

Op Volle Kracht (OVK) is a school-based program intended to prevent depression in adolescents at high risk for developing depressive symptoms. OVK is a translated and adapted version of the Penn Resiliency Program.  OVK is administered to entire classes as part of the regular school curriculum.  Teachers also received a comprehensive manual and could ask questions of the trainers at any time during the training or during the course of the program.  The program is comprised of sixteen lessons taught over the course of six months.  The adolescents are taught skills derived from CBT and social problem solving and coping skills through workbook exercises, group discussions, role playing, and homework assignments.

EVALUATION OF PROGRAM

Evaluated Population: A total of 1,324 adolescents, ages 11 to 16, from low income areas in the Netherlands were in the randomized sample.  Schools with at least 30 percent of their students living in low income areas were invited to participate in the study.  At baseline, the students in the sample had an average age of 13, 52.3 percent were female, 47.7 percent were native Dutch, 47.7 percent had at least one foreign born parent, and 5.9 percent had at least one parent who was seeing a psychiatrist.

Approach: Of the 543 schools that received written invitations to participate in the study, twelve agreed to participate, providing access to 1,440 students in 61 classrooms.  In the final implementation, the study included 1,343 adolescents from 57 classrooms in 11 schools. Classrooms in the schools that agreed to participate in the study were randomly assigned to deliver the curriculum or to be a control classroom.  Classrooms not receiving OVK received the regular curriculum only. The study included 667 students in OVK classrooms and 676 in regular classes.  Parents were asked to submit permission forms for their children’s participation in the study; but, as participation was obligatory for all students in the classrooms assigned to receive OVK, data were not collected for those students whose parents did not submit permission forms.  The regular teachers received four days of training, provided by certified members of the research team, prior to implementation of the program. During the first two days of training, the teachers learn to use cognitive behavior therapy (CBT) skills on their own thoughts and feelings, and during the last two days they practice the lessons of the program.

The primary outcome of interest was the degree to which students experienced depressive symptoms and was measured using the Children’s Depression Inventory (CDI).  CDI is a self-reporting questionnaire that assesses affective, cognitive, and behavioral symptoms of depression.  The secondary outcome of interest was whether students exhibited clinical depressive symptoms.  Data were collected prior to the start of the program, just after the end of the program, and at six and twelve months after the end of the program. Incentives were given to the teachers at the six-month follow-up (a cream cake) and to the schools at the twelve-month follow-ups (10 euros per student, with distribution to be decided by the school).  Data were adjusted for clustering at the classroom level.  At baseline, there was a statistically significant difference between students in program classrooms and those in the control classrooms, with the latter including a greater number of adolescents with parents who were seeing a psychiatrist.  Because of this, parental psychopathology was included as a covariate in the analyses.

Results: The study found that at the one-year follow up, OVK had no impact on depressive symptoms.  At the one-year follow-up, OVK had the unexpected and unintended impact that clinical depressive symptoms increased for adolescents in OVK, compared with students in the control group.  Among students with a parent being treated by a psychiatrist at baseline, positive impacts on depressive symptoms were found.

SOURCES FOR MORE INFORMATION

References

Kindt, K.C., Kleinjan, M., Janssens, J.M.A.M., Scholte, R.H.J. (2014).  International Journal of Environmental Research Public Health, 11, 5273-5293.

KEYWORDS: Adolescents, Males and Females (Co-ed), High-Risk, School-based, Depression/Mood Disorders, Social Skills/Life Skills, Self-esteem/Self-Concept

Program information last updated on 10/23/2014.

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