The Penn Prevention Program (PPP) is a school-based
depression prevention program facilitated by school psychologists or nurses.
Program session included lessons on topics including: feelings and thoughts,
dealing with family conflict, assertion and negotiation, coping skills, social
skills training, decisions making, and problem-solving. Schools were randomly
assigned. The results of the evaluation show that there were no significant
differences between the intervention and control groups at post-intervention or
follow-up for symptoms of depression or optimism. Results post evaluation
showed that children in the intervention group reported less anxiety and
parents in the intervention group were less likely to report internalizing
problems and externalizing problems. The impacts for anxiety still existed at
follow-up. The impact of the intervention was strongest directly after the
DESCRIPTION OF PROGRAM
Target population: Middle schoolstudents at-risk for depression
and anxiety due to elevated depressive symptoms
Penn Prevention program is aimed at reducing depressive and anxious symptoms.
The program consists of 12 sessions led by a facilitator who has 40 hours of
training from the PPP, and a co-facilitator who has 30 hours of training.
Program facilitators and co-facilitators are often school psychologists or
nurses with bachelor’s degrees in behavioral science.
Scripted manuals are used to lead the sessions. Session topics include:
Feelings and thoughts
link between thoughts and feelings
styles and considering causes
thoughts and decatastrophising
with family conflict
tasks and social skills training
EVALUATION(S) OF PROGRAM
Evaluated population: For the study,
189 7th graders from 18 primary schools in rural Western Australia aged 11-13 years were
Approach: The thirteen students in each class who scored highest on the Child
Depression Inventory were selected and schools were randomly assigned to the
treatment or control group. There were 90 children (46 girls) in the
intervention group and 99 children (48 girls) in the control group.
the nine primary schools randomly assigned to receive the program, the children
receiving the intervention attended program sessions during school. The
students in the nine control schools attended their usual health education
measures were used in the evaluation. The Child Depression Inventory
(CDI) was used to measure depressive symptoms. Higher scores mean the
symptoms were more severe, and a cutoff score of 15 was used in this study to
indicate moderate to severe levels of depressive symptoms. The Revised Children’sManifest Anxiety Scale (RCMAS)was
used to measure anxiety. Higher scores for this test also mean more
severe symptoms, and a cutoff score of 16 was used to delineate between
moderate to severe levels of anxiety. The Children’s
Attributional Style Questionnaire (CASQ)
assesses explanatory style for positive and negative events. The MatsonEvaluation of Social Skills with Youngsters (MESSY) measures social skills
and the Child Behavior Checklist (CBCL) measures levels of internalizing
problems such as social withdrawal. A higher score on the checklist
points toward more problems.
Results: The results of the study show that there were no
significant differences in depressive symptoms between the intervention and
control groups at post-intervention or 6-month follow-up. The mean
depression scores on the CDI went down for both groups over time.
Intervention group children reported fewer symptoms of anxiety than control
group children. At post-intervention, the intervention group had a mean
score of 7.38 on the RCMAS and the control group had a score of 8.79. At
the 6-month follow-up, the intervention group had a mean score of 6.02 and the
control group had a score of 7.59. The difference was significant.
The evaluators also formed subgroups of children based on their
pre-intervention scores and the clinical cutoffs for depression and
anxiety. No significant differences were found for the high depression
group or the low anxiety group between the intervention and control groups.
Significant differences were observed for the low-depression group on depression
(intervention=4.80, control=5.88) and anxiety (intervention=5.08, control=6.37)
at post-intervention, but not at follow-up. The high anxiety intervention
group had significantly lower anxiety scores than the control group
(intervention=13.19 control=17.06) at post-intervention, but not at
Significant impacts at
post-intervention, but not at follow-up, were found for internalizing and
externalizing problems. At post-intervention, the intervention group had
a mean score of 5.57 for internalizing problems while the control group had a
score of 6.03. For externalizing behavior at post-intervention, the
intervention group had a score of 7.19 while the while the control group had a
score of 7.74. No significant impacts were found for negative explanatory
style, because both groups became more positive. There was a significant
effect for explaining positive events at post-intervention, with the
intervention group reporting more optimistic explanations for positive events
than the control group (intervention=15.37 control=13.99). No significant
differences between groups were found for appropriate social skills or
SOURCES FOR MORE INFORMATION
R., Thomson, T., Roberts, Clare., Bishop, Brian.
(2003).The prevention of depressive symptoms in
rural school children: A randomized controlled trial. Journal
of Consulting and Clinical Psychology 71(3). 622-628.
Health and Development, Mental Health, Depression, School Based,
Counseling/Therapy, Life Skills Training, School-Based, Anxiety, At-Risk,
Middle School, Cognitive Development, 7th Grade, Rural, Middle
Childhood (6-11), Adolescence (12-17), Children, Adolescents.
information last updated 08/11/04.