The number of adolescents seeking help for their mental health is at an all-time high, with one in five young people meeting the criteria for a probable mental health disorder (NHS England, 2023). However, Child and Adolescent Mental Health Services are struggling to meet the increased demand, exacerbating the problem. This issue, combined with the ongoing stigma surrounding mental health, makes it difficult for adolescents to access evidence-based interventions. One such intervention is Cognitive Behavioural Therapy (CBT), which has shown effectiveness in improving the well-being of young people. To make CBT more accessible to adolescents, we need to move beyond the traditional clinic-based delivery and implementation.
A recent review suggests that developing more accessible CBT treatment modalities can help reduce stigma and improve its effectiveness. Group-based approaches can also enhance access without requiring additional resources. A ‘self-referral’ process, where young people can ask for mental health support, is a key component of the CBT-based “stress management” workshop designed by Brown et al. (2024) to address existing barriers and improve self-efficacy in schools.
A study published in The Lancet Psychiatry, the BESST study, evaluated the effectiveness and cost of implementing these workshops in schools across England. Brown et al. (2024) designed a group-based CBT workshop where adolescents could self-refer themselves to promote mental well-being.
The study included 900 students from 15 localities across four regions of England. Participants were assigned to either the DISCOVER workshop programme or Treatment as Usual (TAU). Results showed a small but significant reduction in Mood and Feelings Questionnaire (MFQ) scores after six months in the workshop group compared to the TAU group. Participants in the workshop group also demonstrated improvements in anxiety scores, well-being, and resilience.
The study found the DISCOVER workshop to be cost-effective and moderately effective in reducing symptoms of anxiety and depression in adolescents. The authors concluded that the workshop was mildly effective in reducing symptoms of depression and anxiety in 16-18 year-olds. The self-referral pathway improved accessibility for young people who had not sought help for their mental health previously.
Strengths of the study included collaboration, attention to diversity, and accessibility in recruitment strategies. Limitations included a lack of detail on the workshop and control group engagement. The study suggests that brief school-based interventions like the DISCOVER workshop could effectively support young people’s mental health and reduce the need for specialist services. However, more research is needed to address the complex needs of young people.
