The impact of a children's literature-based cognitive behavioural therapy skills curriculum on middle-school youth who self-report clinically relevant and non-clinical mental health symptomatology

Objective: To evaluate potential differences in the impact of a children's literature-based mental health literacy and cognitive behavioural therapy (CBT) skills curriculum on middle-schoolers with and without mental health symptoms that may be clinically relevant. Methods: Youth (aged 11–14; grades 7–8) who received a 3-month teacher-delivered intervention embedded in the language arts curriculum (N = 196) were compared to a wait-list control group (N = 233) from a large, diverse, urban school board in Canada. The Revised Child Anxiety and Depression Scale (RCADS) and Life Problems Inventory (LPI) were administered. Youth were divided according to scores of possible clinical relevance into ''clinical'' and ''non-clinical'' groups. A mixed ANOVA (Intervention and Clinical status at baseline are between subject scores and Time is the only repeated measure) was used clustered by classroom. Results: Thirty-three-point six percent of all participants endorsed symptoms of potential clinical relevance on the RCADS and/or one of its subscales. The primary analyses were non-significant but also underpowered to detect outcomes (RCADS β = 0 0.14; LPI β = 0.28). LPI scores improved numerically for intervention vs. control youth (clinical: -8% vs. +24%; non-clinical -9% vs. 0%, effect size = 0.002). Conclusions: This study was underpowered; however, it did identify a potentially clinically meaningful trend in a measure of maladaptive coping (LPI) favouring the intervention. A future, well-powered study is needed to characterize the impact of this intervention.