Group Intervention for Adolescent Anxiety and Depression: Outcomes of a Randomized Trial with Adolescents in Kenya

Background Efforts to improve youth mental health in low resource communities may benefit from interventions that include empirically-supported elements, use stigma-free content, and can be delivered by lay providers in the community. We developed and evaluated such an intervention, targeting adolescent depression and anxiety in Kenya, where mental health care is limited by social stigma and a paucity of providers. MethodsFifty-one high-symptom Kenyan adolescents (N = 51, ages 14-17) were randomized to the four-week “Shamiri” (“thrive”) group intervention or a group study skills control intervention of equal duration. The Shamiri intervention, containing research-derived material from social and clinical intervention science (e.g., including growth mindset, gratitude, and value affirmation), and the control intervention were both delivered by trained lay leaders in school settings. Results Compared to the control, Shamiri produced greater improvements in adolescent depression symptoms (p = .038; d = .32) and anxiety symptoms (p = .039; d = .54) from baseline to four-week follow-up, and academic performance (p = .034; d = .32) from the school-term before versus after the intervention. There were no effects on overall social support or perceived control, but the Shamiri group showed larger increases in perceived social support from friends (p = .028, d = .71). ConclusionsThis appears to be the first report that a brief, lay-provider delivered, community-based intervention may reduce internalizing symptoms and improve academic outcomes in high-symptom adolescents in Sub-Saharan Africa. Larger replication trials with extended follow-ups will help gauge the strength and durability of these effects.