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Key overview details
- Targeted
- Promoting Emotional Wellbeing
- Anxiety / Worry / Stress
- Depression/Low Mood
- Self Esteem / Resilience
- Adolescents: 13 to 18 years
- Show only programmes known to have been implemented in Scotland
The Blues Programme
Summary
The Blues Programme is a targeted intervention that aims to prevent the development of depression, and reduce early signs of depression in young people aged 13-19 years. The school-based manualised programme teaches coping strategies and cognitive restructuring techniques. This is designed to help young people with elevated depressive scores build resilience, challenge negative thinking, reduce anxious thoughts, lessen depressive symptoms, and improve mood. The programme is delivered by trained practitioners over six weeks, in one hour weekly group sessions. The sessions focus on building group rapport, promoting participation in physical activities, boosting cognitive restructuring techniques, and developing positive responses for life stressors. Participants are also assigned home tasks which allows them to practise their new skills.
The Blues programme has been delivered in Scotland, and across several parts of the UK.
Website: https://thebluesprogram.weebly.com/
Core Components
The Blues Programme is a targeted intervention that aims to prevent the development of depression, and reduce early signs of depression in young people aged 13-19 years. The school-based manualised programme is designed to enhance young person’s emotional wellbeing by teaching coping strategies and cognitive restructuring techniques. This is expected to help build resilience, challenge negative thinking, reduce anxious thoughts, lessen depressive symptoms, and improve mood.
The Blues programme is delivered by trained Blues specialists from Action for Children, UK. These specialists identify young people included into this programme using the Centre for Epidemiological Studies Depression (CES-D) tool. Young people with elevated depressive scores (i.e. adolescents who suffer from, or are at risk of depression) are invited to participate in the programme.
The programme is typically delivered over six weeks, with one session delivered weekly over a double period (i.e. 60-minutes). Groups are preferably single-gender, with about 8-10 young people in each group. The sessions focus on building group rapport, promoting participation in physical activities, boosting cognitive restructuring techniques, and developing positive responses for life stressors. Students are also given home practise assignments to reinforce the taught skills, and promote use of these skills in their everyday lives. Individual make-up sessions (lasting 10-15 minutes) are offered to students who miss previous sessions. Make-up sessions are delivered before the next group session, and involve review of past home assignment; discussion of key concepts from the missed session; and completion of new home assignment. The Blues programme also uses motivation enhancing exercises to increase participants’ desire to use their new skills; behavioural strategies to enhance the use of their new skills; self-presentation to increase internalisation of programme key principles; and group activities to promote feelings of social support and group unity. One parent information workshop session delivered over 1.5 hours is typically made available if required or requested. Parent sessions provide information about the blues programme and also equip parents with strategies to apply in their own lives.
The Blues programme is not suitable for young people with current major depression or suicidal ideation. These persons should be referred to Child and Adolescent Mental Health Services.
Fidelity
Programme fidelity is evaluated through the following measures:
- Use of structured session-by-session programme manual
- Completion of protocol adherence form by group facilitator (for self-evaluation) or by supervisor. Adherence forms are unique to each session
- Completion of practitioner competence assessment form after each session. Form is completed by group facilitator (for self-evaluation) or by supervisor
- Monthly practitioner supervision provided by supervisors from Action for Children
Modifiable Components
The Blues programme was developed in USA, so the words/ language used during programme delivery may be altered to enhance understanding of UK participants.
The Blues programme implementation support is provided by trained Action for Children 'Blues' specialists in the UK.
Support for Organisation/Practice
Implementation Support
The Blues programme staff from Action for Children hold an initial meeting with the interested school to assess programme suitability in addressing specific schools’ needs. The programme staff subsequently deliver a one-day staff information workshop to school staff. The Blues programme staff conduct an initial assessment to identify students who are in need of support (and could potentially benefit from the programme), then go on to deliver the programme to the identified students. Programme staff also provide support with the data collection and evaluation for the purpose of assessing programme impact. Lastly, the Blues programme staff are available to deliver one parent information workshop session when required or requested.
The Blues programme staff communicate with a link teacher (from pastoral care/student support) to address group planning, impact feedback and safeguarding concerns. The link teacher also provides support with student attendance and distribution of invitations to the programme.
Licence Requirements
There are no licence requirements for programme delivery.
Start-up Costs
Costs for the Blues equates to £304 per young person for the six week programme (e.g. a group of 10 young people will cost £3,040). Schools pay for individual groups, so the programme is delivered to as many groups as schools are willing and able to pay for, and Action for Children have the staffing capacity to provide.
Building Staff Competency
Qualifications Required
The Blues programme is delivered in schools by trained Blues specialists from Action for Children. These specialists can have varying levels of clinical training, but are ideally familiar with cognitive behavioural techniques for depression prevention and treatment; understand the effects of depression on youths; have experience facilitating manualised groups; and should be empathetic. Two practitioners typically deliver the programme to the each group.
Training Requirements
The Blues programme is delivered by staff from Action for Children. Practitioners are required to receive a two-day Blues programme training prior to delivering the programme. The workshop covers a review of programme session components, and measures to address challenging parts of the programme. Scripted programme manuals are used by practitioners to deliver the programme to participant groups. All staff that support the school environment (including school leadership, teaching staff and pastoral staff) also receive a one-day Blues programme approach training. This training covers the Blues programme principles, and provides school staff with the understanding and operation of the programme.
Supervision Requirements
Staff from Action from Children receive monthly supervision, and have access to an on-call supervisor for when there are safe guarding concerns. Safeguarding policies within schools are always adhered to by the Blues programme practitioners.
Theory of Change
The Blues programme is based on cognitive behavioural principles and ideas. The programme teaches cognitive restructuring techniques and coping strategies to challenge negative thinking and replace them with positive cognitions; develop positive responses for life stressors; and to enhance realisation of autonomy over thoughts and actions.
Adolescents: 13 to 18 years - Rating: 4
Research Design & Number of Studies
The best evidence for the Blues programme comes from two internally conducted RCTs. One study included 378 high school students aged 13-19 years (Rohde et al, 2014), and the other study included 341 high school students aged 14-19 years (Stice et a, 2008; 2010; 2011; Rohde 2012). Both studies included Asian, African American, Caucasian, and Hispanic students, as well as students of mixed heritage.
Outcomes Achieved
Compared to the control group who did not receive the intervention, the following outcomes were observed:
Child Outcomes
- Significantly lower depressive symptom severity at post-test, and significantly lower risk for major depressive disorder onset at 6 months follow-up (Rohde et al, 2014)
- Significantly greater reductions in depressive symptoms at post-test and 6-month follow-up (Stice et al, 2008); and at 1-year follow-up (Stice et al, 2010)
- Significantly greater reductions in substance use at post-test and 6-month follow-up (Stice et al, 2008), and significantly lower rates of substance use at year 1 and 2 follow-up (Rohde et al, 2012)
- Significantly greater improvements in social adjustment at 6-month follow-up (Stice et al, 2008)
- Significantly greater friend social support at the post-test, 6-month, and 1-year follow-up (Stice et al, 2011)
Parent Outcomes
None
Key References
Rohde P, Stice E, Shaw H, Brière FN. Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: acute effects of an effectiveness trial with adolescents. J Consult Clin Psychol. 2014;82(1):65-74
Rohde P, Stice E, Gau JM, Marti CN. Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program. Psychol Addict Behav. 2012 Sep;26(3):599-608.
Stice E, Rohde P, Gau J, Ochner C. Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial. Behav Res Ther. 2011 May;49(5):361-6.
Stice E, Rohde P, Gau JM, Wade E. Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: effects at 1- and 2-year follow-up. J Consult Clin Psychol. 2010 Dec;78(6):856-67
Stice E, Rohde P, Seeley JR, Gau JM. Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: a randomized efficacy trial. J Consult Clin Psychol. 2008 Aug;76(4):595-606.
Values
The Blues Programme is a targeted intervention that aims to prevent the development of depression, and reduce early signs of depression in young people aged 13-19 years. The programme is based on cognitive behavioural principles and ideas. It teaches cognitive restructuring techniques and coping strategies to challenge negative thinking and replace them with positive cognitions; as well as to develop positive responses for life stressors.
- Does this approach align with the key values of your organisation?
Priorities
The Blues programme is a school-based programme that is delivered in a group format to teenagers with elevated depressive scores (i.e. those who suffer from, or are at risk of depression). The programme is not suitable for young people with current major depression or suicidal ideation.
- Is your service looking to commission a programme for adolescents who suffer from, or are at risk of depression?
- Is the service to be delivered to teenagers with current major depression and suicidal ideation?
- Is a school-based programme that is delivered, in group format, by an external organisation, a priority for your service?
- Would an individualised intervention delivered in a different setting be a better fit?
Existing Initiatives
- Does your organisation have existing programmes that aim to prevent the development of depression, and reduce early signs of depression in adolescents?
- Are there components addressed by The Blues programme that are not met by existing programmes?
- Are the existing initiatives effective? Do they fit your current and anticipated future requirements?
Workforce
The Blues programme is delivered in schools by trained Blues specialists from Action for Children, UK. Two practitioners typically deliver the programme to the each group. All staff that support the school environment (including school leadership, teaching staff and pastoral staff) also receive a one-day Blues programme approach training.
- Is your organisation looking to implement a programme that is delivered by external practitioners?
- Can your organisation support the training of all school staff?
Technology Support
There are no technological requirements.
Administrative Support
The Blues programme is a school-based depression prevention intervention. One parent information workshop session is typically made available if required or requested.
- Does your organisation have a venue/ room that can accommodate the programme participants and two facilitators?
- Can your service support the delivery of a parent session if requested or required?
- Does your organisation have administrative capacity and systems for a school based intervention?
Financial Support
Costs for the Blues equates to £304 per young person for the six week programme (e.g. a group of 10 young people will cost £3,040). Schools pay for individual groups, so the programme is delivered to as many groups as schools are willing and able to pay for, and Action for Children have the staffing capacity to provide.
- How many students in your school will the programme be delivered to?
- How many groups will be run in a year?
- Does your organisation have the financial capacity to support this programme?
Comparable Population
The Blues programme is a targeted intervention that aims to prevent the development of depression, and reduce early signs of depression in young people aged 13-19 years. Evidence of effectiveness comes from ethnically diverse high schools students, aged 13-19 years, with elevated depressive scores.
- Is this comparable to the population your organisation would like to serve?
Desired Outcome
The Blues programme is a depression prevention intervention for teenagers with elevated depressive scores. The programme teaches strategies to build resilience, challenge negative thinking, reduce anxious thoughts, lessen depressive symptoms, and improve mood. Programme delivery is associated with significant improvements across several outcomes including reductions in depressive symptoms and substance use, as well as improvements in social adjustment and social support.
- Does your organisation have other initiatives in place that effectively and efficiency address the above outcomes?
- Is delivering a depression prevention intervention that aims to build resilience, reduce anxious thoughts, lessen depressive symptoms, and improve mood a priority for your organisation?
Paul Carroll (Service Coordinator, Action for Children)