Caroline Stokes

Many teenagers experience anxiety or low mood, and the number needing mental health support has increased in recent years. However, services are under considerable pressure, with many young people facing long waits for help. Anxiety is one of the most common mental health difficulties in adolescence, and left untreated, can continue into adulthood, with severe consequences for education, employment and social functioning.

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Currently in England, young people who experience mild to moderate anxiety or low mood are offered low-intensity cognitive behavioural therapy (LI CBT), a type of talking therapy, that consists of around eight appointments with a mental health practitioner. Whilst this can be helpful, not every young person can access or complete these treatments, with many only attending one appointment. This indicates an urgent need to develop alternative support that is shorter, easier to access, and still based on the best available evidence.

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This 12-month project will develop and test two very brief CBT-based interventions for young people: one for anxiety and one for low mood. Each intervention will be delivered in two sessions rather than the current eight. Young people will also be given a workbook or other resources to help them. The anxiety intervention will focus on supporting young people to face situations that they normally avoid, and the low mood intervention will focus on supporting young people to get back to the activities they value and enjoy. These short interventions would not replace the current longer versions, but would be another option that some young people might prefer or be better suited to.

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The project has three stages. First, we will work with young people aged 12-17 who have previously received mental health support for anxiety or low mood. They will be invited to a focus group and then to a co-design workshop to help shape the new interventions. They will advise on various aspects including session length, timing, how parents or carers might be involved, and what accompanying workbooks and other resources should look like. The research team will make particular efforts to include young people from groups who tend to be underserved by traditional services.

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Second, we will test out these new interventions in low-intensity child and adolescent mental health services across South London. Between 20 and 30 young people will receive the new interventions, which will be delivered by trained mental health practitioners. Young people will complete questionnaires before and after their intervention. These questionnaires will ask about anxiety, low mood, wellbeing, and progress towards goals. Whilst the study will be too small to draw firm conclusions about effectiveness, the questionnaires will enable us to explore any early signs that the new interventions may be helpful. We will also look at how many young people agree to receive the new interventions and how many complete them.

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Third, we will invite around ten young people and around ten parents/carers to take part in interviews about their experiences of having received the new interventions. They will be asked what they found helpful and unhelpful, and what could be improved. Their views will be considered alongside a brief treatment satisfaction questionnaire.

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Taken together, our overall findings will show whether these very brief interventions are acceptable to young people, and whether they are practical and feasible to deliver in clinical services. If the interventions show promise, they will be further refined, ready for testing in a future larger, randomised controlled trial to see whether they are effective and offer value for money. In the longer term, this work could improve timely access to effective mental health support for more young people.

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