Middle schoolers from low-income families who learned new ways to cope with stress by participating in the Building a Strong Identity and Coping Skills (BaSICS) program demonstrated significant and lasting reductions in anxiety and depression, according to Penn State Professor of Psychology Martha Wadsworth, who conducted the small-scale randomized clinical trial with 120 participants.
Now, thanks to a five-year, $5.5 million grant from the U.S. National Institutes of Health's (NIH) National Institute of Mental Health (NIMH), Wadsworth and her colleagues will further evaluate the trauma-informed coping and empowerment-based BaSICS program's ability to treat anxiety, depression and traumatic stress symptoms in a larger randomized trial with clinically referred early adolescents across central Pennsylvania.
"The goal of BaSICS is to teach middle school-aged youth new and different ways to cope with chronic stress," said Wadsworth, whose initial study was also funded by NIMH. "High levels of chronic stress can over-activate children's stress response systems so that they are frequently in 'fight or flight' mode. When something small happens at school, for example, they may have an instant stress response and their brains and bodies respond as if they are in a life-or-death situation, which can lead to problems in the school setting. The premise of BaSICS is that learning and practicing new ways to cope with stress and regulate emotions and behaviors can help bring children's stress response system back into alignment and allow children to use their newfound skills in difficult situations."
Middle school, she said, is a particularly opportune time to treat kids, given the dramatic changes brought about by puberty.
"Early adolescence is a very biologically, behaviorally, emotionally plastic time period," said Wadsworth, an affiliated faculty member with the College of the Liberal Arts' Child Study Center. "The brain and associated body systems are undergoing a lot of change and growth, so it's the perfect time to teach new ways of approaching stressors, problems and emotions. In this way, the BaSICS program aims to put kids on a different trajectory - away from mental health problems and toward healthy development."
The new study will include 360 early adolescents from four Pennsylvania sites: Harrisburg, Hershey, State College and the rural Penns Valley Area School District. That will provide a more diverse sample while still being geared to low-income children, a demographic with significant mental health needs that aren't being met because of long waitlists at youth-focused clinics, Wadsworth said. As with the previous trial, half of the children will be randomly assigned to participate in the BaSICS intervention, where they will learn a variety of strategies for handling their emotions and coping with stress, while the others will remain on a clinic waitlist for services.
The youth will be assessed four times. Those assigned to the intervention group will interact with each other and be given activities designed to enhance their coping and problem-solving skills. A positive reinforcement management system will be used to reward those who engage appropriately and volunteer for tasks.
The intervention culminates with the participants engaging in a social action project, such as starting a gardening club at their school or arranging a community forum on a topic of interest. That, Wadsworth said, "gives them hands-on experience using new, collaborative ways to solve problems and active ways to make a difference in their community and in the world."
"In addition to further testing the program's efficacy in treating mental health problems such as anxiety, depression and traumatic stress, we want to begin studying whether there are limits to the program's effectiveness," Wadsworth said. "Does where kids reside matter? Do kids from different racial or ethnic backgrounds respond to the intervention differently? This bigger trial will also allow us to see more definitively how the program impacts the physiologic stress response system. And finally, we will test our theoretical model that it is the acquisition of the skills we teach and the improved functioning of the stress response system that translate into reductions in depression, anxiety and traumatic stress symptoms."
Wadsworth's co-investigators on the study are fellow Penn State faculty members Jarl A. Ahlkvist, associate teaching professor of sociology and criminology; Dara Babinski, clinical psychologist at Penn State Health; Jason J. Bendezú, assistant research professor of psychology; Damon Jones, research professor, Edna Bennet Pierce Prevention Research Center; Jasmin Lagman, associate professor, Pennsylvania Psychiatric Institute; and Dawn P. Witherspoon, professor of psychology and director of the Parents And Children Together (PACT) initiative.
