Ms Deborah Perz, Head of O’Connor House (Acting)
There is little doubt that adolescence is a distinct time of change for young people. The demands of teenage life including personal relationships with family and friends, anxiety related to study and schooling, individualisation and the development of personal identity result in a number of emotional development challenges. These include the regulation of stress and the possible onset of affective disorders. Current neuroscientific research into adolescent brain development centres around the idea that the brain structure in the early teen years undergoes a large amount of change including the development and formation of new connections between neural pathways and the specialisation of specific structural systems. During this time the brain also undergoes a maturation process whereby there is a change from a limbic structure system, based on often primitive emotional responses and immediate impulses, to a more connected and specialised prefrontal cortex used in decision making, long-term planning and impulse control (Johnson, Blum & Giedd, 2009).
The development and balance between the two systems often result in vulnerability in terms of mental health disorders. Early intervention programs with a focus on increasing protective factors and decreasing risk factors can lead to minimising the incidence of mental health issues for the teenager. Programs found to use scaffolding, modelling and role play help build and develop resilient brains that are able to make these refined connections in a safe and supportive also learn to problem solve in a school setting (Mathison, 2012).
At Brisbane Girls Grammar School our School Intent states that we are committed to establishing the foundation to build confidence and resilience in young women. The School recognises there is a need to deliver a contemporary, well-researched program early in adolescent development to help teenagers with self-regulation and self-esteem and to provide resources to counter the onset of possible affective disorders. The Resourceful Adolescent Program (RAP) was developed at the School of Psychology and Counselling at Queensland University of Technology and is designed to build resilience in young people in their early teenage years. It has a focus on the identification and development of individual strengths, growth of positive coping strategies and construction of social support networks to navigate a time of emotional and physical change. RAP aims to address several key areas including the recognition of personal strengths, identification and challenge of negative thinking, self-regulation in stressful situations, problem-solving strategies to evaluate possible solutions, the development of strong support networks, and an understanding of empathy (Shochet & Hoge, 2009). As the young person begins to develop their own sense of identity, separate from that of their parents, RAP provides students with the tools to navigate emotional development and gives them a set of skills to deal with complex circumstances as they arise in a productive and practical way.
Research into the development of RAP was conducted by Ian Shochet and Rebecca Hoge at the Queensland University of Technology. The research team chose to use a universal intervention method of program delivery aimed at reducing the incidence of anxiety and depression across a group of students, irrespective of whether they displayed signs of mental health issues. This model was also selected to provide early intervention to those at risk without drawing attention to specific individuals. This was developed with the understanding that all young people will benefit from a preventative and protective program that draws upon the strengths of each individual student (Shochet, Dadds, Ham & Montague, 2006) and equips them with skills to navigate adolescence from 12-25 years as the prefrontal cortex continues to develop.
The Resourceful Adolescent Program draws upon research developed by Cognitive Behavioural Therapists (CBT) such as Aaron Beck and David Burns and a number of Interpersonal Therapy programs. The CBT components of RAP apply cognitive restructuring (the identification and challenge of negative thoughts and behaviours to develop positive self-talk) by using self-regulation and self-calming strategies and equipping the teenager with problem solving. The Interpersonal Therapy components include activities and material that encourages young people to identify and draw upon a series of social support networks to gain an understanding of the perspectives of others and to develop skills to manage and resolve conflict. Shochet and Hoge (2009) make the statement that for intervention to be successful, it is important for the adolescent to have a deeper understanding of how they interact with one another and with those around them. This will lead to a better understanding of self and helps to develop self-esteem.
The effectiveness of RAP has been evaluated through a series of studies designed to gather both qualitative and quantitative data to increase resilience by minimising risk factors and building protective factors in adolescent development. In a 1997 trial by Shochet, Dadds, Holland, Whitefield, Harnett and Osgarby (2001), 260 Brisbane students aged between 13 to 15 years were split into two main groups, with one receiving RAP aimed at teenagers, and another group receiving no intervention. The RAP program in this instance was delivered by qualified psychologists and results were gathered based on three measures including before, immediately following and 10-months after the program was delivered. Results showed that there were statistically significant reductions in reported depressive symptoms, when compared to the non-intervention group (Shochet et al, 2001) resulting in an increase in self-esteem and feelings of self-worth.
Merry, McDowell, Wild, Bir and Cunliffe (2004) conduced research on a New Zealand trial of RAP whereby 392 participants aged 13-15 years across two schools where placed in an intervention group (those to whom RAP was delivered) and a non-intervention group (where a program excluding the Cognitive Behavioural Therapy components of RAP were omitted). In this trial, the program was tailored for New Zealand students and delivered by teachers who had been trained in the RAP (as opposed to psychologists). The results from this study showed that the program was statistically significant in reducing depressive symptoms. Researchers continued to monitor students over the course of 18 months and found that a large number of students in the intervention group had shown improvement in their level of mood and anxiety. It also showed that there was a net deterioration in depressive symptoms in the non-intervention group (Merry et al, 2004). Further in this study, the results demonstrated that it was equally effective to have trained teachers deliver the program, as opposed to trained psychologists, allowing for school-based intervention across a large population.
A study in 2004 by Montague and Shochet furthered previous research looking at the effectiveness and efficacy of RAP when delivered primarily by teachers with direct support and presence from the wider school community including psychologists, counsellors and nurses. It found that having a number of people for the student to connect with across a school community strengthened the protective factors for the adolescent. In this study students reported increased feelings of self-worth and self-esteem, and were able to reflect upon the thoughts and feelings of those around them. Other students showed signs of higher abilities to problem solve in stressful personal situations.
An ongoing trial across 12 schools with 2500 Year 8 student participants and trained teachers as facilitators conducted by Shochet and Hoge in 2009 has shown those students who are classified as ‘at risk’ indicated improvements in depressive symptoms both in the short and long term due to the RAP. Initial results also show that RAP is effective in reducing symptoms of anxiety and depression in students identified to be ‘at risk’ and also with those who showed no signs of mood disorders.
With current research into adolescent brain development and results of studies related to RAP in mind, a large group of staff members including Year 8 House Group teachers, Heads of House, Marrapatta staff and School Psychologists and Counsellors during Term I were trained by QUT to deliver the program commencing in Term II to all Year 8 students. The program will be primarily delivered by the House Group teachers as a part of the Ethics lesson students have once every two weeks. The House Group teachers were specifically chosen as these are the teachers who see the students each morning and have begun to develop strong, supportive relationships with each girl in the group. The program has 11 sessions and will run through the course of Terms II and III this year. This program will be supported by Head of House and School Psychologists and Counsellors, in partnership with staff at Marrapatta, to further strengthen the program and to reinforce ideas from a range of people within the students support network
References
Johnson S.B. Blum, R. W., & Giedd, J. N. (2009). Adolescent maturity and the brain: the promise and pitfalls of neuroscience research in adolescent health policy. Journal of Adolescent Health, 45(3), 216-221.
Mathison J. (2012). The Teen Brain: New Views from Neuroimaging. In The Developing Brain: What is Means for Treating Adolescents. Rockville, MD: Http://videocast.nih.gov/Summary.asp?File=17260&bhcp=1.
Merry, S., McDowell, H., Wild, C. J., & Cunclifee, R. (2004). A randomized placebo-controlled trial of a school-based depression prevention program. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 538-548.
Montague, R., Shochet, I. M., & Ham, D. (2004). The Resourceful Adolescent Program: A Universal Approach to the Prevention of Depression in Adolescents. In Nirbhay, N. S, Thomas, H. O. , & Ashvind, N. S (Eds.), International Perspectives on Child and Adolescent Mental Health (Vol. 2, pp. 214-230). Oxford, UK: Elsevier Science Ltd.
Shochet I. M., Dadds, M. R., Holland, D., Whitefield, K., Harnett, P. H., & Osgarby, S. M. (2001). The efficacy of a universal school-based program to prevent adolescent depression. Journal of Clinical Child Psychology, 30, 303-315.
Shochet I. M. & Hoge, R. (2009). Resourceful Adolescent Program: A Prevention and Early Intervention Program for Teenage Depression. In Essau E (Ed.), Treatment of Adolescent Depression (pp. 123-157). Oxford, UK: University Press.
Published 5 June 2014