Child Psychology and Psychiatry

FUTURE DEVELOPMENTS AND
CHALLENGES
Whilst school-based prevention programmes offer
the potential to improve the psychological well-
being of children, further research is required
before their widespread implementation can be
advocated. Firstly, from a methodological view-
point, sample sizes are often small, medium-term
follow-ups are lacking, and few have included
comparisons with other active interventions. Most
studies have focused upon adolescents and few
have been designed for, or included, children
under the age of 9 years. In terms of programme
content, those based upon CBT, particularly for
anxiety, show most promise although there are
considerable differences between programmes in
length, core components and delivery. Variations
in effectiveness within similar programmes suggest
the importance of mediating factors relating to
programme leaders (e.g. professional experience,
training, rapport and confidence), students (e.g.
age, gender, engagement) and schools (e.g. class
size, emotional health awareness and available
support).
Secondly, it is unclear whether preventive inter-
ventions that are universal are more effective than
targeted interventions. Universal programmes
have the potential to maximize psychological
well-being. Typically such programmes aim to
reduce symptoms, in addition to maintaining
psychological health. However, the focus of
evaluation has been on whether they reduce
symptomatology, rather than on detailing whether
they maintain emotional well-being and protect
children
from
subsequent
emotional
health
problems. The longer term primary preventive
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