The Blues Programme is a school-based cognitive behavioural therapy intervention for young people aged between 13 and 19 years who are experiencing depressive symptoms. It is delivered by youth support workers/practitioners to groups of young people for six weeks.
The information above is as offered/supported by the intervention provider.
13 to 19 years old
Group
The Blues Programme is a school-based group intervention designed to support young people aged 13 to 19 years who are experiencing early signs of depression. Delivered in secondary schools, this six-week intervention uses cognitive behavioural techniques to help adolescents:
Each weekly session lasts one hour and is co-facilitated by trained Young Persons Practitioners and Support Workers. The sessions include guided group discussions, real-life reflections, and take-home activities to reinforce learning.
Students are invited to participate based on a screening questionnaire (CES-D), which helps identify those who might benefit from the intervention. The intervention is aimed at young people facing challenges such as academic pressure, family issues, low self-esteem, or identity exploration. It is not intended for those with clinical depression.
The Blues Programme can be described as evidence-based: it has evidence from at least one rigorously conducted RCT demonstrating a statistically significant positive impact on a child outcome, and also has evidence of a long-term effect.
13 to 19 years
Adolescents who experience depressive symptoms
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Negative thoughts and feelings can create a vicious cycle and may increase the risk of depression.
Science-based assumption
Thoughts, feelings, physical sensations, and actions are interconnected; engaging in positive activities can positively affect thoughts and feelings.
Science-based assumption
Adolescents aged 13 to 19 who experience depressive symptoms.
Intervention
The intervention aims to teach young people the connection of thoughts, feelings, and actions along with approaches to think in a more positive way by breaking overwhelming problems down into smaller parts.
Short-term
Participants learn how to identify negative thoughts, and work towards cognitive restructuring.
Medium-term
Participants increase their involvement in pleasant social or physical activity.
Long-term
Participants have reduced risk of depression.
Young people who experience depressive symptoms but do not meet the diagnostic criteria for Major Depressive Disorder.
The Blues Programme is delivered in six sessions of one hours’ duration each by two trained support workers, to groups of 8 to 10 young people.
The sessions focus on building group rapport and increasing participant involvement in enjoyable activities across sessions 1 to 6, while introducing cognitive restructuring techniques in sessions 2 to 4, and developing response plans for managing future life stressors in sessions 5 to 6.
In-session exercises allow youth to apply these skills directly, with homework reinforcing the skills learned and supporting their use in everyday life. Motivational enhancement activities are also included to encourage participants’ willingness to adopt the new skills. To further internalise key principles, strategic self-presentation is used alongside behavioural techniques, which reinforce skill use. Group activities create a sense of social support and cohesion among participants.
The intervention is co-facilitated by a Young Persons Practitioner with and a Young Persons Support Worker.
The practitioners have two days of intervention training. Booster training of practitioners is recommended. Practitioners receive 10 hours of booster training in the first year and fewer hours in the years thereafter.
It is recommended that practitioners are supervised by one case management supervisor, with one hour of intervention training.
Additionally, it is recommended that practitioners are also supervised by one fidelity and quality supervisor with two days of intervention training and completion of 12 two-hour fidelity recording checks.
It is recommended that fidelity checks of the host trainer and quality performance coordinator are additionally conducted by one external supervisor (the developer). Each year, three recorded two-hour sessions are reviewed by the developer to check the fidelity scoring of the quality performance coordinator.
Intervention fidelity is maintained through the following processes:
Contact person: Robyn Brady
Organisation: Action for Children
Email address: Blues@actionforchildren.org.uk
Website: https://www.actionforchildren.org.uk/our-work-and-impact/children-and-families/good-mental-health/blues-programme/
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
Blues Programme’s most rigorous evidence comes from three RCTs which were conducted in Canada and the United States. The intervention can be described as evidence-based: it has evidence from at least one rigorously conducted RCT demonstrating a statistically significant positive impact on a child outcome, and also has evidence of a long-term effect.
This study identified statistically significant reductions in Major Depressive Disorder, depressive symptoms, risk of developing major depressive disorder, and Major Depressive Disorder onset. It also found improvements in social adjustment, and reduced substance use frequency.
Reduced risk of developing major depressive disorder
6 months later
Improvement index
Interpretation
Study
Reduced risk of developing major depressive disorder
2 years later
Improvement index
Interpretation
Study
Reduced risk of developing major depressive disorder
6 months later
Improvement index
Interpretation
Study
Reduced risk of developing major depressive disorder
A year later
Improvement index
Interpretation
Study
Reduced depressive symptoms
Post-test
Improvement index
Interpretation
Study
Reduced depressive symptoms
Post-test
Improvement index
Interpretation
Study
Reduced depressive symptoms
6 months later
Improvement index
Interpretation
Study
Reduced depressive symptoms
a year later
Improvement index
Interpretation
Study
Reduced depression symptom severity
post test
Improvement index
Interpretation
Study
Reduced depression symptom severity
6 months later
Improvement index
Interpretation
Study
Decreased substance use
Post-test
Improvement index
Interpretation
Study
Decreased substance use
6 months later
Improvement index
Interpretation
Study
| Identified in search | 8 |
| Studies reviewed | 0 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 3 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 0 |
| Study design | RCT |
| Country | Canada |
| Sample characteristics | 74 secondary school students aged between 14 and 18 years with elevated depressive symptoms in the disadvantaged areas of Montreal, Canada |
| Race, ethnicities, and nationalities |
|
| Population risk factors | Participants were located in disadvantaged areas of Montreal, Canada and had elevated depressive symptoms but did not meet criteria for Major Depressive Disorder |
| Timing |
|
| Child outcomes |
|
| Other outcomes | Increased interactions with parents |
| Study rating | 3 |
| Citations | Brière, F. N., Reigner, A., Yale-Soulière, G. & Turgeon, L. (2019) Effectiveness trial of brief indicated cognitive-behavioral group depression prevention in French-Canadian secondary schools. School Mental Health. 11, 728–740. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 378 students with elevated depressive symptoms aged between 13 and 19 years |
| Race, ethnicities, and nationalities |
|
| Population risk factors | Participants had elevated depressive symptoms |
| Timing |
|
| Child outcomes |
|
| Other outcomes | None |
| Study rating | 3 |
| Citations | Rohde, P., Stice, E., Shaw, H. & Gau, J. M. (2015) Effectiveness trial of an indicated cognitive-behavioral group adolescent depression prevention program versus bibliotherapy and brochure control at 1- and 2-year follow-up. Journal of Consulting and Clinical Psychology. 83 (4), 736–747. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | The study involved 341 students with depressive symptoms aged between 14 and 19 years (mean age = 15.6) |
| Race, ethnicities, and nationalities |
|
| Population risk factors |
|
| Timing |
|
| Child outcomes |
|
| Other outcomes | None |
| Study rating | 3 |
| Citations | Study 3a: Stice, E., Rohde, P., Seeley, J. & Gau, J. M. (2008) Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial. Journal of Consulting and Clinical Psychology. 76 (4), 595–606. Study 3b: Stice, E., Rohde, P., Gau, J. M. & Wade, E. (2010) Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: Effects at 1-and 2-year follow-up. Journal of Consulting and Clinical Psychology. 78 (6), 856. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Action for Children. (2020) The Blues Programme. Reach and impact of the Blues Programme Delivered by Action for Children 2017-20.
Brière, F. N., Rohde, P., Shaw, H. & Stice, E. (2014) Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial. Behaviour Research and Therapy. 53, 55–62.
Burton, E., Stice, E., Bearman, S. K. & Rohde, P. (2007) Experimental test of the affect‐regulation theory of bulimic symptoms and substance use: A randomized trial. International Journal of Eating Disorders. 40 (1), 27–36.
Gau, J. M., Stice, E., Rohde, P. & Seeley, J. R. (2012) Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention. Cognitive Behaviour Therapy. 41 (3), 241–250.
Rohde, P., Stice, E., Shaw, H. & Brière, F. N. (2014) Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: Acute effects of an effectiveness trial with adolescents. Journal of Consulting and Clinical Psychology. 82 (1), 65.
Rohde, P., Stice, E. & Gau, J. M. (2012). Effects of three depression prevention interventions on risk for depressive disorder onset in the context of depression risk factors. Prevention Science, 13 (6), 584–593.
Rohde, P., Stice, E., Gau, J. M. & Marti, C. N. (2012). Reduced substance use as a secondary benefit of an indicated cognitive–behavioral adolescent depression prevention program. Psychology of Addictive Behaviors. 26 (3), 599.
Rohde, P., Stice, E., Shaw, H. & Gau, J. M. (2014) Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: Nonsignificant effects in pilot effectiveness trial with college students. Behaviour Research and Therapy. 55, 48–53.
Stice, E., Rohde, P., Gau, J. & Ochner, C. (2011) Relation of depression to perceived social support: Results from a randomized adolescent depression prevention trial. Behaviour Research and Therapy. 49 (5), 361–366.
Stice, E., Rohde, P., Seeley, J. R. & Gau, J. M. (2010) Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs. Journal of Consulting and Clinical Psychology. 78 (2), 273.
Stice, E., Burton, E., Bearman, S. K. & Rohde, P. (2007) Randomized trial of a brief depression prevention program: An elusive search for a psychosocial placebo control condition. Behaviour Research and Therapy. 45 (5), 863–876.
Stice, E., Shaw, H., Bohon, C., Marti, C. N. & Rohde, P. (2009) A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. Journal of Consulting and Clinical Psychology. 77 (3), 486.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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