Early Adolescent Skills for Emotions (EASE) intervention for the treatment of psychological distress in adolescents: Study protocol for randomised controlled trials in Lebanon and Jordan

Abstract

Background There are significant barriers to accessible, quality mental health care for young adolescents affected by adversity. In an attempt to overcome this, the World Health Organization (WHO) has developed the Early Adolescent Skills for Emotions (EASE) psychological intervention for young adolescents with internalizing problems. EASE is group-based (seven sessions for adolescents, three sessions for their caregivers) and can be delivered by non-specialist providers. This paper outlines the study protocols for two trials of EASE in the Middle-East - one in Lebanon and one in Jordan. Methods We will conduct two, single-blind, two-arm, individually randomised group treatment trials in Lebanon and Jordan, with at least 445 young adolescents per trial. Adolescents will be screened eligible for the trial if they demonstrate levels of psychological distress indicative of internalizing problems requiring treatment. Participants will be randomly assigned to receive the EASE intervention, or enhanced usual care (one home-visit psychoeducation session). The primary outcome is reduction in overall child-reported psychological distress over time, with 3 months post-treatment as the primary end-point. Secondary child-reported outcomes include post-traumatic stress symptoms, depression symptoms, daily functioning, and wellbeing. Secondary caregiver-reported outcomes include parenting style, overall child distress, and caregiver psychological distress. Coping strategy use will be explored as a mediator of treatment effects, and relevant moderators of treatment effects will be explored. Discussion These trials will provide the first assessments of the effectiveness of the EASE intervention for use in the middle-east, with important implications for the use of low intensity, non-specialist interventions for this age range.

Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil

“…Indeed, participants highlighted how comorbid and complex cases were the norm in their adolescent population. One practical implication of this finding concerns the possibility of training health professionals in Brazil in the use of transdiagnostic, brief, and scalable psychological interventions, such as WHO Early Adolescent Skills for Emotions, that have been shown to be effective in addressing an array of symptoms in other contexts affected by adversity [ 47 ].…”

Evaluation of competency-driven training for facilitators delivering a psychological intervention for children in Lebanon: a proof-of-concept study

“…Participants in both arms received an 8-day training, including basic counselling skills, delivering EASE (child and caregiver sessions), skills in group facilitation and facilitator self-care. The training was based on the course previously developed for a randomised controlled trial (RCT) evaluating the effectiveness of EASE in Lebanon (Brown et al ., 2019 ). Training content was the same in the two study arms.…”

Planning the scale up of brief psychological interventions using theory of change

“…It aims to mitigate symptoms of internalizing disorders, such as depression and anxiety. EASE comprises seven group sessions to teach young people skills to enhance psychological coping, complemented by three sessions for caregivers focusing on improving parenting strategies to support their child, and enhance self-care [25].…”

“…PM+ has been proven to be effective in three randomized controlled trials in Pakistan and Kenya (individual PM+ in Pakistan and Kenya, and group PM+ in Pakistan) [ 21 – 23 ]. The Early Adolescent Skills for Emotions intervention (EASE) is a related WHO transdiagnostic intervention [ 24 ] that targets young adolescents [ 25 ]. It aims to mitigate symptoms of internalizing disorders, such as depression and anxiety.…”