Group-based Low-intensity Cognitive Behavioral Therapy for Young People With Moderate Mental Distress: An Open-label Waitlist Randomized Controlled Trial

Abstract

Purpose: This study investigated the effects of group-based low-intensity cognitive behavioural therapy (GB-LiCBT) on alleviating distress, depression, and anxiety among adolescents. Methods: A waitlist randomized controlled trial was conducted between October 2021 and July 2022 and involved 136 young people aged 12–24 years (69.9% female) from the LevelMind@JC project, a large-scale community youth mental health initiative. The participants were randomly assigned to receive either 6–8 weekly sessions of GB-LiCBT (n = 70) or wait until week 12 before receiving GB-LiCBT (n = 66). The assessments were conducted at baseline (T0), week 8 (T1), and week 12 (T2). The primary outcomes were depressive and anxiety symptoms, psychological distress, and health-related quality of life (HR-QoL) using intention-to-treat. Results: Compared with the control group, intention-to-treat analysis revealed that the GB-LiCBT group demonstrated significant improvements in T0–T1HR-QoL and T0–T2future outlook. These results were supported by the per-protocol analysis, which additionally showed significant improvements in the T0–T1psychological distress scores. Subgroup analysis revealed a more pronounced GB-LiCBT effect on T0–T1psychological distress among participants aged ≤18 years and females. Correlation analysis among GB-LiCBT participants found that improved mindful attention linked to reduced anxiety and distress, whereas improved self-esteem linked to reduced distress and improved HR-QoL. Discussion: Although GB-LiCBT had a limited effect on specific depressive and anxiety symptoms, it was effective in improving HR-QoL. Reductions in psychological distress were observed primarily among younger participants and females. These findings suggest the potential of GB-LiCBT as a suitable early intervention for individuals experiencing early stages of elevated psychological distress.