Intervention May Prevent Depression Related to High School Transition

Youth at risk for depression could benefit from prevention efforts that target the student’s ability to manage environmental stressors like school transitions.

The High School Transition Program (HSTP) intervention improved depressive symptoms by targeting factors specific to the transition from middle to high school, according to research results published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Because increased depression during adolescence is a major public health concern and high school transition may exacerbate the risk for depression in vulnerable youth, researchers developed the HSTP. The skills-based intervention includes school attachment (SA) and self-esteem (SE) as mediators of treatment outcomes.

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A group of 497 eighth grade students (61.5% girls) with heightened depressive symptoms were randomly assigned to a brief intervention (n=256) or HSTP (n=241). Participants completed measures at five time points and a multiple mediation model tested whether SA and SE contributed to changes in depression. The Short Mood and Feelings Questionnaire was used to measure depressive symptoms.

The HSTP intervention began in eighth grade; content was presented in group sessions over the course of six weeks, conducted during regular school hours. After transitioning to high school, HSTP participants received 1:1 booster sessions focused on communication skills, connecting with peers and teachers, and goal-setting. Parents of HSTP participants received psychoeducation at home visits — two during eighth grade and two during ninth grade. Students in the comparison group completed the 1:1 standardized interview and clinical follow-up. Their parents received a phone call to review concerns and make recommendations for available services.

Depressive symptoms at baseline vs follow-up were negatively correlated with SE (rs=.27-.62, Ps <.001) and school support (rs=.15-.38, Ps <.001) across time points. School attachment was positively correlated with SE (rs=.21-.41, Ps <.001). Students in the HSTP intervention had higher SA, which predicted improved SE and contributed to lowering depressive symptoms.

The study was limited by the potential inclusion of participants who met clinical criteria for depressive disorder and would have benefited from a more intensive intervention. In addition, school-level demographic data were not available and the study may have benefited from a longer follow-up period.

 “Youth at risk for depression may benefit from prevention efforts that enhance students’ capacity to effectively manage identified environmental stressors, such as school transitions,” stated researchers. This may encourage further interventions being integrated into school settings and that engage social supports like teachers, peers, and caregivers to reduce the negative impact of school transitions on depressive symptoms.


Blossom JB, Adrian MC, Stoep AV, McCauley E. Mechanisms of change in the prevention of depression: an indicated school-based prevention trial at the transition to high school. J Am Acad Child Adolesc Psychiatry. doi:0.1016/j.jaac.2019.05.031