Conference Coverage

Brief stress management training helps teens with mental health complaints


Key clinical point: A brief stress management intervention had a lasting effect on adolescents referred for mental health–related complaints.

Major finding: Nearly all participants found the intervention helpful and felt more relaxed and 44% were interested in additional training.

Study details: A randomized trial including 86 adolescents (mean age, 16 years) referred for anxiety, somatic complaints, or difficulty managing mood.

Disclosures: The investigators reported no conflict of interest.



– A brief stress management intervention left a lasting effect on adolescents referred for mental health–related complaints, significantly reducing perceived distress, and heart rate variability. The majority of recipients expressed interest in additional training at follow-up.

“This model can be easily implemented in a primary health care clinic to better reach adolescents who are unable or unwilling to seek mental health care,” Elizabeth B. Mason, MD, and her colleagues from Rainbow Babies and Children’s Hospital in Cleveland, reported in a poster presentation at the Pediatric Academic Societies annual meeting.

A teen girl talks to a doctor Steve Debenport/Getty Images
Participants included 86 adolescents referred to an urban adolescent medicine clinic for anxiety, somatic complaints, or difficulty managing mood. All completed preintervention questionnaires, including a Subjective Units of Distress Scale (SUDS), Screen for Child Anxiety Related Disorders (SCARED), and the Patient Health Questionnaire–9 modified for adolescents (PHQ-A) Postintervention questionnaires included the SUDS and a satisfaction survey.

The vast majority of participants (96.5%) were African American, mean age was 16 years, and 36% were male. Cutoff criteria for generalized anxiety on the SCARED was met by 35 (41%) participants, and 23 (27%) participants scored positive for depression on the PHQ-A.

Following completion of preintervention questionnaires, 50 of 86 (58%) participants received psychoeducation from an adolescent medicine fellow or a pediatric psychologist on the effect stress has on the body, training in diaphragmatic breathing and progressive muscle relaxation, and no-cost/low-cost exercise options. Study participants also engaged in a peripheral biofeedback program called Unyte that has been shown to improve heart rate variability. The remaining 36 participants received no training and served as controls.

Those in the intervention group had significantly lower SUDS scores postintervention than did the control group. Heart rate variability coherence rates also decreased significantly postintervention in those who received the intervention, compared with controls.

When reached by phone 1 week after the session, 92% of participants said they found the intervention helpful and felt more relaxed, and 44% expressed interest in additional relaxation training.

The investigators concluded that “the results of this study suggest that a brief stress management intervention in an urban adolescent medicine clinic is effective at decreasing subjective distress and improving heart rate variability coherence rates. Future studies should include a control group and longer-term follow-up.”

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