The World Health Organization (WHO) and UNICEF have published a new psychological intervention, Early Adolescent Skills for Emotions (EASE), to support adolescents affected by distress and their caregivers.
1 in 7 adolescents globally experience mental health conditions, which mostly go unseen and untreated. EASE is the first WHO-UNICEF psychological intervention to address the critical shortage of mental health care for adolescents experiencing distress.
EASE is designed to support adolescents aged 10-15 years old who experience distress and their caregivers. The intervention addresses a range of internalizing problems such as symptoms of depression, anxiety and stress.
EASE includes seven group sessions for adolescents focused on building skills to cope with distress and three group sessions for their caregivers to promote supportive parenting and assist the adolescents in practicing the EASE skills. The EASE skills are adapted from aspects of Cognitive Behavioural Therapy and include psychoeducation, stress management, behavioural activation, and problem solving. It was culturally and contextually adapted and field-tested in four countries: Jordan, Lebanon, Pakistan and Tanzania, which included two large randomized controlled trials in Jordan and Pakistan.
EASE can be delivered by trained and supervised non-specialist helpers who receive ongoing supervision by mental health professionals. This task-sharing approach has been successfully adopted in similar interventions for adults such as Problem Management Plus (PM+), which has been implemented widely since its release.
EASE’s task-sharing approach makes it suitable for delivery in contexts where there are few child and adolescent mental health specialists. EASE can be delivered in various settings such as the community, health, and protection services.
Scaling up psychological interventions
Over the past ten years, WHO has implemented a programme of work aiming to support scale up of mental health and psychosocial support services for people affected by adversity.
EASE is the sixth psychological intervention in a series of low-intensity interventions released by WHO. With the series, WHO aims to strengthen delivery of evidence-based interventions by the non-specialist workforce and improve access to evidence-based psychological interventions.
Effective group psychological help for adolescents
EASE was successfully tested in two fully-powered randomized controlled trials in Jordan and Pakistan. In Jordan, 471 adolescent Syrian refugees aged 10-14 years with self-reported distress participated and were randomized into the intervention arm (EASE) or into the control arm (enhanced care as usual). All participants completed assessments before randomization, one week after the intervention and again 3 months later. Adolescents who were randomized into the intervention arm had statistically significant fewer internalizing problems directly after the intervention and 3 months after the intervention compared to adolescents who were randomized into the control arm. In addition, caregiver distress and disciplinary parenting significantly improved at three-month follow-up in the EASE intervention arm relative to the control arm. In Pakistan, 566 adolescents aged 13-15 years with self-reported distress participated in the trial and were randomized into the intervention arm (EASE) or into the control arm (waitlist control). Like the trial in Jordan, all participants completed assessments before randomization, and at one-week and 3-month follow-up. Publication of the results in a scientific article is expected soon.
For more information about EASE, please contact Dr Aiysha Malik ([email protected]) at the WHO Department of Mental Health and Substance Use.