Depression Prevention Program Yielded Different Results in Black, White Youth

A depression prevention program was found to have differing levels of efficacy across youth participants who identified as White and Black living in the US. The study, published in the Journal of Consulting and Clinical Psychology,¹ indicated that future research should focus on the reasons for these discrepancies to better address Black adolescents living with depression.

Adolescents living with depression can have lasting consequences surrounding their diagnosis, including an increased risk of having academic, social, and emotional problems that can affect their performance both socially and academically. The efficacy of interventions that address depression in adolescents has been understudied in the past, with a lack of representation of Black adolescents. The study aimed to use an adolescent depression program that was universal and based at schools to assess the efficacy of the program in Black and White adolescents from the US.

The participants of this study were recruited in ninth grade in 2019, with most of the students coming from Jefferson County Public Schools. All participants were followed for 3 semesters, and only participants who identified as White or Black were included. The depression prevention program was implemented as part of the school curriculum with consent from their guardian.

Black adolescents had less success in improving their depressive symptoms when using the depression prevention program | Image credit: WavebreakMediaMicro - stock.adobe.com

The program consisted of 2 groups, with 1 group receiving the prevention and the other consisting of a nonintervention control. Adolescents who took physical education in the spring were included in the control group. All participants had data collected at baseline, at the end of the semester, and 4 months following the intervention. Adolescents who participated in the prevention were part of a program that originated in Germany called the Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag program. It consisted of 10 weeks of 90-minute meetings conducted by students in a mental health graduate program. All teachers completed a self-assessment on how much of the program they were able to cover, how many students attended, how good engagement was, and if there were distractions. All participants reported their age, gender, and race in a survey.

The participants were primarily girls (58.4%) and Black (57.2%) with 637 total adolescents participating in the intervention. Attendance was reported as 72% by the group leaders, engagement was rated with a mean (SD) score of 2.23 (0.70) out of 3, and disruption was scored with a mean of 0.42 (0.41) from 0 to 1. Participants in the control group were older compared with the prevention condition but were otherwise not significantly different.

White participants reported significantly fewer depressive symptoms after completing the prevention program and at follow-up. Black participants, however, did not have significant differences compared with the control group. The groups had no significant correlation with depressive symptoms after the intervention (r, –0.008) and at follow-up (r, –0.022) in Black adolescents, whereas White adolescents had significant differences in depressive scores after the intervention (r, –0.25) and at follow-up (r, –0.23). The 3-way interaction between time, group, and race also found that there was no significant benefit of the intervention for Black adolescents compared with the control group. White participants reported lower depressive symptoms after the intervention and at follow-up compared with the control group.

“Psychological theories and treatment programs are largely developed based on white, middle-class, female American clients or college students in psychology courses. We need to take a step back and examine the consequences of these limitations. It’s essential to be attentive to cultural and racial differences and not assume there’s a one-size-fits-all approach.” Patrick Pössel, PhD, professor of counseling psychology at the University of Louisville and coauthor of this study, said in a statement.²

This study took place primarily in 1 high school in Kentucky, which may limit its generalizability. Other racial groups were also not represented in the study. Supervision through the use of group leaders may not be sustainable in other parts of the country. These results may not be generalizable to other types of prevention programs.

The researchers concluded that future studies will need to look into alternative methods of engaging Black youth in prevention programs that are more effective in addressing their depressive symptoms, as current prevention programs are not addressing their mental health in a similar way as White participants.

References

1. Seely HD, Pössel P. Equity and inclusion in prevention: depression prevention in Black and White American youth. J Consult Clin Psychol. 2025;93(4):307-316. doi:10.1037/ccp0000918
2. Some depression prevention programs may not help Black youth. News release. American Psychological Association. March 24, 2025. Accessed March 24, 2025. https://www.apa.org/news/press/releases/2025/03/depression-prevention-programs-black-youth