Effectiveness of the Super Skills for Life (SSL) programme in enhancing children’s emotional wellbeing, emotional regulation and cognitive control: a randomized controlled trial study in Mauritius

Ramdhonee-Dowlot, Karishma, S. and Essau, Cecilia A. and Balloo, Kieran ORCID: https://orcid.org/0000-0002-1745-4653 (2019) Effectiveness of the Super Skills for Life (SSL) programme in enhancing children’s emotional wellbeing, emotional regulation and cognitive control: a randomized controlled trial study in Mauritius. In: Researching Education and Mental Health: Where are we now? (BERA 2019), 12 July 2019, London, United Kingdom.


Emotional problems in childhood and adolescence are serious global health care issues in today’s society (Merikangas et al., 2010). According to numerous recent epidemiology studies, emotional problems such as anxiety and depression are the most common mental health problems in childhood and adolescence (Costello et al., 2003), affecting 15 to 32 % of children and adolescents (e.g. Essau et al., 2000; Merikangas et al., 2010). This high prevalence of emotional problems among children and adolescents is concerning. When left untreated, emotional problems that begin early in life tend to be chronic and have a negative course (Kessler et al., 1994) and serve as a risk factor for other mental disorders in later life (Essau et al., 2014). This picture is even more complex for children who are looked after by the state. Higher rates of mental health problems and emotional and behavioural difficulties have consistently been found in looked after children (Minnis et al., 2006; Sempik et al., 2008). The number of children admitted in childcare institutions in low- and middle- income countries (LMICs) is increasingly alarming (UNICEF, 2009). There’s strong evidence that institutionalisation not only affects the child’s mental health and wellbeing, but can have a detrimental effect on a child’s ability to form attachments and relationships and thus affect their emotional and mental health further (Arrons et al., 2010; Leathers, 2002). Nonetheless, availability and access to youth mental health services in both non-clinical and clinical settings in LMICs are limited and grossly inadequate (Saxena et al., 2011). Evidence-based treatment approaches for these young people in LMICs have received little empirical attention. Various anxiety and depression prevention programmes based on cognitive behavioural therapy (CBT) have been evaluated in high incomes countries, however, there are no such programmes in the low-income island of Mauritius.

Therefore this study will use an established transdiagnostic anxiety and depression prevention programme called Super Skills for Life (SSL; Essau et al., 2014) which involves social skills training, behavioural activation, video feedback and cognitive preparation to measure factors that predict and mediate treatment outcome among children and adolescents in institutional care settings. A recent feasibility study of the SSL programme for children in institution care settings has been found to be feasible to the Mauritian children and adapted to their individual cultural and social backgrounds. A randomized controlled trial (RCT) with waitlist control group design to measure the effectiveness of the SSL intervention was used to establish the intervention as an evidence-based treatment for emotional problems in children and adolescents in care institutions in Mauritius.

100 young people aged between 9 to 15 years from six institutional care settings in Mauritius were randomly assigned to the 8 sessions of the SSL intervention programme (n=50) or to a waitlist control group (n=50). The waitlist group received the intervention after the experimental group completed the intervention. Participants in both groups were assessed before, after and 3 months post the SSL intervention programme.

The primary outcomes measured psychological difficulties in five sub-scales of emotional symptoms, conduct problems, hyperactivity/inattention, peer-relationship problems, and prosocial behaviour. Levels of anxiety and depression were measured using the revised children’s anxiety and depression scale which produced a total anxiety and low mood score and separate scores for each of the subscales of separation anxiety; social phobia; generalised anxiety; panic; obsessive compulsive; total anxiety; and, low mood. Secondary outcomes included measures of self-esteem and cognitive emotion regulation strategies and online tasks measuring reaction time were used to assess cognitive inhibitory control and emotional attention bias.

Results & Conclusion:
Data analysis is still in process, however based on previous finding of SSL (Essau et al., 2014, 2019), reductions in anxiety and depression related symptoms and improvements in cognitive control and emotional regulation strategies at post treatment are expected. This RCT study is powered to detect the effectiveness of an anxiety and depression intervention programme, and will contributed to the evidence base for mental health provision for children and adolescents in Mauritius. It will have implications for stakeholders, including policy-makers, institutions for child welfare, practitioners working with children and most importantly to young people of Mauritius. Data analysis and writing up of this RCT study are currently being carried out.

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Item Type: Conference or Workshop Item (Commonwealth Reporting Category E) (Poster)
Refereed: No
Item Status: Live Archive
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 22 Mar 2022 23:16
Last Modified: 30 May 2022 02:44
Uncontrolled Keywords: juvenile mental health; depression; prevention; child and adolescent mental health; children in care
Fields of Research (2008): 13 Education > 1399 Other Education > 139999 Education not elsewhere classified
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111714 Mental Health
Fields of Research (2020): 39 EDUCATION > 3999 Other Education > 399999 Other education not elsewhere classified
52 PSYCHOLOGY > 5201 Applied and developmental psychology > 520101 Child and adolescent development
URI: http://eprints.usq.edu.au/id/eprint/46828

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