Cognitive behavioural therapy (CBT)

CBT programmes aim to support students to manage stress and emotions more effectively.

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Evidence Type
High
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Cognitive behavioural therapy is a type of talking therapy that can help individuals to identify and challenge irrational thoughts and beliefs, and to replace them with more adaptive thinking patterns.

It is designed to help people to deal with low to mild mental wellbeing difficulties (commonly anxiety and depression), as well as to improve confidence and self-esteem.

CBT targeted support programmes aim to support students to manage stress and emotions more effectively, and to enhance their resilience and wellbeing.

Programme information

This information refers to targeted mental wellbeing support programmes evaluated by the National Institute for Health and Care Excellence (NICE). Other programmes may vary in programme length and delivery method.

Length: A wide range - from 1 or 2 standalone sessions to 6-12 weeks of weekly sessions
Delivered by: External providers and internal staff – including school counsellors, trained school staff (e.g., teacher), pastoral staff, therapists, psychologists, external specialists, group leaders (e.g., nurses, educational and psychological counsellors) and graduate students
Delivery method: Group and individual
Age: 7 – 16

Many programmes aimed at secondary schools may also be suitable for FE colleges. Please see individual programmes for guidance.

Targeted support programmes

The following directories are good places to start to identify an appropriately qualified practitioner to deliver CBT support programmes:

The following are some examples of CBT targeted support programmes that you may wish to explore to see if they are right for your setting.

These programmes have been evaluated by a team of researchers as part of the NICE evidence reviews, unless otherwise indicated by an asterisk*.

Any non-UK based programme that is listed will have either been used previously in the UK or may be suitable for adaptation in your setting. You may need to check with the provider to confirm how to best use it in your setting.

DISCOVER

DISCOVER is a school-based workshop programme for students aged 16-18 who experience anxiety, low mood and high stress.

Find out more

Super Skills for Life

Super Skills for Life is a school-based programme for students aged 6 – 18 designed to improve self-confidence and resilience.

Find out more

The Blues Programme*

The Blues Programme is a six week programme to teach young people aged 13 – 19 about emotional resilience, and to reduce low mood and anxious thoughts.

Find out more

Place2Be: CBT-informed therapy*

Partner schools can access targeted support for students in secondary schools presenting with difficulties such as anxiety, depression and low mood.

Find out more

*Please note: these programmes have not been evaluated by Anna Freud, or by NICE as part of their evidence reviews. Their inclusion does not indicate endorsement.

There may be other CBT services and programmes available in your local area. Contact your local authority to find out what is available to your school or college.

If you are unsure who to contact at your local authority, try speaking to your Mental Health Support Team (if applicable), your trust leadership team, or your setting’s safeguarding or pastoral lead.

If you haven’t yet reviewed the targeted support guide, this will help you to consider which types of targeted support might be appropriate for your setting.

What does the evidence show?

CBT is a recommended treatment option approach.

The evidence however varies by outcome and age group, so it is important to consider the needs in your setting. The evidence for CBT for depression and social adjustment in secondary schools is strongest.

CBT targeted support programmes aim to support students to manage stress and emotions more effectively, and to enhance their resilience and wellbeing.

Some programmes are group-based, while others are for delivery with individuals.

The NICE evidence reviews examined the evidence of 18 studies relating to group-based CBT targeted support programmes and one study for an individual-based targeted support programme across primary and secondary settings.

The group sessions involved teaching young people strategies for recognising thought patterns, including cognitive biases, and identifying their emotions and behaviours.

Programmes also taught students strategies for dealing with unhelpful or negative thought patterns, as well as other coping mechanisms. Some of the programmes also set homework for students.

The individual program was manualised, and both students and their parents and carers received written summaries, worksheets and guides for home practice. It was delivered over ten weekly sessions by a counsellor.

Please see the evidence table below for a breakdown of the strength of the evidence by different outcomes and age groups. The evidence varies by outcome and age group, so it is important to consider the needs in your setting. The evidence for CBT for depression and social adjustment in secondary schools is strongest.

NICE evaluated the following outcomes of group-based CBT targeted support programmes:

Outcomes measured	Primary/Secondary	Strength of evidence
Depression diagnosis - RCT	Secondary	High
Social adjustment	Secondary	Moderate
Behavioural difficulties	Primary	Low
Prosocial behaviour	Primary	Low
Emotional competence	Primary	Low
Externalising behaviours	Secondary	Low
Self-esteem	Secondary	Low
Response (reduction in depression symptoms)	Secondary	Low
Behavioural outcomes	Primary	Low
Emotional distress	Secondary	Low
Child-reported anxiety (MASC) at 2.5 months	Primary	Low
Teacher reported behavioural assessment (BASC) at 2.5 months	Primary	Low
Conduct problems	Secondary	Low
Behavioural outcomes	Secondary	Low*
Social Skills	Primary	Very low
Emotional distress	Primary	Very low
Child-reported anxiety (SCAS) at 12 months	Primary	Very low
Mental health difficulties	Primary	No rating

*This evidence rating was given by NICE as combined evidence rating with other types of intervention (Yoga, mindfulness & meditation). It is therefore not possible to give it its own evidence rating.

NICE also evaluated the following outcomes of an individual-based CBT targeted support programme:

Outcomes measured	Primary/Secondary	Strength of evidence
Proactive aggression	Primary	Low
Reactive aggression	Primary	Very low
Self-perception	Primary	Very low

It’s important to note that a ‘low’ or ‘very low’ grading does not indicate that the programme doesn’t work. Rather, it suggests the quality of the study wasn’t high enough to be able to strongly say whether a support programme is effective for the target group, and further research is likely to impact the rating.

Find out more about the NICE evidence reviews.

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