School-based program cuts depression and anxiety in newcomer students

The first randomized control trial of the school-based intervention called Supporting Transition Resilience of Newcomer Groups (STRONG) shows significant reductions in depression, anxiety and behavior problems among refugee and immigrant students. The study, funded by the National Institute of Mental Health, was co-led by Ann & Robert H. Lurie Children's Hospital of Chicago and Loyola University, in partnership with the Chicago Public Schools (CPS). Results were published in the American Journal of Community Psychology.

STRONG is a trauma-informed mental health intervention for newcomer youth in kindergarten through 12^th grade designed to support positive adjustment during resettlement and improve access to mental health services. It includes 10 weekly small group sessions and an individual session, with a focus on recognizing internal strengths, identifying social supports, practicing relaxation and mindfulness, developing cognitive coping and problem-solving skills, and fostering social belonging and cultural pride. STRONG is widely disseminated nationally and internationally.

"We are excited to provide robust scientific evidence that STRONG intervention achieves what it is designed to do – help newcomer students from diverse backgrounds feel more connected and emotionally resilient as they adjust to their new environment," said Co-Principal Investigator Tali Raviv, PhD, Director of School Mental Health at the Center for Childhood Resilience at Lurie Children's and Associate Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. "As more communities welcome newcomer students, our research shows that expanding STRONG to more schools can foster positive integration and mental health."

The study included 64 newcomer students from 19 countries, in grades ranging from third to 12^th. After completing STRONG, student reported symptoms of depression and anxiety were reduced by 21 percent. Behavior problems fell by 8 percent as reported by students, and by 12 percent as perceived by teachers.

Interviews and focus groups with STRONG group facilitators and school staff revealed that participating students exhibited increased confidence, formed friendships, and applied skills, such as mindfulness techniques, during testing and classroom activities. As one group facilitator quoted in the study shared: "All of our students talked about feeling this comfort in knowing that they aren't alone, that they didn't know other kids were dealing with the same challenges and that it was really helpful to them to hear that."

Since 2019, staff from the Center for Childhood Resilience have trained 325 school personnel from 166 schools in Chicago to implement STRONG. They will continue these trainings to disseminate the intervention to more schools in Chicago and beyond.

As a public education system that looks at the whole child, we are not just simply measuring academic progress, we are also ensuring that students have the resources needed for social and emotional wellbeing. We are committed to doing everything we can to lift up our newcomer students because the very best of this District is built on the diversity of our community, and every student who walks through the doors of a CPS school deserves to feel a sense of belonging and connectedness."

Pedro Martinez, CPS CEO 

In addition to Dr. Raviv, study co-authors from Lurie Children's include Yvita Bustos, Saadia Elahi, Rebecca Ford-Paz, Bianca Ramos and Colleen Cicchetti.

The Center for Childhood Resilience is the public health arm of the Pritzker Department of Psychiatry and Behavioral Health at Lurie Children's. It is committed to increasing access to high-quality mental health services and prevention programming for children and youth throughout Illinois and nationwide.