Pilot Evaluation of a Brief Emotion Regulation Intervention for Secondary School Students in Post-Earthquake Nepal

Abstract

Background: Child and adolescent mental health problems are major contributors to the global burden of disease, with the majority of the mental health burden concentrated in low- and middle-income country (LMIC) settings. To advance the evidence base for adolescent mental health interventions in LMICs, we piloted and evaluated the preliminary efficacy of a culturally adapted emotion regulation intervention (Regulating Emotions thought Adapted Dialectical behavior skills for Youth; READY-Nepal) for earthquake-exposed adolescents in Nepal. Methods: A gender-stratified, quasi-experimental design was conducted targeting Nepali secondary school students in one heavily affected post-earthquake district. A total of 102 adolescents (age 13 to 18) were enrolled in the group-based intervention. The primary outcome (emotion regulation) and secondary outcomes (coping skills, anxiety, trauma, functioning, resilience, and suicidal ideation) were measured at baseline and follow-up (four weeks). Results: Contrary to our hypotheses, we found no difference by arm either primary or secondary outcomes at four-week follow-up, with the exception of functioning (with control participants reporting greater improvement than intervention participants). Across arms, females reported greater reductions in anxiety and trauma symptoms relative to males. Conclusion: Further research, including investigation of optimal program dosage, delivery formats, and cultural models of emotion regulation, is necessary to explore the potential of school-based emotion regulation interventions in Nepal and other LMICs.