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ABSTRACT
Background
Children within historically disadvantaged non-Western South African communities are considered as particularly vulnerable to the development of anxiety problems. Although the need for accessible mental health interventions is evident, this need has remained unmet in a country with extreme socio-economic disparities and a lack of mental health resources. Cognitive behavioural therapy-based (CBT-based) interventions that employ brief and intensive delivery methods may overcome existing barriers to access to mental health services faced by many South African children and may ameliorate the burden placed on under-resourced mental health care services.
Aim
To provide preliminary evidence on the effectiveness of a brief, intensive CBT-based anxiety prevention intervention conducted in a South African context.
Method
A mixed-methods approach, with quantitative and qualitative data, was used to evaluate the effects of the CBT-based programme in a sample of 21 farmworkers’ children aged 9–14 years living in disadvantaged semi-rural communities of the Western Cape. A quasi-experimental design with an immediate intervention (experimental) group and a delayed intervention (control) group was applied in the quantitative component of the study. The qualitative component was based on focus group data.
Results
In general, positive effects were noted for the CBT-based anxiety prevention programme in these vulnerable children. Quantitative data revealed a trend reflecting a reduction of self-reported anxiety levels. Qualitative support for the acquisition and application of the CBT-based programme skills was also found.
Conclusion
This pilot study indicates that a brief, intensive CBT-based prevention programme holds promise for the effective reduction of anxiety in vulnerable South African children.
Acknowledgements
Opinions expressed and conclusions arrived at are those of the author(s) and are not to be attributed to the organisations acknowledged in the funding section.
The authors are grateful to the NGO director, social workers and ultimately the participants for their enthusiastic collaboration and significant contribution towards this project.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethical standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Notes
1 Burst that (Thought) Bubble refers to an interactive activity utilised in the I am BRAVE intervention to deliver the core component of cognitive restructuring.
2 The cross and tick refer to an activity used in the I am BRAVE intervention to deliver the evaluative skill in problem solving.
3 Stop and Think refers to a Cognitive Restructuring activity utilised in the I am BRAVE programme.
Additional information
Funding
Notes on contributors
Naomi Myburgh
Naomi Myburgh (MA, PhD (Stell)) completed her PhD in 2019. She is the Academic Head of an academy in South Africa where she strives to make a difference in the lives of children and enjoys putting psychology into practice education. She is passionate about the academic advancement of students and research in the field of childhood mental health, which she pursues in her post-graduate supervision role at Stellenbosch University. Her research interests lie in the development and dissemination of contextually adapted and culturally sensitive mental health measures and interventions. Her specific goals are to contribute to a continued need for effective and accessible mental health services within low-resourced communities, and the development of policies that translate into relevant, effective practice.
Peter Muris
Peter Muris is a full Professor of Developmental Psychopathology at Maastricht University, The Netherlands. He also holds an Extraordinary Professorship at the Department of Psychology, University of Stellenbosch, South Africa, since 2015. Muris is an internationally well-respected researcher on child and adolescent psychopathology and investigates the role of child-related factors such as temperament and cognitive biases as well as anxiety-related rearing behaviours of parents in the aetiology of childhood anxiety disorders. His focus is also on the translation of research findings into clinical interventions. Muris is co-editor of Child Psychiatry & Human Development and Journal of Child & Family Studies, two leading journals in the field. He has published over 400 research papers in peer-reviewed journals, has supervised 12 PhD students to completion and 4 PhD projects are in progress. His current H-Index is 66 (Web of Science) / 105 (Google Scholar).
Helene Loxton
Helene Loxton is currently an Associate Professor in the Psychology Department at Stellenbosch University, South Africa, who focuses her teaching on Developmental Psychology in the undergraduate and Child Psychology and Psychotherapy in the postgraduate programmes. She has a particular interest in promoting childhood development within the South African context. Her growing interest and involvement in fear, anxiety and coping research is reflected in her research focus and outputs both nationally and internationally. Her research started with focusing on childhood fears within different developmental stages. From a developmental perspective, the studies with young children from a diverse range of socioeconomic backgrounds contribute significantly to knowledge on planning and implementation of future early intervention programmes. Her current research represents two broad themes, namely, childhood fears and anxiety in vulnerable populations, as well as the development, implementation and evaluation of CBT-based anxiety interventions for youth, with a specific focus on adapting interventions for the South African childhood context.