Frequently Asked Questions

The Blues Program is a depression prevention intervention and not treatment, so it is important to assess adolescents for current major depression and serious suicidal ideation. If either is present, the adolescent needs to be referred for appropriate treatment. Adolescents with a history of major depression could be appropriate for the Blues Program. We have not excluded adolescents on the basis of other psychiatric disorders but our research suggests that adolescents with high levels of substance use do not significantly benefit from the program.

The use of a depression assessment tool is recommended, such as the CES-D or PHQ-9

In schools: We have had success with a two-pronged approach:

• Promote school wide through universal promotions such as flyers, school emails, and parent communication methods.
• School staff such as guidance counselors, nurses, teachers, club leaders, coaches, and social workers can make individual invitations to students.

Virtual community wide programs: Cast a wide net to let potential referral sources know of this resource! Schools, mental health providers, doctors, youth serving organizations, faith based organizations, and other organizations are often great referrals sources.

We have been very successful recruiting potential participants by inviting them to take part in a class aimed at helping adolescents reduce sadness and promote emotional well-being. In this and other interventions, we have found that referring to the Blues Program as a “class” rather than a “group” helps to reduce the potential for stigma.

Generally, administrators are most receptive to offering these programs when it is demonstrated that research supports a beneficial effect of the intervention for participants, that delivering this program would not interfere with regular school activities, and that it won’t additionally burden administrative staff.
If your school district conducts school climate and/or behavioral health assessments, the Blues Program may be of special interest.

This intervention has been successfully implemented by a variety of individuals with varying levels of clinical training. The ideal group leader would be familiar with cognitive behavioral methods of preventing and treating depression, an understanding of how depression affects youth in our culture, experience conducting manualized groups, and basic therapeutic and empathy skills. Group leaders should carefully read the manual and practice each activity before leading a group, and should be comfortable managing sessions effectively so that the material is covered and sessions stay on track. Being able to tactfully interrupt particularly talkative participants to keep the group on track is also an important skill.

Yes, it is possible to deliver the Blues Program by yourself, especially if you already have experience conducting prevention or treatment groups with adolescents and you have training in cognitive-behavioral intervention approaches. If you do this, it is especially important to carefully prepare so that you clearly understand the session
material and planned exercises. However, if a co-facilitator is available, we recommend that because it allows you to split up the material to present, bounce ideas off of each other in and between sessions, support each other through the group delivery, and have continuity with one facilitator if one of you is sick or unable to attend a session.

In research with high school students, all groups were single-gender. This was done to increase the comfort level of group members, encourage more open and honest sharing, reduce potential distractions, and avoid one gender dominating discussion over the other. It is possible to successfully conduct mixed-gender groups, but we would suggest that you try to have at least 2-3 members of each sex in the group to facilitate cohesion, and to try and make the number of participants in each gender equal.

Research has focused on adolescents in grades 8th-12th (14-19 years of age) and the program has been found to be equally effective of adolescents across that age span (Müller, Rohde, Gau, & Stice, 2015). We suspect that some of the content would not be developmentally appropriate for younger adolescents or children. Other interventions have been developed for younger adolescents (please see the Stice et al., 2009 meta-analysis).

It is strongly recommended to contact a student if she/he misses a session to conduct a brief (10-15 minute) individual make-up session before the next group session. Use the make-up session to review past home practice assignments, discuss the key concepts from the missed session, and give the new home practice assignment so the person can complete it before the next session. Occasionally group members do drop out after not responding to repeated attempts to have them rejoin.

We aim to conduct groups with 4-8 adolescents. If a group is much larger, it is very difficult to cover all the material and involve all group members in the timeframe of each session.

The program developers have no experience delivering this information to adolescents on a 1-on-1 basis and believe there is significant benefit to the adolescents hearing about the experiences and successes of other individuals their own age who are dealing with similar symptoms and stresses. Rather than conducting individual sessions, we would suggest that you try to recruit even two or three appropriate adolescents and conduct a small group.

Yes, this group may be delivered virtually. Several organizations have done so and it has been well received. Holding a virtual class after the school day removes transportation barriers.