Effectiveness of resilience-based interventions to promote mental well-being among secondary school children: A systematic review

Andrea Utz Matus de la Parra¹Marion Gibbon²Dean M Thompson^1*

• ¹Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom
• ²Birmingham City Council, Birmingham, United Kingdom

Background: Mental health conditions are increasingly prevalent among school-aged children. Well-being and resilience play a crucial role in preventing and mitigating mental health difficulties. Strengthening coping strategies and protective behaviours enhances young people’s capacity to manage adversity and supports better psychological outcomes. Although resilience-based interventions have demonstrated effectiveness in reducing mental health problems in adolescents, it remains unclear which components are most beneficial, how long effects are sustained, and what factors influence successful implementation in school settings. This review aimed to identify effective intervention components, examine facilitators and barriers to implementation, and assess variation in outcomes by follow-up duration. Methods: A systematic review and narrative synthesis were conducted. Five electronic databases (EMBASE, MEDLINE, PsycINFO, CINAHL, and CENTRAL) were searched for trials evaluating resilience-based interventions targeting children and adolescents aged 11–19 years in secondary education. Eligible studies reported outcomes related to mental health problems or resilience. Results: Thirty-four trials were included from 3,419 records. Twelve interventions demonstrated significant effects compared with control or alternative intervention across five of nine outcomes: depressive symptoms, anxiety symptoms, resilience, emotional symptoms, and externalising problems. Interventions employing a multicomponent approach demonstrated significant effects in six of twelve trials showing positive results, particularly those combining social skills training, cognitive behavioural therapy (CBT) and positive psychology. Group-based interventions, especially those incorporating peer collaboration and social learning, appeared to be more effective. At short-term follow-up, ten studies reported significant effects across at least one outcome. These included small effects for anxiety, resilience, and externalising problems (k = 4), moderate effects for depressive symptoms and resilience (k = 3), and large effects for resilience and depressive symptoms (k = 2). Notably, one study yielded three significant outcomes, namely depressive symptoms, externalising problems, and resilience. At long-term follow-up, small but significant effects were reported in two studies (k = 2) for depressive and emotional symptoms. Conclusion: Resilience-based interventions show potential to improve mental health outcomes in school children, including reductions in depressive and anxiety symptoms and externalising problems, alongside increased resilience. Future research should prioritise addressing implementation barriers, particularly student engagement and fidelity, to enhance sustainability of effects.