FRIENDS programme reduced anxiety, but has no effect on school academic performance

Last updated 20 December 2023

Anxiety programmes delivered in schools, such as FRIENDS for life,1 have demonstrated efficacy in reducing anxiety symptoms. Whether such programmes have a positive impact on school performance and academic outcomes, however, is unclear. Now, Professor Paul Stallard and colleagues have analysed data from the randomised controlled trial “Preventing Anxiety in Children through Education in Schools” that involved >1,300 children aged 9-10 years from 40 primary schools across England.

Here, they assessed whether the universal school-based cognitive behaviour therapy prevention programme, FRIENDS, was more effective when delivered by health-care staff or school staff compared to usual personal, social, health and education (PSHE) classes. At 12-months post-intervention, the researchers found that health-care-led FRIENDS was significantly more effective at reducing anxiety than both school-led FRIENDS or usual PSHE classes. Interestingly, there was no effect of reduced anxiety on educational outcomes, based on performance in the national standardised attainment tests in reading, writing and maths, regardless of who led the intervention.

The researchers conclude that future work should assess psychological and educational outcomes to fully understand the multiple effects of school-based mental health interventions. Furthermore, they consider these findings particularly timely given the green paper and mental health in schools initiative.2,3

Study Implications

We asked Professor Paul Stallard to explain the key implications from these study data:

Schools and educational practice: “The first issue we highlighted was how the same programme/materials achieved different outcomes depending on who led the intervention (trained member of school versus health professional). This continues to be an important question and has implications in terms of who we should be training to undertake mental health work in schools, and what level of support and supervision is needed”.

Recommendations for further science: “The second issue was our failure to identify any positive effects of the anxiety programme on educational outcomes. The data we obtained (based on standardised attainment tests) might not be sensitive to change over such a short time frame and we urge researchers to look at other more immediate educational outcomes such as exclusion rates, school attendance, attitude towards learning and school connectedness”.

Skryabina, E., Taylor, G. & Stallard, P. (2016), Effect of a universal anxiety prevention programme (FRIENDS) on children’s academic performance: results from a randomised controlled trial. J Child Psychol Psychiatr. 57: 1297-1307. doi: 10.1111/jcpp.12593

Further reading

1Barrett, P. (2004), FRIENDS for life: Group leaders manual for children. Bowen Hill, Qld: Australian Academic Press.

2 Mentally Healthy Schools

3 Transforming Children and Peoples Mental Health – Green Paper