A Cluster Randomised Controlled Trial of a Transdiagnostic Preventative Mental Health Intervention for Adolescents: Building Resilience through Socioemotional Training (ReSET)
Abstract
Background: Rates of mental health problems in adolescents have increased in the last decade, prompting urgent calls for effective, scalable preventative interventions. To determine whether a novel, group-based, transdiagnostic indicated prevention programme (Building Resilience through Socioemotional Training; ReSET), delivered through existing school mental health provision, improves mental health and wellbeing in at-risk adolescents. Methods: Two-arm cluster randomised controlled superiority trial (1:1) evaluating ReSET plus usual care versus usual care only, with outcomes assessed immediately post-intervention and at 12-month follow-up. Adolescents aged 12–14 identified through whole-school screening as scoring in the top 25th percentile for overall psychopathology symptoms, in schools selected to over-represent high-need communities (≥30% free school meals eligibility). ReSET is an 8-session group -based intervention that targets two key mechanisms implicated in risk for psychopathology in adolescents – social functioning and emotional processing. Pre-registered co-primary outcomes were overall self-reported psychopathology (SDQ) and wellbeing (WEMWBS), assessed immediately post-intervention and at 12-month follow-up. Results: Of 4,005 adolescents screened, 1465 met eligibility, 727 consented and 560 were enrolled. There was no evidence of intervention effects on either co-primary outcome immediately post-intervention. At 12-month follow-up, there was evidence of improvement in overall psychopathology (adjusted mean difference −1.36, 97.5% CI −2.23 to −0.50, p=0.0004; SMD=0.25, 95% CI 0.11 to 0.42). Secondary outcomes showed a consistent pattern: no effects immediately post-intervention, but significant benefits for anxiety, depression, general psychopathology, and internalising symptoms at 12-month follow-up. No effects on externalising symptoms were observed at either timepoint. Conclusions: The delayed emergence of benefit is consistent with a skills-based prevention model in which adolescents acquire skills that support resilient functioning when facing subsequent emotional and interpersonal challenges. These findings suggest that transdiagnostic interventions targeting socioemotional processes have the potential to prevent common adolescent mental health problems, though replication and longer-term evaluation are needed.
Related
- Adaptation and feasibility assessment of a school-based Suicide Prevention Intervention for Adolescents (SPREAD Study) in Nigeria: protocol for a cluster randomised controlled feasibility trial
- Efficacy of a personalized, response-based transdiagnostic intervention for emotional disorders delivered via the Internet: a protocol for an adaptive randomized controlled trial
- Testing causal mechanisms of transdiagnostic dissociation in 16-to-25-year-olds: A randomised multiple baseline experimental design series using brief targeted CBT.
- A multicenter randomized controlled effectiveness trial of transdiagnostic treatment for adolescents with subthreshold anxiety and depressive symptoms
- Pilot trial of a transdiagnostic intervention for war-affected men with alcohol misuse in Ukraine
BibTeX
@misc{fearon2026cluster,
title = {{A Cluster Randomised Controlled Trial of a Transdiagnostic Preventative Mental Health Intervention for Adolescents: Building Resilience through Socioemotional Training (ReSET)}},
author = {Pasco Fearon and Alex Lloyd and Peter Martin and Roslyn Law and Laura Lucas and Tom (Chin-Han) Wu and Nick Midgley and Nikolaus Steinbeis and René Veenstra and Jaime Smith},
howpublished = {PsyArXiv},
year = {2026},
month = nov,
doi = {10.31234/osf.io/kjuae_v2},
url = {https://osf.io/preprints/psyarxiv/kjuae_v2/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - A Cluster Randomised Controlled Trial of a Transdiagnostic Preventative Mental Health Intervention for Adolescents: Building Resilience through Socioemotional Training (ReSET)
AU - Pasco Fearon
AU - Alex Lloyd
AU - Peter Martin
AU - Roslyn Law
AU - Laura Lucas
AU - Tom (Chin-Han) Wu
AU - Nick Midgley
AU - Nikolaus Steinbeis
AU - René Veenstra
AU - Jaime Smith
PY - 2026
DA - 2026/11/06
PB - PsyArXiv
DO - 10.31234/osf.io/kjuae_v2
UR - https://osf.io/preprints/psyarxiv/kjuae_v2/
AB - Background: Rates of mental health problems in adolescents have increased in the last decade, prompting urgent calls for effective, scalable preventative interventions. To determine whether a novel, group-based, transdiagnostic indicated prevention programme (Building Resilience through Socioemotional Training; ReSET), delivered through existing school mental health provision, improves mental health and wellbeing in at-risk adolescents. Methods: Two-arm cluster randomised controlled superiority trial (1:1) evaluating ReSET plus usual care versus usual care only, with outcomes assessed immediately post-intervention and at 12-month follow-up. Adolescents aged 12–14 identified through whole-school screening as scoring in the top 25th percentile for overall psychopathology symptoms, in schools selected to over-represent high-need communities (≥30% free school meals eligibility). ReSET is an 8-session group -based intervention that targets two key mechanisms implicated in risk for psychopathology in adolescents – social functioning and emotional processing. Pre-registered co-primary outcomes were overall self-reported psychopathology (SDQ) and wellbeing (WEMWBS), assessed immediately post-intervention and at 12-month follow-up. Results: Of 4,005 adolescents screened, 1465 met eligibility, 727 consented and 560 were enrolled. There was no evidence of intervention effects on either co-primary outcome immediately post-intervention. At 12-month follow-up, there was evidence of improvement in overall psychopathology (adjusted mean difference −1.36, 97.5% CI −2.23 to −0.50, p=0.0004; SMD=0.25, 95% CI 0.11 to 0.42). Secondary outcomes showed a consistent pattern: no effects immediately post-intervention, but significant benefits for anxiety, depression, general psychopathology, and internalising symptoms at 12-month follow-up. No effects on externalising symptoms were observed at either timepoint. Conclusions: The delayed emergence of benefit is consistent with a skills-based prevention model in which adolescents acquire skills that support resilient functioning when facing subsequent emotional and interpersonal challenges. These findings suggest that transdiagnostic interventions targeting socioemotional processes have the potential to prevent common adolescent mental health problems, though replication and longer-term evaluation are needed.
ER -