Introduction
Method
Search Strategy
Inclusion and Exclusion Criteria
Study Selection and Data Extraction
Author | Setting | Overall sample (N) | Age range/ Grade | Intervention and Comparison groups (n) | Format & treatment type category | Facilitator(s) & number of treatment sessions | Stress/Anxiety Outcome Measure(s) | Results | Findings Summary |
---|---|---|---|---|---|---|---|---|---|
1. de Hullu et al. [37] | 24 Dutch schools | 240 | 12 – 16 years Grade not reported | 1. Internet-based CBM training (n = 86) 2. School-based CBT (n = 84) 3. No intervention control (n = 70) | Targeted – high social anxiety at school Cognitive bias modification -computer based tasks to modify interpretation and attention biases, strengthen association between social evaluative situations and positive outcomes and increase implicit self-esteem | Psychologist 20 sessions (2 sessions per week) | 1. Revised Child Anxiety and Depression Scale – Social phobia subscale [38] 2. Spielberger Test Anxiety Inventory (TAI) | Significant decrease of TAI scores, p < 0.0001, d = 0.82 (CBT) and d = 0.65 (CBM) and RCADS scores, p < 0.0001, d = .86 (CBT) & d = 0.79 (CBM). Intervention group interaction not significant, p = 0.32 | Test anxiety and social anxiety significantly reduced from pre-treatment to 2-year follow-up across all conditions, there was no difference between CBM, CBT or no-intervention control |
2. Gaesser & Karan [39] | 10 American schools | 63 | 10—18 years. Grades 6–12 | 1. CBT group (n = 21) 2. Emotional Freedom Technique (EFT) group (n = 21) 3. Waitlist control (n = 21) | Targeted – high ability students with school based anxiety CBT -cognitive reframing -building awareness -systematic desensitisation | Professional instructors 3 sessions | 1. Revised Children’s Manifest Anxiety Scale-2 (RCMAS-2) | Students in EFT group had significantly lower post anxiety (p = 0.005, d = 0.34 | Anxiety significantly decreased pre- to post-intervention for both the EFT and CBT groups. However, only EFT change in anxiety symptoms pre- to post-intervention was significantly higher compared to control |
3. Hains & Ellman [40] | 1 American school | 21 | Age not reported Grades 9, 10, 11, 12 | 1. Stress-inoculation training (n = 11) 2. Waitlist Control (n = 10) | Targeted – self selected CBT -cognitive restructuring -problem-solving -relaxation | Psychologists 13 sessions | 1. State-Trait Anxiety Inventory (STAI; [83]) 2. Adolescent Perceived Events Scale (APES) | Significant trait anxiety reductions at follow-up in high emotional arousal group. T(5) = 3.13, p = 0.013. No effect size given | No significant group differences in anxiety or stress at post-intervention. At follow-up, trait anxiety significantly reduced for students with “high emotional arousal” (scored above a cut-off at baseline) who received the intervention |
4. Johnson et al. [41] | 1 American school | 30 | Age not reported Grade 8 | 1. Systematic desensitisation (n = 8) 2. Speech practice (n = 8) 3. No treatment control (n = 8) | Targeted – high speech anxiety Systematic desensitisation -relaxation and visualisation -speech fear hierarchy -script for desensitisation related to fear hierarchy | Psychologist 9 sessions | 1. Speech Anxiety Survey (researcher adapted) | Significant anxiety drops in intervention groups (D: p < 0.01; P: p < 0.01). No effect size given | Significantly reduced anxiety for students in both intervention groups, relative to control. No significant difference between interventions |
5. Kamour & Altakhayneh [42] | Jordanian private schools | 207 | Age not reported Grade 7 & 8 | 1. SEL program (n = 100) 2. Control group (n = 107) | Targeted – unknown “deliberately chosen” Social Emotional Learning -self awareness -self management -social awareness -relationship skills -responsible decision making | Not reported 16 sessions | 1. Math Anxiety Test (researcher designed) | Reduction of math anxiety. (F = 4413, p = 0.000) | Significant between group difference indicating the SEL group had a greater reduction in math anxiety compared to the control group pre- to post-intervention |
9. Keogh et al. [34] | 1 English school | 209 | 15—16 years Grades not reported | 1. Cognitive-behavioural stress management intervention (n = 80) 2. No intervention control (n = 80) | Universal CBT -psychoeducation -challenging unhelpful cognitions -progressive muscle relaxation -modify meta-cognitions about worry -adaptive problem solving -guided imagery | Psychologist 10 sessions | 1. Revised Test Anxiety Scale (RTA; [43] 2. General Health Questionnaire (GHQ) – Mental ill-Health 3. GCSE points | No significant main, or interactive, effects | No significant changes in test anxiety Mental ill-health improved from pre- to post-intervention for the CBT group but not the control group The CBT group obtained higher GCSE scores compared to the control group, with the CBT group obtaining one letter grade (i.e., B grade) higher than the control group (i.e., C grade) |
10. Khalsa et al. [44] | 1 American school | 121 | 15—19 years. Grades 11 & 12 | 1. Yoga (n = 74) 2. Usual Physical Education class (n = 47) | Universal Mindfulness/ Meditation -training in cognitive skills of mindfulness and self-awareness -yoga based psychological attitude -yoga poses -breathing exercises -visualisation -relaxation -stress management | Professional instructor 11 weeks, 2–3 sessions per week (i.e., 23–32 sessions dependent on class) | 1. Perceived Stress Scale (PSS) 2. Profile of Mood States-Short Form (POMS-SF) 3. Behaviour Assessment Survey for Children-Version 2) – includes test anxiety scale | No significant group differences (p = 0.15) | No significant group differences for anxiety or stress pre- to post- intervention |
11. Kiselica et al. [45] | 1 American school | 48 | Age not reported Grade 9 | 1. Stress inoculation training (n = 24) 2. Active control (n = 24) | Universal CBT -psychoeducation -progressive muscle relaxation -cognitive restructuring -assertiveness training | Psychologists 8 sessions | 1. State-Trait Anxiety Inventory – Trait (STAI A-TRAIT; [85]) 2. Symptoms of Stress Inventory (SOSI; [82]) 3. GPA | Significant dif. between treatment and control participants (F(1,41) = 14.04, p < 0.001) | Significantly lower anxiety and stress for students in the intervention condition compared to the control condition at post-treatment and follow-up. No significant differences between groups for GPA |
12. Lang et al. [46] | 1 Swiss vocational school | 131 | Mean age 16.22 years (range, grade not reported) | 1. PE based coping training -EPHECT (n = 67) 2. No intervention control (n = 64) | Universal CBT -psychoeducation -emotion and problem focussed coping skills | Teachers 8 sessions | 1. Adolescents Stress Questionnaire (ASQ; [47] | Time by group interactive effect at follow- up (F(1,111) = 3.82, p < 0.05) | Significantly greater reduction in stress for the intervention group, relative to controls, at 6-month follow-up |
13. Lang et al. [48] *Same sample as 2016 | 1 Swiss vocational school | 131 | Mean age 16.22 years Age range and grade not reported) | 1. PE based coping training -EPHECT (n = 67) 2. No intervention control (n = 64) | Universal CBT -psychoeducation -emotion and problem focussed coping skills | Teachers 8 sessions | 1. Adolescents Stress Questionnaire (ASQ; [47] 2. Coping Questionnaire for Children and Adolescents (SVF-KJ) | No significant changes pre-post treatment | Intervention group reported greater increase in emotion focused coping compared to control group pre-post intervention No significant changes in perceived stress from pre- to post-treatment |
6. Laxer & Walker [49] | 3 Canadian schools | 119 | Age not reported. Grade not reported | 1. Systematic desensitisation 2. Relaxation alone 3. Simulation alone 4. Relaxation plus simulation 5. Attention control 6. No treatment control *N in each group not reported | Targeted – high test anxiety Systematic desensitisation -deep muscular relaxation -presentation of graded imaginal stimuli associated with examinations | Professional instructors 20 sessions | 1. Alpert-Haber Achievement Anxiety Scale (AAS) 2. Taylor Manifest Anxiety Scale (TAS) | Significant difference only for test anxiety measure. (F = 4.14, p < 0.001) | Test anxiety (TAS) was significantly lower for students in the systematic desensitisation condition and relaxation alone condition, relative to no treatment control |
7. Lowe & Wuthrich [83] | 4 Australian schools | 56 | 17 – 18 years. Grade 12 | 1. Study Without Stress (SWoS) program (n = 28) 2. Usual care control group (n = 28) | Targeted – self selected CBT -psychoeducation -goal setting -time management -cognitive restructuring -problem solving -managing perfectionism and procrastination -preparing for exams | Trained school psychologist or teacher 8 sessions | 1. Depression Anxiety and Stress Scale-21 (DASS-21; Lovibond & Lovibond, 1995) 2. Self-Efficacy Questionnaire for Children (SEQ-C) 3. Strengths and Difficulties Questionnaire-Teacher Version (SDQ-TV) | Significant effect for stress at post-treatment (p = 0.002 (g = 0.20)), F(1,38.011) = 10.607 | Stress significantly reduced pre- to post-intervention compared to control, and this was maintained at 3-month follow-up. No significant change in anxiety or depression pre- to post-intervention compared to control Self-efficacy (emotional and academic) significantly increased pre- to post-intervention compared to control. Increase in emotional self-efficacy was maintained at 3-month follow-up No significant effects for teacher reported symptoms |
8. Puolakanaho et al. [50] | Finnish schools (number of schools not reported) | 249 | Age not reported Grade 9 | 1. Online ACT program (n = 82) 2. Online plus face-to-face ACT program (n = 83) 3. No intervention control (n = 84) | Targeted – academically struggling & non-struggling students CBT -setting goals -cognitive and behavioural strategies based around acceptance and diffusion from one’s thoughts and feelings -promoting good relationships with others through practicing compassion | Professional instructors 5 sessions (plus 2 face to face sessions for the online plus face to face ACT program) | 1. Overall stress (researcher designed) 2. School stress (Scale adapted from the Health Behaviour in School Aged Children study) 3. Academic Buoyancy Scale (ABS) | Intervention groups combined showed significant decrease in overall stress (p = 0.037, d = 0.22) & no clear indication of changes in school stress (p = 0.057, d = 0.18) | Based on the whole sample (intent-to-treat analyses), the intervention groups did not differ significantly from the control group, in terms of their change in overall or school stress Based on the participants who completed treatment, the intervention groups combined (i.e., online ACT and face-to-Face ACT) experienced a significant decrease in overall stress and increase in academic buoyancy. Further, these changes were significantly greater compared to the control group. No significant change in school stress was observed |
9. Putwain & Pescod [51] | 2 English schools | 56 | Age not reported Grades 10 & 11 | 1. CBT test-anxiety intervention (STEPs) (n = 25) 2. Waitlist control (n = 31) | Targeted – high test anxiety CBT -identifying test anxiety -goal setting -replacing negative self-talk -relaxation -improving test taking | Psychologists/computer 6 sessions | 1. Revised Test Anxiety Scale (RTA; [43] | Intervention group showed moderate worry decline t(24) = 4.63, p < 0.001, d = 0.76 | Significantly greater reduction in test anxiety from pre- to post-treatment for students in the intervention, relative to control group |
10. Putwain & von der Embse (2021) | 8 English schools | 146 | 14–16 years. Grades 10 & 11 | 1. CBT test-anxiety intervention (STEPs) (n = 80) 2. Waitlist control (n = 81) | Targeted – high test anxiety CBT -identifying test anxiety -goal setting -replacing negative self-talk -relaxation -improving test taking skills | Professional instructors/ computer 6 sessions | 1. Revised Test Anxiety Scale (RTA; [43] 2. School Related Wellbeing Scale (SWBS) 2. Revised Children’s Anxiety and Depression Scale, general anxiety, and panic subscales (RCADS) | Participants in intervention showed a larger statistically significant decrease in test anxiety: t(64) = 6.75, p < 0.001, d = 0.86, and a small decrease in clinical anxiety: t (64) = 3.74, p < 0.001, d = 0.43 | Significantly greater reductions in test anxiety and clinical anxiety (generalised and panic) for students in the intervention, relative to control group |
11. Shen et al. [52] | 3 Chinese schools | 75 | Age not reported Grade 11 | 1. Expressive writing (n = 38) 2. Control writing (n = 37) | Targeted – high test anxiety Expressive writing -Write about positive emotions felt every day | Teachers 30 sessions | 1. Test Anxiety Scale for Children (TASC) | Avg. post-test TAS score was significantly lower (F = 135.80; p < 0.001) | Significantly lower test anxiety for students in the intervention at post-treatment, relative to control group |
12. Sportel et al. [53] | 24 Dutch schools | 240 | 12–15 years Grades 7 & 8 | 1. Internet-based CBM training (n = 86) 2. School-based CBT (n = 84) 3. No intervention control (n = 70) | Targeted – high test or social anxiety in school setting Cognitive bias modification -computer based tasks to modify interpretation and attention biases, strengthen association between social evaluative situations and positive outcomes and increase implicit self-esteem | Psychologist 20 sessions -Computer tasks to modify interpretation and attention biases | 1. Revised Child Anxiety and Depression Scale – Social phobia subscale [38] 2. Spielberger Test Anxiety Inventory (TAI) | Significantly stronger reduction of test anxiety scores Pre – post (Cohen’s d = 0.32) and post – follow-up (Cohen’s d = 0.58) | Significantly greater reduction in test anxiety symptoms for students in the CBT condition between pre- to post-intervention, and post-intervention to 6-month follow-up, relative to control. No significant differences between CBM and control or CBM and CBT No significant difference in social anxiety symptoms pre- to post-intervention between CBM and control, or CBM and CBT. CBT group had a significantly greater reduction in social anxiety symptoms between post-intervention and 6-month follow-up Between pre-test and 1-year follow-up, significantly larger reduction in test anxiety for students in the CBT intervention relative to control. No other significant effects |
13. Stanton [54] | 1 Australian school | 40 | 12–15 years Grade not reported | 1. Self-hypnosis (n = 20) 2. No intervention control (n = 20) | Targeted – high test anxiety Imagery/ Hypnosis -Relaxation focused on breath -Imagery encouraging positive and disposing of unhelpful characteristics -Imagining a special place, and how they would like to be | Psychologist 2 sessions | 1. Test Anxiety Scale for Children (TASC; [55] | Significant reduction in text anxiety. (df = 19; F = 12.63, p < 0.01) | Test anxiety significantly reduced for students in the intervention, maintained at 6-month follow-up. No changes for the control group |
14. Sud & Prabha [56] | Indian schools (number not reported) | 80 | Age not reported. Grade 9 | 1. Attention Skills Training (n = 20) 2. Attention skills control* (n = 20) 3. Relaxation training (n = 20) 4. Relaxation control* (n = 20) *Control groups met with psychologists for one session | Targeted – high- and low-test anxiety Cognitive Bias Modification -Identification of unhelpful cognitions -Plans for approaching tasks -coping self- statements -counters for irrational rumination -self rewarding statements | Not reported 3 sessions | 1. Test Anxiety Inventory—Hindi (TAI; [57] 2. Present Affect Reaction Questionnaire (PARQ) | Significant (p < .01) pre to posttreatment reduction in W-Trait of high-test anxious girls only in Attentional Skills Training condition. No effect size given | The worry component of test anxiety significantly reduced from pre- to post-intervention for students in the attentional skills training condition only. This was maintained at 4-week follow-up. No significant change in state anxiety (PARQ) scores. No significant between group differences |
15. Van der Ploeg & Van der Ploeg-Stapert [58] | 21 Dutch schools | 68 | 12–20 Grades not reported | 1. Behaviour-modification program (n = 43) 2. Waitlist control (n = 25) | Targeted – high test anxiety CBT -psychoeducation -relaxation -study skills & time management -self-monitoring -dealing with concentration difficulties -ABC (Activating event, Belief system and emotional Consequences) analysis | Psychologists 8 sessions | 1. Spielberger Test Anxiety Inventory – Dutch (TAI) 2. State-Trait Anxiety Inventory – Dutch | significant main effect for treatment versus control group, pre- versus post-test (F = 5.63, p < .001). No effect size given | Significant reduction in test anxiety for the intervention compared to control group pre- to post-intervention. Whereas the control group showed a slight increase in anxiety |
16. Weems et al. [59] | 5 American schools | 1,048 | 8 – 17 years. Grade 3—12 | 1. Test Anxiety Intervention (n = 203) 2. Waitlist control (n = 122) 3. No treatment control (n = 723) | Targeted – high test anxiety CBT -psychoeducation (i.e., cognitive behavioural model of anxiety) -exposure related to test anxiety -building self-efficacy related to tests -test taking skills -relaxation strategies | Counsellors 5 sessions | 1. Test Anxiety Scale for Children (TASC; [60] 2. Revised Child anxiety and Depression Scale (RCADS; [38] 3. Anxiety Control Questionnaire – Child Version (ACQ-C) | Test anxiety and RCADS anxiety: treatment group sig. higher decrease pre to post, compared to waitlist control (test anxiety: co-efficient = .08, t(307) = 2.82, p < .01 d = 0.84; RCADS: co-efficient = .14, t(303) = 2.27; p < .05, d = 0.34). No sig. interaction for age or grade | Test anxiety, and overall anxiety and depression decreased for the intervention over and above the waitlist control group. These results were not moderated by age or grade level. Further, there was a significant change in perceived anxiety control pre- to post-intervention, however this was only seen for youth in grades 9 and above i.e., older youth Follow-up analyses: Reduction in test anxiety was maintained at two-year follow-up |
Author | Setting | Overall sample (N) | Age range/ Grade | Intervention and Comparison groups (n) | Format & treatment type category | Facilitator(s) & number of treatment sessions | Stress/Anxiety Outcome Measure(s) | Results | Findings Summary |
---|---|---|---|---|---|---|---|---|---|
1. Frank et al. [61] | 2 American schools | 251 | Mean age 16 years. Grade 11 | 1. Learning to BREATHE (n = 131) 2. Usual health education class curriculum (n = 124) | Universal Mindfulness/ Meditation -psychoeducation about mindfulness -somatic awareness -automatic self-talk and mindfulness -understanding how emotions effects thoughts and body -stress and stress reactions -cultivating loving kindness | Teachers 12 sessions | 1. Generalized Anxiety Disorder Scale (GAD-7; [62] 2. Adolescent Stress Questionnaire (ASQ; [47] including Stress of School Performance & Stress of Peer Pressure subscales | Practice effects for stress of school performance were just short of significant (d = -0.27) | No significant difference between the intervention group and control group pre- to post-intervention for anxiety or stress |
2. Gregor [63] | 1 English school | 105 | 16 – 17 years. Grade 11 | 1. Mixed CBT and relaxation (n = 26) 2. Relaxation only (n = 26) 3. CBT only (n = 26) 4. Usual class (PSHE; Personal Social and Health Education) control (n = 26*) *One group (not specified) had 27 participants | Universal CBT -exploring/ challenging faulty thoughts and beliefs -addressing responses to anxiety -positive self-talk -mind mapping -problem solving & coping strategies -taking control of learning and performance | Teachers 15 sessions | 1. The Friedben Test Anxiety Scale (FTA; [64] 2. Conners’ Rating Scales – Revised Teacher form (1997) – Anxiety/shy factor | Significant dif in teacher rated anxiety for groups (F(3) = 9.403, p < 0.0005) No significant dif. between groups pre-post treatment | No significant difference in test anxiety between groups pre- to post-intervention, although the CBT alone, relaxation alone and control groups did experience a reduction in test anxiety. Mixed group reported lower level of test anxiety at pre-intervention compared to the remaining three groups Significant difference between groups on teacher rated anxiety: anxiety increased pre- to post-intervention among students in the mixed CBT and relaxation group, whereas it decreased among students in the other three groups |
3. Hiebert et al. [65] study 2 | 2 Canadian schools | 113 | 13—14 years Grade 8 | 1. Progressive relaxation (n = 62) 2. Control -career education class (n = 51) | Universal Relaxation -Monitoring of heart rate and skin temperature -Progressive muscle relaxation script practice -Cue controlled relaxation -Visualisation | Psychologists 8 sessions | 1. State-Trait Anxiety Inventory 2. Psychophysiological Stress Profile (PSP) 3. Symptoms of Stress Inventory (SOSI; [82]) | Significantly lower trait anxiety in intervention condition (F(1,41) = 5.57,p = 0.02) | Significantly lower trait anxiety for students in the intervention condition, relative to control. Reduction in stress pre- to post-intervention for both groups |
4. Keogh et al. [34] | 1 English school | 209 | 15—16 years Grades not reported | 1. Cognitive-behavioural stress management intervention (n = 80) 2. No intervention control (n = 80) | Universal CBT -psychoeducation -challenging unhelpful cognitions -progressive muscle relaxation -modify meta-cognitions about worry -adaptive problem solving -guided imagery | Psychologist 10 sessions | 1. Revised Test Anxiety Scale (RTA; [43] 2. General Health Questionnaire (GHQ) – Mental ill-Health 3. GCSE points | No significant main, or interactive, effects | No significant changes in test anxiety Mental ill-health improved from pre- to post-intervention for the CBT group but not the control group The CBT group obtained higher GCSE scores compared to the control group, with the CBT group obtaining one letter grade (i.e., B grade) higher than the control group (i.e., C grade) |
5. Khalsa et al. [44] | 1 American school | 121 | 15—19 years. Grades 11 & 12 | 1. Yoga (n = 74) 2. Usual Physical Education class (n = 47) | Universal Mindfulness/ Meditation -training in cognitive skills of mindfulness and self-awareness -yoga based psychological attitude -yoga poses -breathing exercises -visualisation -relaxation -stress management | Professional instructor 11 weeks, 2–3 sessions per week (i.e., 23–32 sessions dependent on class) | 1. Perceived Stress Scale (PSS) 2. Profile of Mood States-Short Form (POMS-SF) 3. Behaviour Assessment Survey for Children-Version 2 – includes test anxiety scale | No significant group differences (p = 0.15, d = 0.33) | No significant group differences for anxiety or stress pre- to post- intervention |
6. Kiselica et al. [45] | 1 American school | 48 | Age not reported Grade 9 | 1. Stress inoculation training (n = 24) 2. Active control (n = 24) | Universal CBT -psychoeducation -progressive muscle relaxation -cognitive restructuring -assertiveness training | Psychologists 8 sessions | 1. State-Trait Anxiety Inventory – Trait (STAI A-TRAIT; [85]) 2. Symptoms of Stress Inventory (SOSI; [82]) 3. GPA | Significant dif. between treatment and control participants (F(1,41) = 14.04, p < 0.001, η2 = 0.25) | Significantly lower anxiety and stress for students in the intervention condition compared to the control condition at post-treatment and follow-up. No significant differences between groups for GPA |
7. Lang et al. [46] | 1 Swiss vocational school | 131 | Mean age 16.22 years Age range and grade not reported | 1. PE based coping training -EPHECT (n = 67) 2. No intervention control (n = 64) | Universal CBT -psychoeducation -emotion and problem focussed coping skills | Teachers 8 sessions | 1. Adolescents Stress Questionnaire (ASQ; [47] | Time by group interactive effect at follow- up (F(1,111) = 3.82, p < 0.05, η2 = 0.035) | Significantly greater reduction in stress for the intervention group, relative to controls, at 6-month follow-up |
8. Lang et al. [48] *Same sample as 2016 | 1 Swiss vocational school | 131 | Mean age 16.22 years Age range and grade not reported) | 1. PE based coping training -EPHECT (n = 67) 2. No intervention control (n = 64) | Universal CBT -psychoeducation -emotion and problem focussed coping skills | Teachers 8 sessions | 1. Adolescents Stress Questionnaire (ASQ; [47] 2. Coping Questionnaire for Children and Adolescents (SVF-KJ) | No significant changes pre-post treatment | Intervention group reported greater increase in emotion focused coping compared to control group pre-post intervention No significant changes in perceived stress from pre- to post-treatment |
9. Putwain et al. [66] | 10 English schools | 3225 | 14—16 years Grades 9, 10 & 11 | 1. CBT test-anxiety intervention (STEPs) (n = 1600, only 624 completed all or some of the program) 2. Waitlist control (n = 1625) | Universal CBT -identifying test anxiety -goal setting -replacing negative self-talk -relaxation -improving test taking | Teachers/ computer 6 sessions | 1. Revised Test Anxiety Scale (RTA; [43] 2. Friedben Test Anxiety Scale – Social Derogation (FTAS; [64] | Statistically significant declines in worry: t(329) = 4.89, p < 0.001, d = 0.63 and tension: t(329) = 3.46, p = 0.001 | Significantly reduced test anxiety for highly test anxious students in the intervention group, from pre- to post-intervention. No significant changes in test anxiety for students with low or mild test anxiety, or for students who did not complete the intervention |
10. Stanton [67] | 2 Australian schools | 60 | 13 years Grade not reported | 1. Guided imagery program (n = 30) 2. Waitlist control (n = 30) | Universal Imagery/ Hypnosis -Relaxation focused on breath -Imagery encouraging positive and disposing of unhelpful characteristics -Imagining a special place, and how they would like to be | Psychologist 3 sessions | 1. Student Stress Inventory | Significant stress reduction (t = 6.32: df = 29; p < 0.001) | Significant reduction in stress reported by students at post-intervention and at 6-month follow-up. No significant reduction for the control group |
11. Szabo & Marian [35] | 2 Romanian schools | 191 | 15–17 Grades not reported | 1. Stress Inoculation Training (n = 64) 2. Counselling (n = 65) 3. No treatment control (n = 62) | Universal CBT -psychoeducation -cognitive appraisal -problem solving -personal experiments including imagery, role play, behavioural reversal and modelling | Psychologists 10 sessions | 1. Perceived Stress Questionnaire (PSQ) 2. State-Trait Anxiety Inventory (STAI; [84]) | Participants receiving SIT training reported lowest levels; (PSQ: F (2,188) = 361.08; p = .001; STAI: F(2,188) = 553.26; p = .001) | Participants in the intervention group reported significantly lower anxiety and perceived stress post-intervention compared to the counselling and control groups At three-month follow-up, participants in the intervention group reported significantly lower perceived stress compared to the counselling and control groups |
12. Venturo-Conerly et al. [68] | 2 Kenyan schools | 895 | 14 – 18 years. Grades not reported | 1. Growth intervention (n = 240) 2. Gratitude intervention (n = 221) 2. Value Affirmation intervention (n = 244) 3. Control intervention – Study Skills (n = 190) | Universal Cognitive bias modification Growth: -discussed neuroplasticity and growth in face of challenges -growth strategy implementation e.g., problem solving -helping someone else grow Gratitude: -discussion of feeling gratitude -gratitude letter- thanking someone -writing three things they felt gratitude for each day for one week Value Affirmation: -Selected and wrote about a chosen value -completed a value promoting activity at home | Lay providers i.e., recent high school graduates 1 session with an at home activity | 1. General Anxiety Disorder screener – 7 (GAD-7; [62] 2. Patient Health Questionnaire – 8 (PHQ-8) | Clinical sample: significant time*condition interaction effect on anxiety symptoms favouring the values condition (B = − 2.22, p < .01; Cohen’s d = 0.49 [0.09–0.89]) and the growth condition (B = − 1.78, p < .05; Cohen’s d = 0.39 [0.01–0.76])) over the control | Whole sample: Significant reduction in anxiety pre- to post-intervention among students in the Value Affirmation group compared to the control group Clinical subsample: Significant reduction in anxiety pre- to post-intervention among students in the Value Affirmation and Growth groups compared to the Control group |
13. Wang et al. [69] | 70 Chinese schools | 7,495 | Age not reported. Grades 7 & 8 | 1. Social Emotional Learning Program (n = 3,694) 2. No intervention control (n = 3,801) | Universal Social Emotional Learning - emotion management -self-awareness -setting goals -establishing positive relationships | Teachers 32 sessions | 1. Learning Anxiety Index, 15 questions from the Mental Health Test (MHT) | Students who received the SEL program were 0.061 SDs more likely to choose more appropriate responses to such challenges (p = 0.008) | Significant reduction in school dropout and learning anxiety symptoms among the SEL compared to control group at 8-months post baseline assessment (post-intervention). However, this was not maintained at follow-up (15-months post baseline) For at risk students (i.e., older students and those who kept in touch with students who had dropped out of school) there was a significant reduction in school dropout and learning anxiety from pre- to post-intervention and this was maintained at follow-up |
14. Weems et al. [70] | 1 American school | 94 | 13 – 16 years. Grade 9 | 1. Test Anxiety Intervention (n = 16) 2. Waitlist control (n = 14) 3. No treatment control (n = 64) | Universal CBT -psychoeducation (i.e., cognitive behavioural model of anxiety) -exposure related to test anxiety -building self-efficacy related to tests -test taking skills -relaxation strategies | Psychologist 5 sessions | 1. Test Anxiety Scale for Children (TASC; [60] 2. Grade Point Average (GPA) results | Treatment group: [t(15) = 5.05, p b .001, p rep = .998, 90% C.I. for the mean difference 2.4 to 4.9, d = 1.2] | Significantly reduced state and test anxiety for students in the intervention, relative to control groups GPA significantly increased for both intervention and waitlist groups, but the effect size was higher for the intervention group |
15. Yahav & Cohen [71] | 2 Israeli schools (1 Jewish, 1 Arab) | 255 | 14–16 years Grade 9 | 1. Cognitive-behavioural stress management training (n = 126) 2. No intervention control (n = 129) | Universal CBT -identification of stress and common reactions -psychoeducation -cognitive model of stress and thought restructuring -relaxation with biofeedback, progressive muscle relaxation and imagery | Psychologists 8 sessions | 1. State-Trait Anxiety Inventory – State subscale [87] 2. Spielberger Test Anxiety Inventory -(TAI; [57], adapted by Zeidner) | Test anxiety: Intervention group sig. decrease compared to control group (F(1, 223) = 6.39, p < .01). State anxiety: Intervention group sig. decrease compared to control group for Arab school only (Group x school interaction: F(1, 223) = 5.93, p < .05) | Significant decrease in test anxiety for students in the intervention group, compared to students in the waitlist group pre- to post-intervention. This effect was more prominent for Arab compared to Jewish students. For state anxiety, significant decrease pre- to post-intervention seen only for the Arab students |
Methodological Quality
Author | Focused issue | Adequate sample | Unlikely measurement bias | Appropriate design/ confounds considered | Adequate analysis/ interpretation |
---|---|---|---|---|---|
Targeted | |||||
1. de Hullu et al. [37] | Yes | Yes | Yes | Yes | Yes |
2. Gaesser & Karan [39] | Unclear | No | Yes | No | Unclear |
3. Hains & Ellman [40] | Yes | No | Yes | Yes | Yes |
4. Johnson et al. [41] | Yes | No | No | Yes | Yes |
5. Kamour & Altakhayneh [42] | Yes | Yes | No | No | No |
6. Laxer & Walker [49] | Unclear | Yes | Yes | Unclear | Unclear |
7. Lowe & Wuthrich [83] | Yes | Yes | Yes | Yes | Yes |
8. Puolakanaho et al. [50] | Yes | Yes | Unclear | Yes | Yes |
9. Putwain & Pescod [51] | Yes | Yes | Yes | Yes | Yes |
10. Putwain & von der Embse (2021) | Yes | Yes | Yes | Yes | Yes |
11. Shen et al. [52] | Yes | Yes | Yes | Yes | Unclear |
12. Sportel et al. [53] | Unclear | Yes | Yes | Yes | Yes |
13. Stanton [54] | No | No | Yes | No | Yes |
14. Sud & Prabha [56] | No | No | Yes | No | Yes |
15. Van der Ploeg & Van der Ploeg-Stapert [58] | Yes | No | Unclear | No | No |
16. Weems et al. [59] | Yes | Yes | Yes | Yes | Yes |
Universal | |||||
1. Frank et al. [61] | Yes | Yes | Yes | Yes | Yes |
2. Gregor [63] | Yes | No | Yes | Yes | Yes |
3. Hiebert et al. [65] | No | Unclear | Unclear | Unclear | Yes |
4. Keogh et al. [34] | Yes | Unclear | Yes | Yes | Yes |
5. Khalsa et al. [44] | No | Unclear | Yes | No | No |
6. Kiselica et al. [45] | Yes | Unclear | Yes | Unclear | Unclear |
7. Lang et al. [46] | Yes | Unclear | Yes | Yes | Yes |
8. Lang et al. [48] | Yes | Unclear | Yes | Yes | Yes |
9. Putwain et al. [66] | Yes | Yes | Yes | Yes | Yes |
10. Stanton [67] | No | Unclear | No | Unclear | Yes |
11. Szabo & Marian [35] | Yes | Yes | Yes | Yes | Yes |
12. Venturo-Conerly et al. [68] | Yes | Yes | Yes | Yes | Yes |
13. Wang et al. [69] | No | Unclear | Yes | Unclear | Unclear |
14. Weems et al. [70] | Yes | No | Yes | Yes | Yes |
15. Yahav and Cohen [71] | Yes | Yes | Yes | Yes | Yes |