We need better ways to help students avoid the harms of stress: Results of a meta-analysis on the effectiveness of school-based stress management interventions

The level of psychological stress in children and adolescents has increased rapidly over the past decade. The aim of the present meta-analysis was to evaluate the effectiveness of school-based intervention programs targeting stress management and coping/resilience in school-aged children. The present study used more rigorous selection criteria than previous meta-analyses by only including randomized controlled trials to increase the validity of the meta-analysis. Fifty-five studies were selected for the analysis, including 66 comparisons in the case of stress and 47 comparisons in the case of coping/resilience outcomes. A meta-regression with robust variance estimation was used. Effects were calculated as the standardized mean difference (Hedges' g) between the intervention and control conditions at posttest. The results highlighted important methodological issues and the influence of outliers. Without outliers, the results indicated a small significant overall effect on stress (g = −0.15, p < .01) and coping/resilience (g = 0.14, p = .01). When outliers were included, the effect sizes markedly increased in both cases (g_stress = −0.26, p = .022; g_{coping/resilience} = 0.30, p = .009). Stress management interventions were more effective if they were delivered by mental health professionals or researchers than by teachers. Coping/resilience interventions were more effective in older age groups, in selective samples, and if they included cognitive behavioral therapy. An explanation of the results and a detailed discussion of the limitations of the study and its implications for practice are considered.