Effectiveness of Group-Based Cognitive Behavioral Therapy in Reducing Depression and Anxiety Among Adolescents in Residential Institutions: A Randomized Controlled Trial

Research on cognitive behaviour therapy (CBT) for depressed and anxious orphaned adolescents in Malaysian sheltered homes is limited. This randomised controlled trial evaluated the effectiveness of group CBT, known as the SAHABAT programme, compared to a waitlist control. One hundred thirty-nine orphaned adolescents from nine sheltered homes participated: SAHABAT (4 homes, n = 71) and waitlist control (5 homes, n = 68), selected through clustered sampling. The SAHABAT group attended eight sessions over a month, while the control group received no intervention. Psychological outcomes were assessed at six-time points over six months using five self-report questionnaires. Generalised linear multi-modelling analysis showed that the SAHABAT programme had mild to moderate effects in reducing depression (η² = .05), anxiety (η² = .05), negative automatic thoughts (η² = .05), and anger (η² = .07). It also significantly improved self-esteem (η² = .02). Depression symptoms reduced from mild to minimal, anxiety from moderate to mild, negative automatic thoughts from high to low, and anger from mildly elevated to normal, while self-esteem increased. The SAHABAT programme positively impacted mental health outcomes over six months post-intervention. The findings highlight SAHABAT’s positive impact and the need for enhanced mental health policies for vulnerable adolescents in Malaysia.