A photo from the Airbel Impact Lab archive

Early Adolescent Skills for Emotions (EASE) Tanzania: Adapting and Piloting an Evidence-Based Low-Intensity Psychological Intervention for Young Adolescents

Building on the growing international momentum to address the major data gaps and lack of tailored responses for addressing the needs of adolescents, the IRC with its partners, WHO and John Hopkins University (JHU) adapted and piloted the Early Adolescent Skills for Emotions (EASE) programme, a brief group psychological intervention developed by WHO and delivered by non-specialist providers for young adolescents exposed to adversity and impaired by distress, for Burundian refugees in Tanzania.

The EASE Tanzania project had two main components: (1) adapting the EASE intervention for Burundian refugees and (2) piloting and evaluating the adapted intervention to assess its feasibility, relevance, and acceptability.

In the pilot phase, 82 young adolescents and their caregivers, were randomized into the EASE sessions (treatment) or an “enhanced treatment as usual” (control) condition. 

EASE has four core features: 

  • Seven weekly group sessions for young adolescents and three sessions for their caregivers; 
  • Delivered by non-specialists; 
  • Trans-diagnostic: addressing depression, anxiety, distress, and other problems as defined by the young people themselves; and 
  • Designed for young people and their caregivers in low- and middle-income countries living in communities affected by adversity. 

The participants in the “enhanced treatment as usual” received a visit from trained facilitators who provided one 30-minute psychoeducation session to the adolescents and their caregivers. 

The process evaluation interviews (N=36) indicated that EASE was feasible, relevant and acceptable for Burundian refugees in Tanzania. Attendance rates were high for both adolescents (94%) and their caregivers (86%). Future pilots may want to further simplify the Kirundi being used in EASE materials, as well as better coordinate EASE session schedules with school schedules. 

Baseline and endline surveys (adolescents, N=82; caregivers, N=64) were conducted to provide indicative trends of mental health outcomes before and after the EASE treatment. However, this sample size was not powered to detect statistically significant differences in impact and the following results are indicative only. We found:  

  • Significant decreases in total psychological distress in adolescents, between baseline and endline, but no significant differences between the EASE and ETAU groups overall.
  • Stronger decreases in distress and internalizing symptoms for boys participating in EASE compared to girls.
  • Caregivers had significant improvement in reported depressive symptoms for EASE caregivers compared to ETAU caregivers. EASE caregiver participants reported decreased symptoms.