A study at Stellenbosch University (SU) has shown that a brief mental health prevention programme can help to reduce anxiety in children from low-resourced, semi-rural communities in the Western Cape.

The study focused on developing an innovative programme that is suitable for these children, given that the need for accessible mental health interventions has remained unmet in a country with extreme socio-economic disparities and a shortage of mental health resources. The key findings were published recently in Child Care in Practice by Dr Naomi Myburgh and Prof Helene Loxton from SU’s Department of Psychology and Prof Peter Muris from Maastrict University in The Netherlands.

​I am BRAVE Programme

Called I am BRAVE, the brief programme consists of eight 45-minute sessions that could be completed in only two weeks. It was designed to develop specific Cognitive Behavioural Therapy (CBT)-based skills in children between the ages of 9 and 13.

The first four sessions teach children to identify anxious feelings, unhelpful thoughts, and unhelpful behaviours when they feel threatened. Children are then taught relaxation skills, cognitive restructuring techniques like coping-self-talk and problem-solving skills to help them overcome anxiety. The programme includes four more sessions that help children practise their new skills to empower them to deal with anxiety.

According to the researchers, “the programme has the potential to assist children in distinguishing between the avoidance of unrealistic fears and the everyday, protective and necessary avoidance of dangers associated with many South African contexts.”


They say the results showed a promising downward trend in anxiety to what is considered normal levels after participation in the I am BRAVE programme.

“We found that the programme helped the children to become more resilient and taught them how to relax when they became anxious. It also improved their coping and communication, and problem-solving skills.

“The children reported that the intervention helped them to manage challenging interpersonal relationships, particularly conflict associated with those relationships. They also reported that they gained core CBT knowledge regarding thoughts, feelings and behaviour, as well as skills to manage their emotions, thoughts and unhelpful behaviour.”

The researchers say that it was particularly encouraging that the children used skills learnt in the programme months later in threatening situations, such as being fearful of criminals at night, specific fears of animals, bullying, speaking in front of others, making friends, and dealing with conflict to name a few.  They add that the children also taught their siblings and parents these skills to manage anxiety and felt brave enough to try things that had made them anxious.

According to the researchers, the intervention is quite versatile. “Not only is it possible to integrate the short programme into schools, after-school or community centre programmes, but it also offers the possibility of using trained community members to deliver it.”

They say brief CBT-based interventions, like the I am BRAVE programme, may help to overcome existing barriers to accessing mental health services faced by many South African children and reduce the burden placed on under-resourced mental health care services.

“These types of interventions are crucial because the World Health Organisation states that childhood is critical to lifelong mental health and that 50% of mental health conditions develop by the age of 14 years.”

According to the researchers, the I am BRAVE intervention programme indicates the potential of such an approach in addressing anxiety amongst vulnerable children in low-resourced, semi-rural communities in South Africa.

  • ​SOURCE: Myburgh, N; Muris, P & Loxton, H 2021: Promoting Braveness in Children: A Pilot Study on the Effects of a Brief, Intensive CBT-based Anxiety Prevention Programme Conducted in the South African Context, Child Care in Practice, DOI: 10.1080/13575279.2021.1902785