RESUMEN
Anxiety disorders are the most prevalent mental disorders experienced by adolescents. As students spend a significant amount of time within a school environment, it is not surprising that factors in the school environment have been linked to student mental health. Positive teacher-student relationships (TSRs) in children have been found to improve student mental health outcomes, with supportive TSRs associated with reduced student anxiety, and in turn, student anxiety has also been associated with reduced poorer TSR quality. The findings in adolescents are less clear. This review aimed to systematically evaluate the impact of TSRs on anxiety in secondary school students, and vice-versa using PRISMA guidelines. Searches were conducted in five databases and studies screened against inclusion and exclusion criteria, and rated for study quality by two independent researchers. Twenty-six studies across 12 countries were included. Most studies reported higher quality TSRs (e.g., those that are perceived as more supportive, caring, and warm) was associated with decreased anxiety. Conversely, TSRs that were characterised by dependence, motivational support, conflict, or harassment, were associated with increased anxiety. Most studies used a cross-sectional design and as such conclusions regarding causality as well as the direction of the effects cannot be made. However, early evidence from a limited number of longitudinal studies indicated that positive TSRs reduced anxiety over time. Future research is warranted to investigate whether anxiety affects TSRs, as well as exploring specific strategies and approaches teachers can use to establish positive relationships with their students.
RESUMEN
The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.
