肥田 乃梨子

Background/Objectives: School-based universal mental health interventions offer an inclusive and scalable approach to promote mental health and well-being among children. This study evaluates the Let’s Learn About Emotions (Opitaan tunteista in Finnish) program, an evidence-based, teacher-led universal school-based intervention originally developed in Japan and culturally adapted for Finnish primary schools. Methods: A total of 512 fourth-grade students from 14 schools participated in the 12-week program during spring 2023. Using a mixed-methods design, we assessed (1) the program’s acceptability among students, parents, teachers, and school principals, (2) fidelity of implementation, and (3) changes in students’ mental well-being pre- to post-intervention. Quantitative data included standardized questionnaires with valid responses collected from 233 students at baseline and 209 students at post-intervention, as well as parents and teachers. Qualitative data were collected through focus group discussions involving parents, teachers, and school principals during spring 2024. Results: Acceptability was high across all respondent groups. Teachers adhered closely to the teaching manual, as confirmed by self-reports and direct classroom observations. Statistically significant improvements were observed in parent-reported conduct problems, hyperactivity, and peer problems, though student self-reports did not show similar benefits. Conclusions: The program was found to be both acceptable and culturally appropriate in the Finnish context. Findings from this study provide valuable insights for refining and improving the program for future implementation. To more rigorously examine its effectiveness, future studies should employ a randomized controlled trial design.

Introduction Emotional awareness and emotion regulation are crucial for cognitive and socio-emotional development in children. School-based interventions on socio-emotional skills have the potential to prevent these problems and promote well-being of children. The Japanese school-based program, Universal Unified Prevention Program for Diverse Disorders (Up2-D2), has shown preventive effects on mental health of children in Japan. The aims of this protocol paper are to describe the unique process of adapting the Up2-D2 from Eastern to Western context, and to present a feasibility study of the intervention, conducted in Finland. Methods The cultural adaptation process started with the linguistic translation of materials, followed by the modification of language to fit the Finnish context. While the Japanese ideology was saved, some content was adapted to fit Finnish school children. Further modifications were made based on feedback from pupils and teachers. The Finnish version of the program was named “Let’s learn about emotions” and consisted of 12 sessions and targeted 8- to 12-year-old pupils. A teacher education plan was established to assist Finnish teachers with the intervention, including a workshop, teachers’ manual, brief introductory videos, and online support sessions. A feasibility study involving 512 4th graders in the City of Hyvinkää, South of Finland, was conducted. It assessed emotional and behavioral problems, classroom climate, bullying, loneliness, perception of school environment, knowledge of emotional awareness, and program acceptability. Discussion The originality of this study underlies in the East–West adaptation of a cognitive behavioral therapy-based program. If promising feasibility findings are replicated in Finland, it could pave the way for further research on implementing such programs in diverse contexts and cultures, promoting coping skills, awareness, social skills and early prevention of child mental health problems. Ethics The ethical board of the University of Turku gave ethics approval for this research. The educational board of the City of Hyvinkää accepted this study.

本研究では特別支援学校高等部に在籍する軽度から中度の知的障害生徒（8名）を対象にUniversal Unified Prevention Program for Diverse Disorders（Up2-D2: Ishikawa et al., 2019）を対象者に合わせてアレンジして実施し、メンタルヘルスへの効果とプログラムの適用可能性について検討した。その結果、抑うつに有意な得点の低下が示された。以上よりUp2-D2は生徒の発達や理解度に合わせてアレンジを加えながら実施することで知的障害のある生徒にも適用可能であり、メンタルヘルスの改善にも一部効果があることが示された。今後の課題として補助的な指導教材の作成や体験的な学習の機会を取り入れていくことなどがあげられた。

問題を未然に防ぐための予防的介入は，目の前にある問題を解決する治療的介入と比較して，効果が見えにくいために実施が遅れることが多い。しかし，子どもたちのメンタルヘルスの悪化やコロナ禍の影響を踏まえると，学校教育現場における予防的介入の実装が求められている。本総説では学校でのメンタルヘルス予防教育の現状と課題について，こころあっぷタイム（Up2-D2: Universal Unified Prevention Program for Diverse Disorders）の社会実装を通じて解説を行った。本総説では社会実装における研究面での課題として，有効性の確立，測定指標の選定，対象者の拡大，構成要素の洗練化と短縮化，既存プログラムからの選定，若手研究者の育成，について議論した。加えて，実践面での課題として，キーパーソンの確保，授業時間の確保，実施者の養成，運営資金の調達，広報活動の実施，について議論した。

Abstract Background The present study examined the effectiveness of the Universal Unified Prevention Program for Diverse Disorders (Up2-D2) for internalizing and externalizing problems for children aged 9–11 years. Methods We used two feasibility studies. The Up2-D2 entailed 12 sessions delivered by teachers; each session was developed based on cognitive-behavioral and positive psychological interventions. In Studies 1 and 2, 58 elementary school children aged 9–11 and 73 elementary school children aged 10–11 attended the Up2-D2. The teachers in Study 1 received 1.5 h of on-site teacher training for learning rationales for interventions, how to run the program, and received ongoing supervision by professionals with mental health expertise. In contrast, the teachers in Study 2 were given self-learning DVD materials in place of on-site training and ongoing supervision. Results Mixed models revealed that general difficulties, which is total score of both internalizing and externalizing problems, decreased in Study 1 but not in Study 2. Additional analyses for children with subclinical general difficulties revealed that general difficulties, internalizing problems, and externalizing problems decreased in Study 1, whereas in Study 2, general difficulties and internalizing problems decreased, except for externalizing problems. Conclusions These results suggest that on-site teacher training and ongoing supervision are imperative for improving general difficulties in children at a universal level. In addition, universal preventive interventions by classroom teachers without on-site training and continuous supervision might be efficacious for reducing general difficulties and internalizing problems for children with subclinical difficulties.

<title>Abstract</title> School closures due to the coronavirus disease 2019 (COVID-19) pandemic have worsened mental health problems for children and adolescents worldwide. We aimed to examine the effectiveness of a transdiagnostic universal prevention program for the mental health of junior high school students after a nationwide school closure during the COVID-19 outbreak in Japan. A total of 117 junior high school students were included in the analysis. We used the Unified Universal Prevention Program for Diverse Disorders (Up2-D2) program; the Up2-D2 comprises cognitive-behavioral and positive psychological interventions provided over twelve 45-minute sessions. The program was originally implemented between June and July 2020, immediately after pandemic-related school closures had ended in Japan. The program assessments were based on students’ responses to a questionnaire incorporating five scales to measure indicators of internalizing and externalizing problems. Assessments were carried out before, immediately after, two-month, and six-month after implementing the program using student-reported questionnaires. Mixed models for the whole sample showed small anxiety improvement effects immediately post-intervention and two-month, and six-month assessments (<italic>g</italic> = -0.25, <italic>g</italic> = -0.44, and <italic>g</italic> = -0.30, respectively). The anxiety reducing effects were even greater for the higher-anxiety group at the post-, 2-month, and 6-month assessments (<italic>g</italic> = -1.48; <italic>g</italic> = -1.59; <italic>g</italic> = -1.06, respectively). These results indicate that the transdiagnostic universal prevention intervention effectively reduced anxiety for junior high students returning to school following school closures related to the COVID-19 pandemic in Japan.

本研究は，中学校の通常学級におけるユニバーサルタイプの診断横断的予防プログラムの実施において，参加者への有効性を検討することを目的として行われた。認知行動的技法を中心に全12回で構成されたプログラムを，担任教師が通常教育課程の一環として実施した。中学1年生の生徒120名が本研究に参加し，プログラムの実施前後に質問紙へ回答した。その結果，実施前との被験者内比較において，実施後における参加者全体の不安得点が下がり，自己効力感の下位尺度の安心感が有意に向上する部分的な効果が示された一方，怒り得点および仲間関係の問題得点が増加する結果となった。加えて，自己評定において心理的な困難さがみられた参加者は，実施後に抑うつ得点および心理的な困難さにおいて軽減する傾向が認められた。これらの結果より，新型コロナウイルス感染拡大に伴う参加者への影響を加味した上で，プログラムの有効性に関する議論と，今後の課題が挙げられた。研究論文

精神疾患に対する否定的な態度は，援助を必要とする者の専門家への受診を妨げる重大な問題であると指摘されている。しかしながら，そのような態度を測定できる青年版の尺度は存在しないというのが本邦の現況である。そこで本研究は，パブリックスティグマの一側面に位置づけられる社会的距離の概念に基づいた，青年版社会的距離の近さ尺度(Social Distance of Adolescents Scale : SDAS)の作成および信頼性と妥当性の検討を目的として行われた。中根他(2010)の成人を対象とする社会的距離尺度を参考に，教育現場での活用を考慮した上で，青年期の生徒が理解できる表現に改めた6項目が作成された。研究1では中学生を対象に調査を行い，信頼性と妥当性を検討したところ，十分な信頼性と妥当性が確認された。続いて研究2において，高校生を対象にSDASを測定し尺度の因子構造を再度探索的に検討したところ，中学生と同様の結果が得られた。SDASは不安症の子どもに対する態度を示すパブリックスティグマを測る尺度として有用であることが示唆され，SDASの汎用可能性について議論された。研究論文

研究論文本研究は，心の不調に関する心理教育がメンタルヘルスリテラシーの向上におよぼす効果について検討することを目的として行われた。本研究では，中学１年生99名を対象に，研究実施協力校に所属するスクールカウンセラーによって，宿泊研修の機会を利用した120分間の介入プログラムが行われた。介入プログラム「心の不調と対処法」では，心の不調の受容，自分自身で実行できる対処法についての検討（グループワーク），学内での相談先の紹介，そして大人へ相談することでの早期対応の必要性を扱った。他者に援助を求めるかどうかの態度の測定は被援助志向性尺度を用いた。また，メンタルヘルスリテラシーの測定は，不安症を呈する中学生の架空事例を作成した上で，それに対する回答から測定した。介入の結果，分析対象となった82名の内，不安症の症例が「心の不調である」と認識する者の人数が減少し，「心が弱い」「特別な問題である」という偏見や差別の意識が改善された。実験デザインや測度，そして介入プログラムの内容の改善が，今後の課題として挙げられた。