Teacher-Delivered Short-Term Group-Based Cognitive Behavioural Therapy Programme to Tackle Depression in Adolescents in West Africa (Ghana, Nigeria & Sierra Leone) (360G-Wellcome-340529_Z_25_Z)

Adolescent depression poses a substantial public health burden in West Africa. This study aims to scale up a school-based, teacher-delivered group Cognitive Behavioural Therapy (group-CBT) programme for adolescents (aged 13–18) with early-stage depression (PHQ-9 ≥ 10), building on interventions that have been developed and evaluated for efficacy by the Centre for Child and Adolescent Mental Health (CCAMH), University of Ibadan. The implementation of the intervention in Ghana, Nigeria, and Sierra Leone will be led by CCAMH alumni who set up pioneering CAMH services in these countries. Teachers will be trained to deliver manualized, five-session group-CBT programme focusing on psychoeducation, behavioural activation, cognitive restructuring, spiritual integration, and relaxation techniques. This is a hybrid effectiveness–implementation study. The foundation phase will focus on co- adapting the intervention using the ADAPT-ITT framework and engaging stakeholders, including implementation partners and persons with lived experiences, to foster sustainable partnerships and strengthen capacity for the subsequent impact phase. Multisectoral implementation partnerships and economic evaluation models will be developed. The impact phase features a cluster-randomized controlled trial to assess clinical effectiveness, cost- effectiveness, fidelity, acceptability and appropriateness. This study will provide a scalable, evidence-based model to tackle adolescent depression in West Africa.