Exploring Promising Mental Health Support for Adolescents

Mental health disorders are the leading cause of disability in youth, accounting for about 13% of the global disease burden. Up to half of all mental health conditions begin before the age of 14, and worldwide, about 1 in 7 adolescents aged 10 to 19 experience a mental health disorder. 

These conditions, characterised by disturbances in emotion, thought, or behaviour, can severely affect social connections and daily activities. If not addressed, these issues can have long-lasting repercussions, extending into adulthood.

Psychological treatments specifically designed for adolescents have received less attention than those for adults, often being adapted without focusing on the age group's unique needs. Treatment rates for adolescents (13-18) remain low, particularly for common issues such as depression (36%) and anxiety (20%). This highlights an urgent need for effective and accessible therapeutic approaches for this age group.

One area gaining traction is metacognitive interventions. Metacognition is often described simply as "thinking about thinking". It involves being aware of one's own cognitive processes and the ability to assess and manage them. As adolescents mature, they naturally develop these abilities, moving from concrete to more abstract thought. They gain the capacity to monitor their own thinking, understand their thoughts and those of others, plan ahead, and foresee consequences.

Metacognitive interventions build on this inherent ability. Their primary aim isn't to change what someone thinks (the content), but rather to help individuals understand and modify how they think – focusing on dysfunctional cognitive processes. These interventions work by targeting specific metacognitions or their functions. They are goal-oriented and seek to enhance metacognitive capacities, leading to greater flexibility in managing thoughts and feelings. Examples include Metacognitive Therapy, which addresses beliefs about thinking, and Metacognitive Training, which targets specific cognitive biases. While research in adults shows effectiveness, studies in adolescents are only now emerging.

Given the growing interest and potential of this approach, a new scoping review is being undertaken to map and summarise the metacognitive interventions currently being implemented for adolescents with mental health disorders.

The study hopes to achieve several key goals. It will identify which specific mental health disorders are being targeted by these interventions. It will also detail the characteristics of the interventions, such as the number of sessions, how often they occur, the delivery method (e.g., individual, group, online), who delivers them (trained healthcare workers), and in what settings. Finally, it will examine the outcomes measured and the tools used to assess them.

This scoping review is important because it will provide a clearer picture of the current landscape of metacognitive interventions for adolescent mental health. Mapping the existing evidence helps identify the knowledge gaps and ultimately guide future research in this promising area, helping to advance effective mental health support for young people globally.

The protocol is available in JBI Evidence Synthesis:

Metacognitive interventions for mental health disorders in adolescents: a scoping review protocol

Espírito Santo, Andreia; Silva, Rosa; Balzan, Ryan; Pinho, Lara Guedes de; Sampaio, Francisco Less

JBI Evidence Synthesis. 23(6):1257-1265, June 2025.