STEVE INSKEEP, host:

Its MORNING EDITION from NPR News. Good morning. Im Steve Inskeep. Renee Montagne is back on the air. Renee, welcome back. We missed you.

RENEE MONTAGNE, host:

Thank you very much. Im glad to be back. And back healthier and rested up.

INSKEEP: Good.

MONTAGNE: Now we can move on to Your Health. NPRs Allison Aubrey continues her occasional series on small changes that can make a big difference in health, this time a focus on teaching emotional resilience to middle-school kids as a way to prevent depression.

ALLISON AUBREY: I want to begin my story with a man who told me that it took him 45 years to learn what he mightve been taught in sixth grade. John Kelly told me that the mind is a funny thing. He wonders how many of us have caught ourselves thinking, ugh, how can I be so stupid? Or, ugh, this will never work out. Its something he certainly did a lot of.

Dr. JOHN KELLY (Orthopedist): Absolutely. And my childhood was riddled with those thoughts. And you believe the things your mind tells you.

AUBREY: Seven or so years ago, Kelly hit a rough spot. His father was in a nursing home very sick, and he was facing a malpractice suit in his orthopedic practice.

Dr. KELLY: In retrospect, I did nothing wrong. At the time, you believe, boy, maybe Im not so good. And the thoughts start, you know, rising and you buy into it and you get this negative spiral. So I was really down.

AUBREY: When Kelly reached out for help to a therapist at the Beck Institute in Philadelphia, it had never dawned on him that he could see these bad circumstances any differently. His guilty thoughts were telling him that he was a terrible son not seeing his dad enough, and a terrible doctor.

But in a few months of therapy, he learned something new. He learned to play detective with his own thoughts, to look for evidence as to whether they were true.

Dr. KELLY: I was world champ at all-or-nothing thinking, like if one surgery didn't go well, then I was a no-good surgeon. Thats a common distortion that our mind plays on us. And after writing, you know, my thoughts down and looking at them and writing what I thought was a more realistic interpretation, after a while, you start really, truly recognizing that they were false.

AUBREY: Kelly says realizing this was a game changer. With more realistic thinking, his emotions changed, too.

Dr. KELLY: Youd often get immediate relief looking at the thoughts right away on paper and saying, this is crazy. I don't know why Im thinking these things.

AUBREY: When I asked Kelly if he wished hed known how to use these strategies earlier in life...

Dr. KELLY: Oh, my gosh, without question. I - look at all the years that I suffered needlessly - and you - what you learn is, you rewire your brain.

AUBREY: What studies show is that there are lots of John Kellys out there, and when they learn to check their negative thoughts against the facts and cope with stress, it can be as effective as taking antidepressant medicines. The evidence is quite strong.

Unidentified Man #1: If you're in the gym line, can you show me whos ready?

AUBREY: Now, where the story goes from here may sound like a leap, so stay with me. Ive moved on to a school, and Im standing outside the fifth-grade classrooms, a good place to explain that the latest research shows you can introduce the same techniques that John Kelly learned during one-on-one therapy to groups of 10-year-olds in a classroom.

Mr. TOM BRUNZELL (Dean KIPP Infinity Charter School): Listen, 10-year-olds are very good lawyers.

AUBREY: Tom Brunzell, dean of the KIPP Infinity Charter School in Harlem, says these kids are really ready for this Emotional Health 101 kind of class.

Mr. BRUNZELL: They're constantly looking for fairness in the world, and they're spotting unfairness in the world.

AUBREY: Brunzell says it does no good just to say, buck up or get over it. This is the age you can begin to show kids how to take control of their negative thoughts.

Mr. BRUNZELL: So we are going to talk about how your self-talk, the things you tell yourself, your thoughts, can lead you to different feelings when disappointing things happen.

AUBREY: Brunzell hands each kid a copy of the same cartoon strip, and he describes the picture in the first panel...

Mr. BRUNZELL: Youre going to see an angry coach talking to the players, to the team.

AUBREY: The coach is pointing to a zero score and looking down on the players, as if to say...

Mr. BRUNZELL: This team did a terrible job today. When are we going to do better in practice?

AUBREY: In the second panel, theres one boy, a player on the team, standing next to the coach. The thought bubble over his head is blank. The kids job is to fill it in. What must this kid be thinking? Brunzell tells them to jot it down.

Mr. BRUNZELL: Then write an arrow to the feeling that you think is connected to this belief? OK? Go.

AUBREY: As they picked up their pencils and began writing, I found myself wondering: Is there really more than one way the kids will see this situation? As the mom of a boy this age, Ive got pretty good insights into the 10-year-old brain. Turns out, the answer is yes.

Mr. BRUNZELL: OK. So I see people are almost finished.

AUBREY: Alicia Echavarriato shares first.

Ms. ALICIA ECHAVARRIATO (Student): What I wrote in my thought bubble was: Why is he so mean? His screaming makes me want to cry. I think I have a tear.

AUBREY: Alicia says the coach's anger feels like a personal attack, so she draws an arrow to sadness. If this happened to Alicia, it sounds as if shed really be down.

Mr. BRUNZELL: OK. It looks like Anthonys ready. Anthony, why don't you share?

AUBREY: Anthony Ortizs self-talk is a downer, too.

Mr. ANTHONY ORTIZ (Student): Man, we lost. We let the coach down. Were the worst team ever.

AUBREY: Another example of a kid taking it on himself and feeling bad. But heres a third interpretation.

Mr. BRYCE MARCUS (Student): What I wrote in my thought bubble was, I wont be mad next time. I will be better. The coach can be mad. So what? I'll do better next time.

AUBREY: So Bryce Marcus' player wasnt sad or angry. He actually felt OK. He realized the situation wasnt permanent. So here we have three kids, three different internal dialogues, each leading to a different emotional reaction.

Mr. BRUNZELL: So what I want you to understand here is that yes, the coach is being very negative in this cartoon. But you have a lot more control over your feelings than you think. And if you focus your self-talk on really feeling, you know, better about the next time, youre going to have a better shot at winning that game.

AUBREY: The kids nod their heads. They seem to get it. But can they actually put it to practice in real life?

Anthony Ortiz says it's tough. Take just the other day, when he missed what he says was an easy problem on a math test.

Mr. ORTIZ: You just think that you're stupid automatically, and that's the first thought that comes into your mind. But you have to try to like, fight that away.

AUBREY: He learned to stop and think about the real facts. Overall, his math grade is pretty good. And then there's Bryce Marcus. He says he's trying to use what he's learned.

Mr. MARCUS: It's come in handy here sometimes, when I get mad.

AUBREY: A few weeks ago, he said he was furious with his sister when he came home from school and found his video game broken on the floor. But before he started a fight, he stopped to find out the facts. Turns out, it was an accident.

Mr. MARCUS: I went into the bathroom, and I looked in the mirror and I was like...

(Soundbite of breathing)

Mr. MARCUS: ...and I was trying to calm down with facial expressions.

AUBREY: So is stepping back from a highly emotional reaction a sign that Bryce is learning to be more emotionally resilient?

Dr. JANE GILLHAM (Co-director, Penn Resiliency Program): Absolutely. I think that's a wonderful example, and that's really what we hope for, is that kids will internalize the skills enough that they can use them in the moment.

AUBREY: That's Jane Gillham, a lead researcher of resilience training. She says there are now more than a dozen published studies, all showing benefits.

Dr. GILLHAM: Well, I'm a skeptic. I'm a scientist and a skeptic, so it took a lot for me. But the evidence is starting to accumulate now that these skills can prevent the onset of depression, and that they have powerful effects.

AUBREY: None of this implies that resilience skills are some kind of magic bullet. Clearly, there are genes and life events that put some folks at higher risk.

Take, for example, 17-year-old Victoria Fornataro(ph). Clinical depression runs in her family, and she started struggling early in high school.

Ms. VICTORIA FORNATARO: I didnt have much energy. I wasnt sleeping at night.

AUBREY: After her primary care doc at Kaiser Permanente flagged it, she ended up in cognitive therapy, learning the same strategies John Kelly and the fifth graders learned. At the time, she was hanging out with a group of girls who were bringing her down.

Ms. FORNATARO: And just mean, petty things being said and done.

AUBREY: And she internalized all of it.

Ms. FORNATARO: And you start thinking, well, you know, maybe because of all these people dont like me, other people aren't going to like me. It's all me.

AUBREY: But after learning to check her thoughts and to look for evidence, she realized she was very likeable - and liked - around another set of friends, so she chose to start spending more time with them.

Researcher Greg Clark says there's evidence that teens like Fornataro are being helped by these strategies.

Mr. GREG CLARK (Researcher): If we make a difference and change the trajectory at that early point, then we might see - we hope we'll see better life outcomes for these teenagers that will extend in many ways.

AUBREY: Now just in the teen years, but perhaps over a whole lifetime.

Allison Aubrey, NPR News.

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