What is the DISA-method?

The DISA-method is a school-based approach rooted in Cognitive Behavioral Therapy to prevent stress and depression among secondary school students. The method is prevention and promotion, and should never be used for treatment purposes!

Participating in DISA instruction helps students become more aware of how thoughts and behaviors affect how they feel, exploring both how happy thoughts and activities can lift our mood, and how negative thoughts and activities can lower our mood.

DISA stands for Depression in Swedish Adolescents (although most group leaders call it Developing Inner Strength Awareness and is largely based on Gregory Clarke and Peter Lewisohn’s studies in the US

The Centre for Epidemiology and Community Medicine, Södersjukhuset, Stockholm County Council, customized the manuals for the Swedish school system and Swedish conditions and the method was evaluated with very positive results by Britt-Marie Treutiger in 2006.

Pernilla Garmy’s thesis "Supporting positive mental health development in adolescents with a group cognitive intervention" was completed at Lund University in the Spring of 2016. The conclusion based on the results of this thesis were:

  • DISA reduces depressive symptoms and enhances young people's self-rated health.
  • The cost of DISA is low in relation to its effect, indicating cost-effectiveness.


How do DISA group leaders work?

  • DISA education can be held wherever young people can be reached in a group setting. It is a universal approachnot a form of treatment, and therefore fits best in school environment. In school, we have students: those who are doing excellent, mediocre, decent, and poorly. We have those who feel good at times and bad at times. We have some who know why they feel the way they do, and some who do not have a clue.
  • Within the school environment we have the opportunity to work proactively and preventatively with all students. As we don’t know know who will suffer from depressive symptoms or too much stress in the future, it is of tremendous value to be able give this "toolbox" in the form of DISA-method to all. DISA also help those who are doing well to understand what it is that helps them have a positive frame of mind and reinforces this.
  • DISA is different from many other discussion groups. The work is done in groups, but a large part of the work still happens on an individual level. As working with the method requires some planning and preparation, it is important that school principals and leadership and other stakeholders are involved in the planning and implementation of the work.
  • Leaders: It is ideal to be two team leaders when working with DISA. It is much more stimulating and fun to work as a team. The workload is less if you can share it with someone else. The leaders can role-play with each other for the students to show examples in distinct ways. Four eyes and ears hear and see much more,
  • Planning: How much time does it take to work with DISA? It takes approximately 1.5 hours per week with the group over a ten-week period. Planning will take about another 60-90 minutes per week, as it is important to have a proper understanding of the lesson to be taught. It is also important for instructors to be able to debrief after the end of each lesson. Participants appreciate if you offer something to eat at each group session. Maybe some breakfast items from the school dining hall, or juice and cake, or some fruit. Everything is appreciated.
  • Participants: The number of participants in the group should not exceed 12-14. The instruction should be held on the same day and time, and preferably in the same room (as much as possible). The group members should be fixed with no new members being added after the initial session (with the exception of new additions to the class, in which case it is the responsibility of the group leaders to help the new member to "catch up"). If someone misses an session, a classmate should be asked to inform them regarding homework assignments that are to be done prior to the next class session.
  • Material: The manuals are very structured, with each lesson building on the previous one. (Leaders should not skip parts as the material becomes "choppy" and the common thread is lost.) The participants each receive student manuals containing all of the materials and lessons. These manuals should be brought to every session.
  • Room: A conference room or classroom with plenty of space for all participants as well as for the group leaders is ideal. Participants need room to have their folder on their table or desk and to be able to sit and work both individually and in groups as needed. It is good if everyone can have eye contact with each other.
  • Leaders: DISA works best when the group leaders like working with a mindset that is based upon cognitive behavioral therapy (CBT). DISA is not treatment and you need no prior training in CBT to work with the method. However, it is important to have experience of working with young people in groups. It is also important to have the background, education and knowledge to receive and support the participants in a professional manner. That can mean offering individual conversations about a student's situation, or channeling them to appropriate resources as needed.

The material is available in English.

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