School-Based Interventions for Adolescent Emotional Regulation Post-COVID 19 Within the Scope of Occupational Therapy Scoping Review
Main Article Content
Keywords
occupational therapy, adolescent, emotional regulation
Abstract
Introduction: The COVID-19 pandemic significantly altered youth mental health needs, creating a heightened demand for interventions that support emotional regulation and reduce reliance on punitive discipline. However, the professionals currently responsible for providing these interventions are often overextended, which can significantly limit effective support for adolescents. Although multiple disciplines provide support, occupational therapy practitioners (OTPs) remain underutilized due to limited awareness of their role in addressing mental health. Given the presence of OTPs in school practice, clarifying how OTPs can support emotional regulation is essential and could serve to reduce the strain on existing providers.
Methods: A comprehensive search was conducted across several databases, including CINAHL Plus, ERIC, and APA PsycInfo, following the PRISMA-ScR guidelines. Inclusion criteria required studies to occur between 2020 and 2025, address school interventions for adolescents aged 9–19 in countries with similar educational systems to the U.S. Exclusion criteria ruled out studies involving participants with physical or developmental disabilities.
Results: The search identified 595 articles, of which 526 were excluded after title and abstract review. After full-text screening, 14 articles met the inclusion criteria. Interventions identified to address emotional regulation included meditation (n=3), dialectical behavior therapy (n=3), mindfulness (n=10), yoga (n=1), interoception (n=1), biofeedback (n=5), and sensory regulation (n=1). OTs were identified as providers in only two of these interventions.
Conclusions: There is a sizable opportunity for OTPs to collaborate with interdisciplinary teams to develop school-based emotional regulation programs. OTPs should advocate for their role in these interventions and conduct more research to highlight their value in supporting adolescent mental health.
References
2. Pigott C, Stearns AE, Khey DN. School resource officers and the school to prison pipeline: discovering trends of expulsions in public schools. Am J Crim Justice. 2017;43(1):120–138. doi: 10.1007/s12103-017-9412-8
3. Pfirman N, Rivera C, Saffer A. Health promotion and wellness for all students: school-based occupational therapy as a preventive approach. Am J Occup Ther. 2023;77(2):1–5. doi: 10.5014/ajot.2023.050242
4. American Occupation Therapy Association. Occupational therapy practice framework: Domain and process (4thed.). Am J Occup Ther. 2020;74(Supplement 2):1-87. doi: 10.5014/ajot.2020.74S2001
5. American Occupational Therapy Association. Mental health promotion, prevention, and intervention in occupational therapy practice. Am J Occup Ther. 2017;71(Supplement 2):1-19. doi: 10.5014/ajot.2017.716s03
6. Pedrini L, Meloni S, Lanfredi M, Rossi R. School‐based interventions to improve emotional regulation skills in adolescent students: a systematic review. J Adolesc. 2022;94(8):1051–1067. doi: 10.1002/jad.12090
7. Lorenzetti NL, Johnson H. The relationship between teachers’ implicit racial attitudes and their labeling of classroom behavior. Crit Questions Educ. 2023;14(1):72–86.
8. Cameron R, Elleman B. School-Based Interventions for adolescent emotional pegulation Post-COVID 19 within the scope of occupational therapy: A scoping review protocol [registration]. Open Science Framework. April 4, 2024. https://osf.io/p65nh/overview?view_only=d40ffb843d8f44b88d9d9aec08daba10
9. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan: a web and mobile app for systematic reviews. Syst Rev. 2016;5(210). doi: 10.1186/s13643-016-0384-4
10. American Occupational Therapy Association. Levels of Strength of Evidence. Aota.org. 2026. Accessed March 15, 2026. https://www.aota.org/career/continuing-education/approved-providers/levels-and-strength-of-evidence.
11. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The Prisma 2020 statement: An updated guideline for reporting systematic reviews. BMJ. https://doi.org/10.1136/bmj.n71
12. Atkiss E, Stringer P. Developing the social and emotional competence of adolescents through implementation of the steps-A Curriculum. Educ Child Psychol. 2023;40(3):47–71. doi: 10.53841/bpsecp.2023.40.3.47
13. David, O. A., & Fodor, L. A. (2022). Are gains in emotional symptoms and emotion-regulation competencies after the REThink therapeutic game maintained in the long run? A 6-month follow-up. European Child & Adolescent Psychiatry, 32(10), 1853–1862. https://doi.org/10.1007/s00787-022-02002-w
14. Gomes A, Vieira dos Santos J, Vieira LS. Meditation effects on anxiety and resilience of preadolescents and adolescents: a randomized controlled study. Children. 2021;8(8):689–698. doi: 10.3390/children8080689
15. Green AL, Ferrante S, Boaz TL, Kutash K, Wheeldon-Reece B. Effects of the spark teen mentoring program for high school students. J Child Fam Stud. 2022;31(7):1982–1993. doi: 10.1007/s10826-022-02298-x
16. Kuyken W, Ball S, Crane C, et al. Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the myriad cluster randomised controlled trial. Evid Based Ment Health. 2022;25(3):99–109. doi: 10.1136/ebmental-2021-300396
17. Mahler K, Hample K, Jones C, Sensenig J, Thomasco P, Hilton C. Impact of an interoception-based program on emotion regulation in autistic children. Occup Ther Int. 2022;2022(1):1–7. doi: 10.1155/2022/9328967
18. Martinez RR, Marraccini ME, Knotek SE, Neshkes RA, Vanderburg J. Effects of dialectical behavioral therapy skills training for emotional problem solving for adolescents (DBT steps-A) program of rural ninth-grade students. School Ment Health. 2021;14(1):165–178. doi: 10.1007/s12310-021-09463-5
19. McLeod C, Boyes M. The effectiveness of social-emotional learning strategies and mindful breathing with biofeedback on the reduction of adolescent test anxiety. Can J Educ. 2021;44(3):815–847. doi: 10.53967/cje-rce.v44i3.4869
20. McMahon K, Berger M, Khalsa KK, Harden E, Khalsa SB. A non-randomized trial of Kundalini Yoga for emotion regulation within an after-school program for adolescents. J Child Fam Stud. 2021;30(3):711–722. doi: 10.1007/s10826-021-01911-9
21. Miller AL, Gerardi N, Mazza JJ, Dexter‐Mazza E, Graling K, Rathus JH. Delivering comprehensive school‐based dialectical behavior therapy (CSB‐DBT). Psychol Sch. 2023;60(8):2762–2781. doi: 10.1002/pits.22887
22. Saarinen A, Hintsanen M, Vahlberg T, Hankonen N, Volanen S. School‐based mindfulness intervention for depressive symptoms in adolescence: for whom is it most effective? J Adolesc. 2022;94(2):118–132. doi: 10.1002/jad.12011
23. Schussler DL, Oh Y, Mahfouz J, et al. Stress and well-being: a systematic case study of adolescents’ experiences in a mindfulness-based program. J Child Fam Stud. 2020;30(2):431–446. doi: 10.1007/s10826-020-01864-5
24. Vestad L, Tharaldsen KB. Building social and emotional competencies for coping with academic stress among students in lower secondary school. Scand J Educ Res. 2021;66(5):907–921. doi: 10.1080/00313831.2021.1939145
25. Eeles J, Walker D. Mindfulness as taught in dialectical behaviour therapy: A scoping review. Clinical Psychology & Psychotherapy. 2022;29(6):1843-1853. doi:10.1002/cpp.2764
26. Chapman AL. Acceptance and mindfulness in behavior therapy: A comparison of dialectical behavior therapy and acceptance and commitment therapy. International Journal of Behavioral Consultation and Therapy. 2006;2(3):308-313. doi:10.1037/h0100785
27. Latifi K, Patterson K, Rider JV, Lau C. Impact of sensory activity schedules on school performance of students with Sensory Processing Differences: A systematic review. The American Journal of Occupational Therapy. 2025;80(1). doi:10.5014/ajot.2025.051334
28. USDOE. Every student succeeds act (ESSA). U.S. Department of Education. September 23, 2025. Accessed March 9, 2026. https://www.ed.gov/laws-and-policy/laws-preschool-grade-12-education/every-student-succeeds-act-essa.
29. Ohio Legislature. House Bill 123. House Bill 123 | 133rd General Assembly | Ohio Legislature. 2026. Accessed March 9, 2026. https://www.legislature.ohio.gov/legislation/133/hb123.
30. The Alert Program. Who can benefit from the alert program®? The Alert Program. February 10, 2025. Accessed March 15, 2026. https://www.alertprogram.com/can-benefit-alert-program/.
31. Kuypers L. Zones of regulation. The Zones of Regulation. January 9, 2026. Accessed March 15, 2026. https://zonesofregulation.com/.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright, 2026 by the authors. This work is licensed under the Creative Commons Attribution 4.0 International License.