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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Nov 19, 2024
Open Peer Review Period: Dec 3, 2024 - Jan 28, 2025
Date Accepted: Jun 12, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Maintaining Resilience and Well-Being in the Era of Climate Change: Protocol of an Acceptability and Feasibility Pilot of the Bee Well Program for Treating Eco-Anxiety in Rural Children Exposed to Natural Hazards

Cosh SM, Bartik W, Ryan R, Jefferys A, Fallander K, Tully PJ, Lykins AD

Maintaining Resilience and Well-Being in the Era of Climate Change: Protocol of an Acceptability and Feasibility Pilot of the Bee Well Program for Treating Eco-Anxiety in Rural Children Exposed to Natural Hazards

JMIR Res Protoc 2025;14:e69005

DOI: 10.2196/69005

PMID: 40681170

PMCID: 12317292

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Maintaining resilience and wellbeing in the era of climate change: Protocol of an acceptability and feasibility pilot of the Bee Well program for treating eco-anxiety in rural children exposed to natural hazards

  • Suzanne M. Cosh; 
  • Warren Bartik; 
  • Rosie Ryan; 
  • Amanda Jefferys; 
  • Kaii Fallander; 
  • Phillip J. Tully; 
  • Amy D. Lykins

ABSTRACT

Background:

The impacts of climate change on mental health are becoming widely recognised. Climate change can detrimentally impact mental health through direct and indirect exposure to natural hazards, as well as through the overarching awareness of climate change and the resultant environmental decline – the latter is termed eco-anxiety. Exposure to natural hazards also increases eco-anxiety, further compounding mental health impacts. Young people and children are especially vulnerable to the mental health impacts of climate change, and have higher rates of eco-anxiety than other age groups. Those in rural areas are also more likely to be impacted by natural hazards, further underscoring the need to support this population. However, to date there remains scant evidence regarding how to best support young people in relation to eco-anxiety, with few interventions, especially for children, having been evaluated. As such, there is a clear need for growing the evidence base to inform treatment for children and young people for climate change-related distress.

Objective:

This study pilots a novel group-based mental health and resilience intervention in relation to eco-anxiety. Specifically, this project aims to explore the acceptability, feasibility, and clinical utility of a group-based eco-anxiety intervention.

Methods:

The project is an acceptability, feasibility, and clinical utility pilot of a group-based intervention using a pre- post-design with a single group. A minimum sample of 12 children aged between 10-14 years located in a rural area and with exposure to at least one natural hazard will be enrolled in the study. Children will complete measures of psychological distress (subjective units of distress, the Depression, Stress and Anxiety Scale – Youth), climate emotions, and resilience (Resilience Scale for Children -10) pre- and post-intervention. Acceptability will also be assessed post-intervention through a series of Likert-scale and open-ended questions. Eligible children will take part in a novel five module group-based intervention designed to build resilience, promote nature connectedness, build social support, and foster meaning-focused coping.

Results:

This study has received ethical board approval. As of October 2024, recruitment has not yet commenced. The study will be conducted from late 2024 to 2025.

Conclusions:

Rural children and young people are an especially vulnerable population for the mental health impacts of climate change. However, currently there is minimal evidence to guide clinicians and practitioners with how to best support children experiencing eco-anxiety, especially following exposure to a natural hazard. To date, the evidence base for interventions for treating eco-anxiety remains sparse, especially young people and children who typically have higher rates of eco-anxiety than older age groups. This study will provide preliminary evidence of a group-based treatment for children and adolescents experiencing eco-anxiety that can inform practitioners. Clinical Trial: ACTRN12624001287527


 Citation

Please cite as:

Cosh SM, Bartik W, Ryan R, Jefferys A, Fallander K, Tully PJ, Lykins AD

Maintaining Resilience and Well-Being in the Era of Climate Change: Protocol of an Acceptability and Feasibility Pilot of the Bee Well Program for Treating Eco-Anxiety in Rural Children Exposed to Natural Hazards

JMIR Res Protoc 2025;14:e69005

DOI: 10.2196/69005

PMID: 40681170

PMCID: 12317292

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