None listed
Conditions
Brief summary
Adolescent depression is a costly problem for our communities, families and young people. Currently, when detected, treatment provided for depression within Australian Child and Adolescent Mental Health Services (CAMHS) is of unknown content and effectiveness. The objectives of the clinical research are: 1. to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents (IPT-A) for the treatment of adolescent depression within a rural CAMHS compared with Treatment as Usual (TAU). 2. to evaluate the issues associated with implementing a clinical trial in CAMHS (i.e. feasibility, acceptability, sustainability). Half the participating clinicians will receive IPT-A training and supervision, with the remaining clinicians providing their usual care (i.e. Treatment as Usual). Treatment as Usual (TAU) for adolescent depression in CAMHS is anticipated to vary in content and frequency according to who is providing it. One outcome of the project will be the clarification of what TAU comprises within the rural CAMHS. Eligible and consenting therapists will be randomized to either stream (within each site) where possible. Implementation issues will be investigated qualitatively using focus groups with clinicians and interviews with clients, carers and clinicians. The research will be conducted within the Latrobe Regional Hospital (LRH) CAMHS in Gippsland. All clinicians, employed full- or part-time within the LRH CAMHS, will be invited to participate. The trial aims to include a minimum of 60 adolescent clients of LRH CAMHS, aged 12 to 18 years, recruited over two years. Adolescents will be eligible to participate if they have significant depressive symptoms (exceeding Reynold’s Adolescent Depression Scale clinical cutoff) or a DSM-IV diagnosis of a depressive disorder (i.e. Major Depressive Disorder (MDD), Dysthymic Disorder, Depressive Disorder Not Otherwise Specified (NOS), or Adjustment Disorder with Depressed Mood) and a Children’s Global Assessment Scale (CGAS) of 65 or lower. All eligible clients will need parental consent and the agreement of the CAMHS consultant psychiatrist, regarding diagnosis and client suitability, to participate. Monitoring and outcome assessment will use the usual CAMHS outcome measures as well as some additional reliable and valid measures applied in similar research. They will include adolescent self-report, parent-report and clinician ratings. Treatment groups will be compared for demographic characteristics, diagnosis, measures of clinical improvement and treatment acceptability. Themes from focus group and interview data will be detected in qualitative analysis of transcripts using the constant comparative cyclic analysis method. The project is expected to increase understanding of the issues and outcomes associated with implementing and evaluating an evidence-based intervention for adolescent depression in a rural child and adolescent mental health service.
Interventions
Intervention
Half the participating clinicians will be randomised to receive training and supervision in Interpersonal Psychotherapy (IPT). This treatment stream will comprise IPT plus any/all relevant elements of usual CAMHS care (e.g. liaison with school; family support; medication) deemed relevant by the treating clinician or team. These elements will be recorded. IPT treatment will comprise sessions of manual-based IPT over 12 weeks with the adolescent (and family member where relevant).
Intervention Half the participating clinicians will be randomised to receive training and supervision in Interpersonal Psychotherapy (IPT). This treatment stream will comprise IPT plus any/all relevant elements of usual CAMHS care (e.g. liaison with school; family support; medication) deemed relevant by the treating clinician or team. These elements will be recorded. IPT treatment will comprise sessions of manual-based IPT over 12 weeks with the adolescent (and family member where relevant). Maintenance IPT will be continued for up to a further 12 weeks.
Sponsors
Dr. Cate Bearsley-Smith
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
12 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
Adolescent participants have significant depressive symptoms (Reynold’s Adolescent Depression Scale >clinical cut-off of T=61) or a DSM-IV diagnosis of a depressive disorder (i.e. Major Depressive Disorder (MDD), Dysthymic Disorder, Depressive Disorder NOS, or Adjustment Disorder with Depressed Mood) and a CGAS of 65 or lower. Adolescents will not be included if they are actively suicidal, have a life-threatening condition, psychosis or schizophrenia. Parents/guardian’s will be eligible to participate if their adolescent is participating in the study. They will comprise primary caregivers as identified by the participating adolescents. Up to two carers will be invited to participate for each adolescent.
Exclusion criteria
No exclusion criteria
Outcome results
None listed