None listed
Conditions
Brief summary
Depressive symptoms are common in young people with early or emerging psychosis (YPEEP), occurring in up to 75% of this client group. It is essential to establish safe, effective and acceptable treatments for depression in YPEEP as depression is associated with poor outcomes. Meta-analyses show that Behavioural Activation (BA) therapy is as effective in the treatment of depressive symptoms as Cognitive behavioral therapy (CBT) in the general population. "BA is a structured, brief psychotherapeutic approach that aims to: (a) increase engagement in adaptive activities (which often are those associated with the experience of pleasure or mastery), (b) decrease engagement in activities that maintain depression or increase risk for depression, and (c) solve problems that limit access to reward or that maintain or increase aversive control”(Dimidjian et al. 2011:3-4). Theoretically, BA may also help depressed YPEEP reconnect with positive experiences by using activity monitoring and goal-led activity scheduling. Importantly, BA is an intervention that can be delivered high levels of fidelity by non-specialist clinicians and requires minimal training, which would be of particular benefit in areas with a lack of psychologists, such as the NT. The project will establish the feasibility of clinician delivered BA as an adjunct to usual care for young people with early or emerging psychosis (YPEEP). This will inform the design of a subsequent full, appropriately powered randomized controlled trial.
Interventions
The intervention is Behavioural Activation (BA) therapy. The treatment protocol is based on previous trials of BA for depression, the COBRA trial protocol and recommendations from the National Institute for Health and Care Excellence. The study will be conducted at a youth early psychosis service offered within a mental health youth centre located in a regional city. In the intervention group, participants will receive BA in addition to standard care. This will involve 12 sessions of BA, twice w
The intervention is Behavioural Activation (BA) therapy. The treatment protocol is based on previous trials of BA for depression, the COBRA trial protocol and recommendations from the National Institute for Health and Care Excellence. The study will be conducted at a youth early psychosis service offered within a mental health youth centre located in a regional city. In the intervention group, participants will receive BA in addition to standard care. This will involve 12 sessions of BA, twice weekly, in 30-minute sessions, for six weeks. BA is administered on a one-to-one basis. BA involves collaboration between therapist and client and activities are centred around supporting the client to monitor relationships between their mood and the environment, and in commencing novel or adaptive behaviours that are aligned with goals. Attendance at 6 sessions (i.e. 50%) will be considered as an adequate ‘dose’ of the intervention. The BA therapy will be delivered in person by eight mental health clinicians at in the youth early psychosis service, who will be trained in BA techniques using the credited and established online “Professional Certificate in BA for Depression” program offered by the University of South Australia. Clinicians will complete this training program as part of the intervention. This training will consist of 5 modules undertaken over 10 weeks and will take 157 hours to complete. Clinicians will complete training one month prior to commencing BA delivery.
Sponsors
Charles Darwin University,
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
15 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
Clients of the youth early psychosis service who are aged 15 years and older are eligible to participate if they: 1. have experienced early/emerging psychosis (for less than 5 years), received care for 1 month or more, and are experiencing depressive symptoms [BPRS depression item score greater than or equal to 3, according to the most recent BPRS assessment conducted by clinical staff within routine clinical practice]; 2. are understand the study information and communicate in English; and 3. are able to provide informed consent.
Exclusion criteria
Potential participants will be excluded if they have a primary diagnosis of substance misuse, express suicidal ideation or present a known risk to themselves/others.
Outcome results
None listed