None listed
Conditions
Brief summary
This study aims to determine whether behavioural activation treatment reduces symptoms of depression in adolescents with intellectual disability and depression, using a treatment called Beat-D. Behavioural activation treatment involves increasing people’s behaviours and engagement in things they enjoy doing, aiming to improve their mood and overall wellbeing. Half of the participants involved in the research study will be randomly allocated to receive the behavioural activation treatment, and the other half will be randomly allocated to continue to receive their usual care.
Interventions
The treatment is designed to be delivered to individuals alongside a parent carer. It is a structured, time limited, manualised psychological therapy, developed to treat those with an intellectual disability and depressive symptoms. There is an initial training session for carers regarding their role in the treatment, then 8-12 sessions (one hour) held weekly or every two weeks, spanning approximately 4 months. The treatment can be delivered in person, or using video conferencing.
The program
The treatment is designed to be delivered to individuals alongside a parent carer. It is a structured, time limited, manualised psychological therapy, developed to treat those with an intellectual disability and depressive symptoms. There is an initial training session for carers regarding their role in the treatment, then 8-12 sessions (one hour) held weekly or every two weeks, spanning approximately 4 months. The treatment can be delivered in person, or using video conferencing. The program is divided into two phases, starting with an assessment period (sessions 1 to 4), where the participant with intellectual disability and their carer are socialised into the model and an individual formulation is developed. Key components of this phase include: i) identifying avoidant behaviours linked to depressive symptoms and monitoring activity, ii) identifying life goals, and iii) psycho-education concerning the link between depression and activity. The subsequent 6 active treatment sessions (sessions 5 to 10) focus on: (i) recovering lost skills and interests and new skills training, (ii) graded exposure to reduce avoidant behaviours, (iii) targeting inherently reinforcing activity and activity likely to increase access to other positive reinforcers in three life domains: domestic tasks, purposeful daytime activity and social/recreational activity, and iv) addressing other emotional or inter-personal barriers to change, including anxiety and anger. The final two sessions (sessions 11 and 12) after the active treatment phase have a future focus and are concerned with helping the participant and carer to maintain and build on progress they have made. A booklet is prepared for the participant and carer, reviewing progress and identifying changes that have been made, along with a plan for long-term maintenance and improvement. This booklet is developed specifically for the participant and is developed collaboratively between the participant, support person, and the therapist throughout the treatment. The participant, support person, and therapist will work together to develop therapy goals. The treatment sessions are focused on developing achievable behavioural activities that the adolescent can engage in between sessions. Activities may include social outings, recreational or hobby related activities, and exercise. The therapist, support person and adolescent will problem solve any barriers to engaging in these activities during the treatment sessions. Therapy will conclude with a review of progress and a plan for maintenance of gains. Completion of the treatment is defined as attendance and participation in a minimum of eight sessions. This will be monitored by the completion of therapy session checklists. The treatment will be delivered by a research assistant experienced in psychological assessment and working with people with intellectual disability, trained in the delivery of the Beat-D intervention.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
12 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
1. Adolescents with a mild to moderate intellectual disability, defined by a score of 70 or below on standardised assessments and deficits in adaptive functioning, and/or administratively defined as having an intellectual disability, for example, enrolled in a special school for children/adolescents with mild intellectual disability 2. Adolescents with the capacity to assent/consent to take part in the research (and therefore would have sufficient communication and understanding to take part in the treatment) 3. Aged 12-17 years 4. Clinically significant unipolar depression as determined using information gathered through clinical interview (Anxiety Disorder Interview Schedule for Children) 5. Has support from a family member or paid carer who can support them throughout the treatment 6. If on medication for depressive symptoms, have been on a stable dose for 4 weeks prior to commencement of intervention
Exclusion criteria
1. A suicide attempt in the past 6 months 2. Intensive inpatient treatment for mental illness in the past 6 months 3. Factors that prevent the young person from interacting with the supporter and therapist or retaining information from the therapy (for example, severe psychosis, degenerative condition) 4. Currently receiving any psychological therapy for a mental health problem 5. Insufficient English language skills to complete the measures or participate in the treatment.
Outcome results
None listed