ClearlyMe Blended Care: Evaluating the acceptability and feasibility of a blended care approach for adolescent depression.

ClearlyMe is a self-guided, smartphone application developed by the Black Dog Institute for adolescents with mild to moderate depression. ClearlyMe comprises 37 brief (5–10 minute), non-sequential activities that target key symptoms of depression, including low mood, negative automatic thoughts, and reduced motivation. It is based on a gold-standard CBT approach to treating depression, with the activities incorporating key CBT components including psychoeducation, cognitive restructuring, goal setting, and activity scheduling. Example activities include; • “5, 4, 3, 2, 1 – Grounded” – A grounding activity to help settle intense emotions. • “Question your thoughts” – A thought challenging exercise to reframe negative thoughts. • “Setting goals” – Short term goal setting activity. • “Get moving” – Behavioural activation activity. • “What is mindfulness” – Psyhoeducation about mindfulness and an audio gui • “Sleep better” – A guided meditation for use at bed time. This trial will evaluate the acceptability and feasibility to clinicians of a newly developed digital platform, ClearlyMe Blended Care (CMBC). The platform was designed to support clinicians in private practice or related settings who are delivering cognitive behavioural therapy (CBT) to adolescent clients experiencing symptoms of depression, by allowing them to prescribe (and their clients to complete) activities from the ClearlyMe intervention. For the purposes of this pilot trial, all 37 ClearlyMe activities will be recreated in a web-based platform (ClearlyMe Blended Care). Participating clinicians will be granted access to the platform and will be able to invite their clients to access ClearlyMe content via the platform where they deem it clinically appropriate. On enrolment in the study, participating clinicians will complete a brief (~1h) online training module that provides an orientation to the CMBC platform and high-level guidance on how ClearlyMe content might be used to support therapy. These training resources will remain accessible to participating clinicians throughout the trial. Participants (i.e. clinicians) will have access to the CMBC platform for a period of four months in which they can register their clients to access prescribed content. Following this four month period, clinicians will retain access to the platform to use with previously registered clients until completion of their treatment, however they will be unable to register new clients. Clinicians will have complete discretion over which activities and how many activities they prescribe to their clients, and these activities will complement (not replace) in-person delivery of therapy. Participation in this trial places no restrictions on the frequency or duration of in-person sessions. Clinicians will retain complete autonomy as to how they choose to provide treatment to their clients, whether they choose to use CMBC activities with their clients, and how they choose to integrate these activities alongside standard care. The platform will automatically collect data on the number of clients registered, which activities were prescribed and completed, and which training resources were accessed.