Depressive Symptoms
Conditions
Keywords
depression, therapeutic alliance, youth, Ecological Momentary Assessment, e-mental Health, e-Health, adherence
Brief summary
Youth depression is a matter of concern worldwide. It affects an important part of the young population around the world and its consequences both physically and mentally make this issue an important research field for psychologists and other health related professionals (Zuckerbrot, Cheung, Jensen, Stein & Laraque, 2018). Two of the biggest challenges that clinicians and researchers face when dealing with youth depression are adherence and the establishment of a therapeutic alliance (TA; Nock & Ferriter, 2005). While several treatments are available to relief depressive symptomatology in youths, a significant number do not access them for a variety of reasons (DiMatteo, Lepper & Corgan, 2000). In the last decades, substantial research has been conducted on how youths and the general population perceive therapy, and different methods have been developed to assess clients and therapists in order to improve outcomes and other aspects of the psychotherapy process, such as feedback tools and real-time measurements like Ecological Momentary Assessment (EMA) (Shiffman, et al., 2008). With the aid of Information Communication Technologies (ICTs) and eMental Health strategies, feedback and assessment tools can be presented in a friendly manner, providing a novel way to possibly improving adherence rates and TA scores. This study aims to develop and test the effectiveness of an Ecological Momentary Assessment mobile application to improve initial adherence and TA in psychotherapy for youths with depression. The hypotheses for this trial are: 1. Applying an EMA baseline screening application one week before the beginning of treatment for youth depression will significantly improve the TA. 2. Applying an EMA baseline screening application one week before the beginning of treatment for youth depression will significantly improve initial adherence.
Interventions
BEHAVIORALEMA prompting for patients
EMA prompting will consist of the delivery of the PHQ-4 and PANAS questionnaires, as well as basic identification, therapy motivations and expectations, location, current activity and social interactions. These prompts will be presented to patients during a 7 day period, 5 times per day.
BEHAVIORALPDF Reports for therapists
After the patients' EMA data is collected, a previously designed R script will summarize and transform the data into a brief and graphic report for therapists in the experimental arm of the study. These reports are intended to provide detailed information about the patients' mood, anxiety levels, positive and negative affects, as well as crossed data such as mood according to location, anxiety according to activity, etc.
Sponsors
ANID - Millennium Science Initiative Program - NCS17_03 Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Millennium Institute on Immunology and Immunotherapy
Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
Vania Martínez-Nahuel
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
for Patients: * Owning a mobile phone with permanent access to the internet, * Scoring from eleven to nineteen points in the PHQ-9 questionnaire. * Having completed the eighth grade of basic education.
Exclusion criteria
for Patients: * Being diagnosed with Depression with psychotic symptoms, * Having a depressive episode as part of a bipolar disorder diagnosis * Having suicidal thoughts and/or behaviour as measured by the PHQ-9 and evaluated by the physician. * Alcohol and/or substance abuse. Inclusion Criteria for Therapists: \- Having 1 or more years of clinical experience.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Working Alliance Inventory, Patient Form (WAI-P) | Immediately after the end of first three psychotherapy sessions. | Likert scale with answers that range from 1 to 7. Higher scores suggest a better perception of the Therapeutic Alliance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Working Alliance Inventory, Therapist Form (WAI-T) | Immediately after the end of first three psychotherapy sessions. | Likert scale with answers that range from 1 to 7. Higher scores suggest a better perception of the Therapeutic Alliance. |
| Assistance to sessions | Immediately after the end of first three psychotherapy sessions. | Assistance to sessions will be registered by therapists as a measurement of initial adherence. |
Countries
Chile
Outcome results
None listed