Innovations in Practice: A randomised controlled feasibility trial of Behavioural Activation as a treatment for young people with depression

Abstract

Background: Behavioural Activation (BA) treatment effectively reduces symptoms of depression in adults and is more cost-effective than more complex therapies. Two recent systematic reviews of BA for depression in young people highlighted the need for more studies in this area. Methods: In order to evaluate the acceptability of BA treatment for adolescents with depression and the feasibility of conducting a trial of this intervention in Child and Adolescent Mental Health Services (CAMHS), 22 patients from across three sites were randomised to BA or usual CAMHS care. Existing CAMHS staff were trained to deliver the manualised intervention via a brief course. Following treatment, young people and their parents/carers were asked to complete a feedback survey. Symptoms and functioning were assessed at 3-and 6-month follow-up. The trial was registered with the ISRCTN Registry (ref: ISRCTN52147450; https://www.isrctn.com/). Results: Recruitment targets were achieved through screening large numbers of CAMHS service users. Intervention adherence by the participating adolescents was high (median number of completed BA sessions was seven out of a total of eight). There were tentative suggestions of improvements following treatment; a large change in a positive direction for the BA group, but not for usual care, was observed by visual comparisons of mean scores on measures of depression, self-esteem and functioning. No adverse events were reported. Conclusions: The findings suggest that BA in this setting is acceptable and warrants evaluation via a fully powered randomised controlled trial.

Feasibility study of a new behavioural activation programme for young people with depressed mood

“…Outcomes after therapy from the second study are in line with published RCTs of psychological therapies (Goodyer et al, 2008(Goodyer et al, , 2017. Other researchers using BA in specialist CAMHS have found similar results (Gudmundsen et al, 2016;Kitchen, Tiffin, Lewis, Gega, & Ekers, 2020;Pass, Lejuez, & Reynolds, 2018).…”

The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis

“…Psychological treatments are considered to be one of the main treatment options for youth depression and meta-analyses have shown that these treatments are indeed effective, although the effects are modest, [ 7 ] and smaller than those in adults, especially in younger children [ 8 ]. Although most studies have focused on cognitive behaviour therapy (CBT) and to a smaller extent interpersonal therapy (IPT), several other types of therapy have also been examined in randomised controlled trials, including behavioural activation [ 9 ], problem-solving therapy [ 10 ] and family therapy [ 11 ].…”

Barriers and enablers for young people, parents and therapists undertaking behavioural activation for depression: A qualitative evaluation within a randomised controlled trial

“…An overview of the BUDDY RCT's design, quantitative methods and results has been published elsewhere (Kitchen et al, 2021 ). In brief, all study participants (young people) were asked to complete standardised questionnaires at three‐months post‐randomisation, and all those in the BA study arm ( n = 11) were invited to a qualitative interview.…”