Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial

Dunn, Barney; Widnall, Emily; Warbrick, Laura; Warner, Faith; Reed, Nigel; Price, Alice; Kock, Merle; Courboin, Clara; Stevens, R.; Wright, Kim; Moberly, Nicholas J.; Geschwind, Nicole; Owens, Christabel; Spencer, Anne; Campbell, John; Kuyken, Willem

doi:10.1016/j.eclinm.2023.102084

Cited by 16 publications

(10 citation statements)

References 34 publications

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“…The ADepT competency scale is still at an early stage of development (cf. Dunn et al, 2023) and has yet to be extensively psychometrically validated. Ratings in the current study were predominantly intended to provide developmental feedback to each therapist, so were only coded by a single trainer/supervisor, meaning inter-rater reliability of the present ratings was not established.…”

Section: Discussionmentioning

confidence: 99%

“…Therapists were trained to deliver ADepT following the protocol described in the ADepT pilot trial (Dunn et al, 2023), with the exception that due to service constraints clients were not offered the five optional booster sessions in the year after acute treatment finished. As this was an audit of a routine service improvement initiative, ethical approval for research was not applied for, and trainees were not required to give written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…Dunn et al, 2023). This is a bespoke tool developed for the purposes of the ADepT pilot trial (Dunn et al, 2023), with preliminary evidence suggesting it has acceptable inter-rater reliability (see online Supplementary material; Dunn et al, 2023). The ADepT competency rating scale generates a competency rating for style, structure and technique, on a scale from 0 ('incompetent') to 6 ('expert').…”

Section: Evaluation Of Training and Supervision Pathwaymentioning

confidence: 99%

“…Overall competency is assessed by averaging these scores. The competency rating was completed by one of the two ADepT supervisors in the audit (half by one supervisor, half by the other supervisor), both of whom are experienced in delivering ADepT having been therapists in the earlier ADepT case series and pilot trial (Dunn et al, 2019a;Dunn et al, 2019b;Dunn et al, 2023). The sessions were single rated, so no measure of internal-rater reliability is reported.…”

Section: Evaluation Of Training and Supervision Pathwaymentioning

confidence: 99%

“…In a pilot randomised controlled trial, 82 depressed clients with anhedonic features were recruited predominantly from NHS-TTad high-intensity waiting lists and randomised to receive either 20 sessions of CBT (following a Beckian protocol) or 15 weekly sessions of ADepT plus up to five optional booster sessions (Dunn et al, 2019b;Dunn et al, 2023). The pilot trial met its feasibility aims, in that clients could be recruited, randomised, retained, engaged adequately with each treatment, and provided an adequate amount of follow-up data.…”

Section: Introductionmentioning

confidence: 99%

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A pilot evaluation of a training and supervision pathway for Augmented Depression Therapy (ADepT) in a Devon NHS Talking Therapies Service

Warbrick,

Meehan,

Carson

et al. 2024

tCBT

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Augmented Depression Therapy (ADepT) is a novel wellbeing and recovery-oriented psychological treatment for depression. A recent pilot trial run in a university clinic setting suggests ADepT has potential to be superior to cognitive behavioural therapy (CBT) at treating anhedonic depression in a NHS Talking Therapies for anxiety and depression (NHS–TTad) context. Before proceeding to definitive trial in pragmatic settings, it is important to establish if therapists in routine NHS-TTad settings can be trained to deliver ADepT effectively and to assess therapist views on the feasibility and acceptability of ADepT in this context. A bespoke training and supervision pathway was developed (2-day workshop, four 2–hour skills classes, and 6 months of weekly supervision) and piloted with 11 experienced therapists working in a single NHS–TT service in Devon. Nine out of 11 therapists completed the placement, treating 24 clients with a primary presenting problem of depression; 21/24 completed a minimum adequate dose of therapy (≥8 sessions), with 17/24 (71%) showing reliable improvement and 12/24 (50%) exhibiting reliable recovery. Eight out of nine therapists submitted a session for competency assessment, all of whom were rated as competent. Nine therapists submitted feedback on their experiences of training. Eight out of nine therapists felt the ADepT model would be effective in an NHS–TTad context; that training was interesting, useful, well presented and enhanced their own wellbeing; and that they felt sufficiently skilled in core ADepT competencies at the end of the placement. This suggests that NHS–TTad therapists can be trained to deliver ADepT competently and view the treatment as feasible and acceptable. Key learning aims (1) To become familiar with the Augmented Depression Therapy (ADepT) approach for enhancing wellbeing in depression. (2) To evaluate the potential utility and feasibility of ADepT model in NHS Talking Therapies Services (NHS–TTad). (3) To understand the pilot ADepT training and supervision pathway for CBT therapists in NHS–TTad services. (4) To consider the opportunities and challenges of training therapists to deliver ADepT in NHS–TTad services.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Evaluation Of Training and Supervision Pathwaymentioning

confidence: 99%

Section: Evaluation Of Training and Supervision Pathwaymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A pilot evaluation of a training and supervision pathway for Augmented Depression Therapy (ADepT) in a Devon NHS Talking Therapies Service

Warbrick,

Meehan,

Carson

et al. 2024

tCBT

Self Cite

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What do clients think about amplifying positivity? Client change perspectives following a cognitive and behavioural positive activity intervention for anxiety and depression

Satchwell,

Hoffman,

Rassaby

et al. 2024

Couns and Psychother Res

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BackgroundThe positive valence system (PVS) is increasingly recognised as an important target in facilitating recovery from anxiety and depression. Amplification of positivity (AMP), a cognitive and behavioural intervention, targets the PVS through repeated and intentional activities (e.g. savouring positive experiences, gratitude and acts of kindness). Initial data demonstrate that AMP engages positive valence targets (e.g. positive affect) and outcomes (e.g. social connectedness) in people seeking treatment for anxiety or depression; however, client perspectives on AMP are not well understood. This study aimed to qualitatively explore clients' experiences to better understand post‐treatment client changes and advance the development and effectiveness of AMP and other emerging positive valence‐focussed interventions.MethodsTranscripts were analysed from 11 participants who completed an optional qualitative interview after completing AMP treatment in a randomised controlled trial (NCT04945239).ResultsTwo superordinate themes with several subthemes emerged. The first theme, Changes in Self, revealed common changes consistent with the core targets of AMP, as well as changes less explicitly targeted by AMP. The second theme, The Positivity Pivot, uncovered clients' perceptions on the emphasis of positive emotions in treatment. Overall, clients enjoyed and reaped benefits from amplifying positivity; some clients also reported wanting more time and space to discuss negative valence symptoms.ConclusionPeople seeking treatment for anxiety or depression are receptive to amplifying positivity and experience the mental and social benefits of doing so. Positive valence‐centred treatments may therefore be valuable for some clients. Treatment protocols that integrate positive valence‐ and negative valence‐targeted approaches may be preferred by some clients.

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A Comparative Study on the Efficacy of Group Positive Psychotherapy and Group Cognitive Behavioral Therapy on Flourishing, Happiness and Satisfaction with Life: A Randomized Controlled Trial

Furchtlehner,

Fischer,

Schuster

et al. 2024

J Happiness Stud

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The present study examines the efficacy of Positive Psychotherapy (PPT) on psychological well-being, happiness, and satisfaction with life. We investigated people suffering from different kinds of depressive disorders, comparing it to Cognitive Behavioral Therapy (CBT). PPT is an empirically validated intervention targeting positive resources and personal strengths. It aims at amplifying well-being while also ameliorating the impact of symptoms. In a controlled two-center-study, we randomly assigned 92 out-patient participants with a DSM-IV diagnosis of major depressive disorder and/or Dysthymia to 14 sessions of manualized PPT or CBT group therapy. We assessed outcomes related to well-being using the Flourishing Scale, the Satisfaction with Life Scale, and the Positive Psychotherapy Inventory (PPTI). The PPTI represents the five components of Seligman’s PERMA-model of flourishing, encompassing positive emotions, engagement, positive relationships, meaning, and accomplishment. We took measurements before and after the intervention, and at a 6-months follow-up. Moreover, we considered a list of moderators that may impact the efficacy of PPT. PPT resulted in significant improvements in all measures, and these improvements remained stable for up to 6 months. Using 2 × 2 mixed-effects models (T1 vs. T2), we found significant interactions for all three main scales and two out of the five PPTI subscales. These interactions depicted significantly better outcomes for PPT at post-treatment. Regarding the follow-up (T1 vs. T3), we did not find significant interactions, and thus, there were no differences between the two therapies. No demographics or characteristics of the treatments were significant moderators. Summarized, these findings provide support for the effectiveness of PPT in increasing happiness, well-being, and quality of life. We can confirm that PPT is an additional tool for the enhancement of positive mental health.

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Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial

Cited by 16 publications

References 34 publications

A pilot evaluation of a training and supervision pathway for Augmented Depression Therapy (ADepT) in a Devon NHS Talking Therapies Service

A pilot evaluation of a training and supervision pathway for Augmented Depression Therapy (ADepT) in a Devon NHS Talking Therapies Service

What do clients think about amplifying positivity? Client change perspectives following a cognitive and behavioural positive activity intervention for anxiety and depression

A Comparative Study on the Efficacy of Group Positive Psychotherapy and Group Cognitive Behavioral Therapy on Flourishing, Happiness and Satisfaction with Life: A Randomized Controlled Trial

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