Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-16T13:23:41.686Z Has data issue: false hasContentIssue false
  • English
  • Français

Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

Published online by Cambridge University Press:  31 July 2017

Laura Pass ,
Carl W. Lejuez  and
Shirley Reynolds
Laura Pass*
Affiliation:
Charlie Waller Institute, School of Psychology and Clinical Language Sciences, University of Reading, UK
Carl W. Lejuez
Affiliation:
University of Kansas, Strong Hall, Room 200, Lawrence, KS 66045, USA
Shirley Reynolds
Affiliation:
Charlie Waller Institute, School of Psychology and Clinical Language Sciences, University of Reading, UK
*
Correspondence to Laura Pass, Charlie Waller Institute, School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

Keywords

depressionadolescentsbehavioural activation
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 2 , March 2018 , pp. 182 - 194
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM- IV (4th edition). Washington, DC: American Psychiatric Association.Google Scholar
Cash, S. J. and Bridge, J. A. (2009). Epidemiology of youth suicide and suicidal behavior. Current Opinion in Pediatrics, 21, 613–619. doi: 10.1097/MOP.0b013e32833063e1 Google Scholar
Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A. and Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38, 835–855. doi: 10.1016/S0005-7967(99)00130-8 CrossRefGoogle ScholarPubMed
Chorpita, B. F., Moffitt, C. E. and Gray, J. A. (2005). Psychometric properties of the revised child anxiety and depression scale in a clinical sample. Behaviour Research and Therapy, 43, 309–322. doi: 10.1016/j.brat.2004.02.004 Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.Google Scholar
Cuijpers, P., van Straten, A., Andersson, G. and van Oppen, P. (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909.CrossRefGoogle ScholarPubMed
Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J. and Johnson, L. D. (2003). The Session Rating Scale: Preliminary psychometric properties of a ‘working’ alliance measure. Journal of Brief Therapy, 3, 3–12.Google Scholar
Duncan, B. L., Sparks, J., Miller, S. D., Bohanske, R. and Claud, D. (2006). Giving youth a voice: A preliminary study of the reliability and validity of a brief outcome measure for children, adolescents, and caretakers. Journal of Brief Therapy, 5, 66–82.Google Scholar
Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F. and Weisz, J. R. (2010). A psychometric analysis of the revised child anxiety and depression scale-parent version in a clinical sample. Journal of Abnormal Child Psychology, 38, 249–260. doi: 10.1007/s10802-009-9363-8 CrossRefGoogle Scholar
Ekers, D., Richards, D. and Gilbody, S. (2008). A meta-analysis of randomized trials of behavioural treatment of depression. Psychological Medicine, 38, 611–623. doi: 10.1017/S0033291707001614 Google Scholar
Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D. and Gilbody, S. (2014). Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. Plos One, 9 (6), e100100. doi: 10.1371/journal.pone.0100100 Google Scholar
Fletcher, J. M. (2008). Adolescent depression: diagnosis, treatment, and educational attainment. Health Economics, 17, 1215–1235. doi: 10.1002/hec.1319 Google Scholar
Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J. et al. (2016). Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial. The Lancet Psychiatry. doi: 10.1016/S2215-0366(16)30378-9 Google Scholar
House of Commons Health Committee (2014). Children's and Adolescents’ Mental Health and CAMHS. Third Report of Session 2014–2015. London: The Stationary Office Limited. Retrieved from: http://www.publications.parliament.uk/pa/cm201415/cmselect/cmhealth/342/34202.htm Google Scholar
Lejuez, C. W., Hopko, D. R. and Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25, 255–286. doi: 10.1177/0145445501252005 Google Scholar
Lejuez, C. W., Hopko, D. R., Acierno, R., Daughters, S. B. and Pagoto, S. L. (2011). Ten year revision of the brief behavioral activation treatment for depression: Revised treatment manual. Behavior Modification, 35, 111–161. doi: 10.1177/0145445510390929 Google Scholar
Martell, C. R., Addis, M. E. and Jacobson, N. S. (2001). Depression in Context: Strategies for Guided Action. New York: Norton.Google Scholar
Martell, C. R., Dimidjian, S. and Hermann-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician's Guide. New York: Guilford.Google Scholar
McCauley, E., Gudmundsen, G., Schloredt, K., Martell, C., Rhew, I., Hubley, S. and Dimidjian, S. (2015). The adolescent behavioral activation program: Adapting behavioral activation as a treatment for depression in adolescence. Journal of Clinical Child & Adolescent Psychology, 45, 291–304. doi: 10.1080/15374416.2014.979933 Google Scholar
McLeod, G. F. H., Horwood, L. J. and Fergusson, D. M. (2016). Adolescent depression, adult mental health and psychosocial outcomes at 30 and 35 years. Psychological Medicine, 46, 1401. doi: 10.1017/S0033291715002950 CrossRefGoogle ScholarPubMed
Miller, S. D. and Duncan, B. L. (2000) The Outcome Rating Scale. Chicago.Google Scholar
National Institute for Health and Care Excellence (2015). CG28: Depression in children and young people: Identification and management in primary, community and secondary care. NICE clinical guideline 28, September 2005; updated March 2015. Retrieved from: http://www.nice.org.uk/guidance/cg28 Google Scholar
National Institute for Health and Care Excellence (2016). CG90: Depression in adults: Recognition and management. NICE clinical guideline 90, October 2009; updated April 2016. Retrieved from: http://www.nice.org.uk/guidance/cg90 Google Scholar
National Society for the Prevention of Cruelty to Children (2015). Postcode lottery of waiting times in local mental health services. Retrieved from: https://www.nspcc.org.uk/fighting-for-childhood/news-opinion/postcode-lottery-of-waiting-times-in-local-mental-health-services/ Google Scholar
Orchard, F., Pass, L., Marshall, T. and Reynolds, S. (2016). Clinical characteristics of adolescents referred for treatment of depressive disorders. Child and Adolescent Mental Health. doi: 10.1111/camh.12178 Google Scholar
Pass, L., Brisco, G., Hodgson, E. and Reynolds, S. (2015a). Brief Behavioural Activation for depressed adolescents (Brief BA) Therapist Guide. Unpublished manual, University of Reading.Google Scholar
Pass, L., Brisco, G. and Reynolds, S. (2015b). Adapting brief Behavioural Activation (BA) for adolescent depression: A case example. the Cognitive Behaviour Therapist, 8, e17. doi: 10.1017/S1754470X15000446 Google Scholar
Pass, L., Hodgson, E., Whitney, H. and Reynolds, S. (2017). Brief Behavioural Activation treatment for depressed adolescents (Brief BA) delivered by nonspecialist clinicians: A case illustration. Cognitive and Behavioral Practice. doi: 10.1016/j.cbpra.2017.05.003 Google Scholar
Pass, L. and Reynolds, S. (2014). Treatment manual for Brief Behavioural Activation for depressed adolescents (Brief BA). Unpublished manual, University of Reading.Google Scholar
Pass, L., Whitney, H. and Reynolds, S. (2016). Brief Behavioural Activation (BA) for adolescent depression: Working with complexity and risk. Clinical Case Studies. doi: 10.1177/1534650116645402 CrossRefGoogle Scholar
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A. and Rohde, L. A. (2015). Annual research review: A meta‐analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345–365. doi: 10.1111/jcpp.12381 Google Scholar
Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C. et al. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial. The Lancet. Advance online publication. doi:10.1016/S0140-6736(16)31140-0 Google Scholar
Ruggiero, K. J., Morris, T. L., Hopko, D. R. and Lejuez, C. W. (2005). Application of behavioral activation treatment for depression to an adolescent with a history of child maltreatment. Clinical Case Studies, 2, 1–17. doi: 10.1177/1534650105275986 Google Scholar
Stem4 (2016). ‘A Time Bomb Waiting to Explode’, A Survey of GPs’ Concerns about Mental Health Services for Children and Young People [online report]. Retrieved from: http://www.stem4.org.uk/wp-content/uploads/2016/11/A-Time-Bomb-Waiting-to-Explode.pdf Google Scholar
Thapar, A., Collishaw, S., Pine, D. S. and Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379, 1056–1067.Google Scholar
Weisz, J. R., McCarty, C. A. and Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychological Bulletin, 132, 132–149. doi: 10.1037/0033-2909.132.1.132 CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.