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A Pragmatic Randomized Controlled Trial of Computerized CBT (SPARX) for Symptoms of Depression among Adolescents Excluded from Mainstream Education

Published online by Cambridge University Press:  05 December 2011

Theresa Fleming ,
Robyn Dixon ,
Christopher Frampton  and
Sally Merry
Theresa Fleming*
Affiliation:
The University of Auckland, New Zealand
Robyn Dixon
Affiliation:
The University of Auckland, New Zealand
Christopher Frampton
Affiliation:
University of Otago, Christchurch, New Zealand
Sally Merry
Affiliation:
The University of Auckland, New Zealand
*
Reprint requests to Theresa Fleming, The University of Auckland, Department of Psychological Medicine, Private Bag 92019, Auckland 1142, New Zealand. E-mail: t.fleming@auckland.ac.nz
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Abstract

Background: Adolescents excluded from mainstream education have high mental health needs. The use of computerized Cognitive Behavioural Therapy (cCBT) has not been investigated with this group. Aims: To test the efficacy of the SPARX cCBT programme for symptoms of depression among adolescents in programmes for students excluded or alienated from mainstream education. Method: Adolescents (32; 34% Maori, 38% Pacific Island, 56% male) aged 13–16 with Child Depression Rating Scale Revised (CDRS-R) scores indicating possible through to almost certain depressive disorder were randomized to SPARX to be completed over the following 5 weeks (n = 20) or to waitlist control (n = 12). Assessments were at baseline, 5 weeks and 10 weeks. Those in the wait condition were invited to complete SPARX after the 5 week assessment. Results: Most participants (n = 26, 81%) completed at least 4 levels of SPARX and 22 (69%) completed all 7 levels. Among the 30 (94%) participants who began treatment as randomized and provided 5-week data, significant differences were found between cCBT and wait groups on the CDRS-R (baseline to 5-week mean change –14.7 versus –1.1, p<.001), remission (78% vs. 36%, p = .047) and on the Reynolds Adolescent Depression Scale (–4.6 vs. +3.2 p = .05) but not on other self-rating psychological functioning scales. In intent-to-treat analyses CDRS-R changes and remission remained significant. Gains were maintained at 10-week follow-up. Conclusions: SPARX appears to be a promising treatment for students with symptoms of depression who are in alternative schooling programmes for those excluded from mainstream education.

Keywords

AdolescentsdepressionCCBTcomputer

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 5 , October 2012 , pp. 529 - 541
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

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