Skip to main content Accesibility Help
×
×
Home

A Pilot Double Blind Randomized Placebo Controlled Trial of a Prototype Computer-Based Cognitive Behavioural Therapy Program for Adolescents with Symptoms of Depression

  • Karolina Stasiak (a1), Simon Hatcher (a1), Christopher Frampton (a2) and Sally N. Merry (a1)
Abstract

Background: Depressive disorder is common in adolescents and largely untreated. Computers offer a way of increasing access to care. Computerized therapy is effective for depressed adults but to date little has been done for depressed adolescents. Aims: The objective of this study was to examine the feasibility, acceptability, and effects of The Journey, a computerized cognitive behavioural therapy (cCBT) program for depressed adolescents. Method: Thirty-four adolescents (mean age 15.2 years, SD = 1.5) referred by school counsellors were randomly assigned to either cCBT or a computer-administered attention placebo program with psychoeducational content (CPE). Participants completed the intervention at school. Data were collected at baseline, post-intervention and at a 1-month follow-up. The primary outcome measure was the Child Depression Rating Scale Revised (CDRS-R); secondary outcome measures were: RADS-2; Pediatric Quality of Life Inventory; Adolescent Coping Scale (short form); response and remission rates on CDRS-R. Completion rates and self-reported satisfaction ratings were used to assess feasibility and acceptabililty of the intervention. Results: Ninety-four percent of cCBT and 82% of CPE participants completed the intervention. Eighty-nine percent liked The Journey a lot or thought it was “okay” and 89% of them would recommend it for use with others as is or after some improvement. Adolescents treated with cCBT showed greater symptom improvement on CDRS-R than those treated with CPE program (mean change on cCBT = 17.6, CI = 14.13–21.00; CPE = 6.06, CI = 2.01–10.02; p< .001). Conclusions: It is feasible, acceptable and efficacious to deliver computerized CBT to depressed adolescents in a school setting. Generalizability is limited by the size of the study.

Copyright
Corresponding author
Reprint requests to Karolina Stasiak, Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. E-mail: k.stasiak@auckland.ac.nz
References
Hide All
Adelman, H. S. and Taylor, L. (1991). Early school adjustment problems: some perspectives and a project report. American Journal of Orthopsychiatry, 61, 468474.
Bulkeley, B. E. (2007). School Guidance Counsellors and Adolescent Depression: beliefs, knowledge and practice. The University of Auckland, Department of Psychological Medicine: unpublished Doctoral Thesis.
Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M. Z., et al. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147159.
Calear, A. L. and Christensen, H. (2010). Review of internet-based prevention and treatment programs for anxiety and depression in children and adolescents. The Medical Journal of Australia, 192, S12–14.
Cavanagh, K., Shapiro, D. A., Van Den Berg, S., Swain, S., Barkham, M. and Proudfoot, J. (2006). The effectiveness of computerized cognitive behavioural therapy in routine care. British Journal of Clinical Psychology, 45, 499514.
Christensen, H., Griffiths, K. M. and Jorm, A. F. (2004). Delivering intervention for depression by using the internet: randomised controlled trial. British Medical Journal, 328, 265269.
Cunningham, M. J., Rapee, R. M. and Lyneham, H. J. (2006). Feedback to a prototype self-help computer program for anxiety disorders in adolescents. Australian e-Journal for the Advancement of Mental Health, 5 (3). Retrieved from http://pubs.e-contentmanagement.com/doi/pdf/10.5172/jamh.5.3.216
Farrand, P., Perry, J., Lee, C. and Parker, M. (2006). Adolescents’ preference towards self-help: implications for service development. Primary Care and Community Psychiatry, 11, 7379.
Fergusson, D. M., Horwood, J. and Lynskey, M. T. (1993). Prevalence and comorbidity of DMS-III-R diagnoses in a birth cohort of 15 year olds. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 11271134.
Fleming, T., Dixon, R., Frampton, C. and Merry, S. (2011). A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education. Behavioural and Cognitive Psychotherapy, Online first, 1–13.
Fleming, T., Dixon, R. and Merry, S. (2012). It's mean!: the views of young people alienated from mainstream education on depression, help seeking and computerised therapy. Advances in Mental Health, 10, 110.
Frydeberg, E. and Lewis, R. (1993). Adolescent Coping Scale Admininistrator's Manual. Melbourne: Australian Council for Educational Research (ACER).
Kaltenthaler, E., Parry, G., Beverley, C. and Ferriter, M. (2008). Computerised cognitive-behavioural therapy for depression: systematic review. The British Journal of Psychiatry, 193, 181184.
Kataoka, S., Zhang, L. and Wells, K. (2002). Unmet need for mental health care among U.S. children: variations by ethnicity and insurance status. American Journal of Psychiatry, 159, 15481555.
Kessler, R. C., Avenevoli, S. and Merikangas, K. R. (2001). Mood disorders in childhood and adolescents: an epidemiologic perspective. Biological Psychiatry, 49, 10021014.
Khanna, M. S. and Kendall, P. C. (2008). Computer-assisted CBT for child anxiety: the coping cat CD-ROM. Cognitive and Behavioral Practice, 15, 159165.
Le Surf, A. and Lynch, G. (1999). Exploring young people's perception relevant to counselling: a qualitative study. British Journal of Guidance and Counselling, 27, 231243.
Lenhart, A. P. K., Smith, A. and Zickhur, K. (2010). Social Media and Young Adults. Washington, DC: Pew Internet and American Life Project.
Levy, A. J. and Land, H. (1994). School-based interventions with depressed minority adolescents. Child and Adolescent Social Work Journal, 11, 2135.
Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R. and Andrews, J. A. (1993). Adolescent psychopathology: prevalence and incidence of depression and other DSM-III R disorders in high school students. Journal of Abnormal Psychology, 102, 133144.
March, S., Spence, S. H. and Donovan, C. L. (2009). The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology, 34, 474487.
Merry, S., Stasiak, K., Frampton, C., Shepherd, M., Fleming, T. and Lucassen, M. (2012). A randomised controlled non-inferiority trial of the effectiveness of SPARX, a computerised self-help intervention for adolescents seeking help for depression. British Medical Journal, 344 (e2598). doi: 10.1136/bmj.e2598
Mission Australia (2005). National Youth Survey 2005: key and emerging issues. Sydney: Mission Australia.
National Institute for Clinical Excellence (2002). Computerised Cognitive Behaviour Therapy for Depression and Anxiety. Sheffield: University of Sheffield, School of Health and Related Research Rapid Reviews Group.
National Institute for Clinical Excellence (2004). Computerised Cognitive Behaviour Therapy for Depression and Anxiety Update: a systematic review and economic analysis. London: NICE.
National Institute for Health and Clinical Excellence (2006). Computerised Cognitive Behaviour Therapy for Depression and Anxiety: a review. London: NICE.
O'Kearney, R., Gibson, M. and Christensen, H. (2006). Effects of a cognitive-behavioural internet program on depression, vulnerability to depression and stigma in adolescent males: a school-based controlled trial. Cognitive Behaviour Therapy, 35, 4354.
Poznanski, E. O. and Mokros, H. B. (1996). Manual for the Children's Depression Rating Scale-Revised. Los Angeles: Western Psychological Services.
Proudfoot, J., Goldberg, D., Mann, A., Everitt, B., Marks, I. and Gray, J. A. (2003). Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychological Medicine, 33, 217227.
Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A., et al. (2004). Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry, 185, 4654.
Reynolds, W. M. (2002). Reynolds Adolescent Depression Scale, 2nd edn. (RADS-2): professional manual. Lutz: Psychological Assessment Resources.
Richardson, T., Stallard, P. and Velleman, S. (2010). Computerised cognitive behavioural therapy for the prevention and treatment of depression and anxiety in children and adolescents: a systematic review. Clinical Child and Family Psychology Review, 13, 275290. doi: 10.1007/s10567-010-0069-9
Stasiak, K. (2008). Computer-Administered Cognitive Behavioural Self-Help Intervention for Adolescents with Mild to Moderate Depressive Symptoms: programme development and examination of feasibility, efficacy and acceptability. Unpublished PhD thesis, University of Auckland.
Varni, J. W., Burwinkle, T. M. and Katz, E. (2004). The PedsQL in pediatric cancer pain: a prospective longitudinal analysis of pain and emotional distress. Journal of Developmental and Behavioral Pediatrics, 25, 239246.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
  • URL: /core/journals/behavioural-and-cognitive-psychotherapy
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed