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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
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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