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Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study

BACKGROUND: Computerised cognitive–behavioural therapy (CCBT) in the care pathway has the potential to improve access to psychological therapies and reduce waiting lists within Child and Adolescent Mental Health Services, however, more randomised controlled trials (RCTs) are needed to assess this. A...

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Autores principales: Wright, Barry, Tindall, Lucy, Hargate, Rebecca, Allgar, Victoria, Trépel, Dominic, Ali, Shehzad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001485/
https://www.ncbi.nlm.nih.gov/pubmed/31829300
http://dx.doi.org/10.1192/bjo.2019.91
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author Wright, Barry
Tindall, Lucy
Hargate, Rebecca
Allgar, Victoria
Trépel, Dominic
Ali, Shehzad
author_facet Wright, Barry
Tindall, Lucy
Hargate, Rebecca
Allgar, Victoria
Trépel, Dominic
Ali, Shehzad
author_sort Wright, Barry
collection PubMed
description BACKGROUND: Computerised cognitive–behavioural therapy (CCBT) in the care pathway has the potential to improve access to psychological therapies and reduce waiting lists within Child and Adolescent Mental Health Services, however, more randomised controlled trials (RCTs) are needed to assess this. AIMS: This single-centre RCT pilot study compared a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression at referral to evaluate the clinical and cost-effectiveness of CCBT (trial registration: ISRCTN31219579). METHOD: The trial ran within community and clinical settings. Adolescents (aged 12–18) presenting to their primary mental health worker service for low mood/depression support were assessed for eligibility at their initial appointment, 139 met inclusion criteria (a 33-item Mood and Feelings Questionnaire score of ≥20) and were randomised to Stressbusters (n = 70) or self-help websites (n = 69) using remote computerised single allocation. Participants completed mood, quality of life (QoL) and resource-use measures at intervention completion, and 4 and 12 months post-intervention. Changes in self-reported measures and completion rates were assessed by group. RESULTS: There was no significant difference between CCBT and the website group at 12 months. Both showed improvements on all measures. QoL measures in the intervention group showed earlier improvement compared with the website group. Costs were lower in the intervention group but the difference was not statistically significant. The cost-effectiveness analysis found just over a 65% chance of Stressbusters being cost-effective compared with websites. The 4-month follow-up results from the initial feasibility study are reported separately. CONCLUSIONS: CCBT and self-help websites may both have a place in the care pathway for adolescents with depression.
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spelling pubmed-70014852020-02-19 Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study Wright, Barry Tindall, Lucy Hargate, Rebecca Allgar, Victoria Trépel, Dominic Ali, Shehzad BJPsych Open Papers BACKGROUND: Computerised cognitive–behavioural therapy (CCBT) in the care pathway has the potential to improve access to psychological therapies and reduce waiting lists within Child and Adolescent Mental Health Services, however, more randomised controlled trials (RCTs) are needed to assess this. AIMS: This single-centre RCT pilot study compared a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression at referral to evaluate the clinical and cost-effectiveness of CCBT (trial registration: ISRCTN31219579). METHOD: The trial ran within community and clinical settings. Adolescents (aged 12–18) presenting to their primary mental health worker service for low mood/depression support were assessed for eligibility at their initial appointment, 139 met inclusion criteria (a 33-item Mood and Feelings Questionnaire score of ≥20) and were randomised to Stressbusters (n = 70) or self-help websites (n = 69) using remote computerised single allocation. Participants completed mood, quality of life (QoL) and resource-use measures at intervention completion, and 4 and 12 months post-intervention. Changes in self-reported measures and completion rates were assessed by group. RESULTS: There was no significant difference between CCBT and the website group at 12 months. Both showed improvements on all measures. QoL measures in the intervention group showed earlier improvement compared with the website group. Costs were lower in the intervention group but the difference was not statistically significant. The cost-effectiveness analysis found just over a 65% chance of Stressbusters being cost-effective compared with websites. The 4-month follow-up results from the initial feasibility study are reported separately. CONCLUSIONS: CCBT and self-help websites may both have a place in the care pathway for adolescents with depression. Cambridge University Press 2019-12-12 /pmc/articles/PMC7001485/ /pubmed/31829300 http://dx.doi.org/10.1192/bjo.2019.91 Text en © The Royal College of Psychiatrists 2019 http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Papers
Wright, Barry
Tindall, Lucy
Hargate, Rebecca
Allgar, Victoria
Trépel, Dominic
Ali, Shehzad
Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title_full Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title_fullStr Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title_full_unstemmed Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title_short Computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a UK randomised controlled trial pilot study
title_sort computerised cognitive–behavioural therapy for depression in adolescents: 12-month outcomes of a uk randomised controlled trial pilot study
topic Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001485/
https://www.ncbi.nlm.nih.gov/pubmed/31829300
http://dx.doi.org/10.1192/bjo.2019.91
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