Mental health problems affect a large portion of adolescents in the population, with depression being one of the most common conditions. This disorder is highly debilitating; it can affect the whole individual—psychologically, socially, and academically—and also has a major impact on society. If left untreated at a young age, depression can continue later on into adulthood.
Several forms of psychotherapy, including cognitive behavioral therapy (CBT), are recommended as first-choice options for the initial treatment of depression or even for cases of continued moderate-severe depression. Issues related to medication efficacy and side effects also make psychological interventions preferable options in mild-to-moderate depression. Despite its proven efficacy, CBT is not available to many in the population. There has been a call for researchers and clinicians to develop and implement low-intensity CBT interventions, which require reduced involvement of specialists. This is intended to make treatment available for wider populations, especially for those with milder cases of depression. Early interventions can have a tremendous impact on an individual’s overall health as well as an important financial relief on society. Given that many individuals use mobile devices throughout their day, one way to deliver these low-intensity CBT interventions is by making them available on mobile devices. The addition of a minimal coaching component can improve adherence rates for self-administered treatments. Also, delivering a more parsimonious form of therapy (pure behavioural activation, BA, rather than a full CBT) could achieve similar treatment outcomes with less intensive interventions. There is evidence that BA itself can produce positive effects in children and adolescents with depression; however, the literature is scarce for internet-based behavioural activation treatments.
Our ultimate goal is to help many adolescents with mild-to-moderate depression achieve symptom remission as soon as possible. To achieve this goal over a three-year study period, we will develop and test the usability and feasibility of a mobile intervention based on pure behaviour activation with minimal coaching for adolescents with mild-to-moderate depression. This intervention will be designed primarily for use on mobile devices, but also available from PCs and tablets for improved accessibility.
The development of this project will occur in three major stages:
- Initial planning phase: We will create the core content of the intervention based on evidence-based treatment protocols, along with a storyboard to communicate the concept and a dissemination plan to maximize its impact. During this phase, we will conduct a competitive analysis study and facilitate a session with stakeholders (experienced clinicians, policy makers, and patient representatives) to discuss our proposal and take their suggestions and comments into account.
- Design and development phase: We will design the application by following a user-centered design process. Multiple rounds of iterative design and testing with potential end users, first in the lab and then through a field study, will be conducted. Usability experts will consulted throughout the design process.
- Testing phase: We will test the feasibility and potential effects of the resulting product on depression (primary outcome), functional impairment and emotional difficulties (secondary outcomes) when compared with online psychoeducation. The results of this pilot RCT will be used to inform the design of a future full RCT.
The team is a group of experienced mental health and educational-technology professionals including psychiatrists, psychologists, and educators that have extensive experience in developing, implementing, and evaluating treatment protocols for health. This team also has experience integrating technology into the field of health to improve children and adolescents’ access to care at a national and international level.
|Patrick McGrath||Vanessa Varalli – Coordinator|
|Anna Huguet||Simon MacIntyre – IT|