Systematic Review (in progress)
We are currently conducting a systematic review to identify the most relevant evidence and existing work relating to our own research programme.
Stakeholder Consultation (ongoing)
Engagement with our stakeholders, including the professionals in schools and community organisations who will deliver the intervention, the young people who will undertake it, and their parents/guardians, is a hugely important part of our project. The feedback we have gathered to date has been critical in shaping the progress of our work, including the intervention materials – particularly the manual and worksheets, the patient information sheets plus consent forms, and several questionnaires associated with the study. We will continue to seek the input and guidance of representatives from these groups in shaping the development of the project.
Feasibility Study (completed)
Last year we completed a feasibility study with a single group of young people undertaking our Behavioural Activation (BA). Their feedback helped us to finalise the content and delivery format of the intervention for the larger randomised controlled trial (RCT) to follow.
Randomised Controlled Trial (commenced)
We are conducting a Randomised Controlled Trial (RCT) with 236 young people aged between 12 and 18 with mild to moderate depression. All the young people are being recruited from our participating sites, which include schools and local community organisations and charities, across the UK. Our RCT, by randomly allocating the young people who consented to participate in the project to receive either BA or usual care, will enable us to compare the effectiveness and acceptability of our BA intervention against usual care. We will record and monitor what “usual care” means in different community settings. We will monitor and report recruitment, randomisation, follow-up and adverse event rates. Interviews with both adolescents and professionals who support them will explore their experiences of BA in comparison to usual care.
We cannot give BA to everyone straightaway as we do not yet know whether it is more effective than existing approaches. The only way to tell this is by comparing BA against these existing approaches in a way that cancels out any other variables that may influence outcomes, for example, an individual’s personality and family circumstances.
Economic Evaluation (alongside the RCT)
Alongside the RCT, we will estimate whether BA is good value for money, immediately after completing the intervention and long-term. We will do this by conducting an economic evaluation and constructing an economic model. We will estimate the cost consequences of the intervention and of usual care for NHS and non-NHS agencies and undertake a within-trial cost-effectiveness analysis using the RCT’s data.
Finally, we will explore whether, how and why BA may work better, or less well, for different adolescent groups and in different community settings. We will make recommendations about how to roll out BA successfully and avoid pitfalls in its wider implementation in diverse community settings. We will monitor the impact of community-based BA on subsequent help-seeking from other agencies and on CAMHS referrals.