Perceptions and opinions on a computerised Behavioural Activation Programme for the treatment of depression in young people: A Thematic Analysis (Preprint)

BACKGROUND Depression is one of the leading causes of illness and disability in young people, with approximately twenty percent having experienced a depressive episode by the age of eighteen. Behavioural Activation (BA), a NICE recommended treatment for adults with depression has also shown preliminary evidence with young people. BA may have the potential to be adapted and delivered in a computerised format to address the barriers often associated with young people accessing support. However, in the development of new treatments, the limited effectiveness of some programmes has been attributed to a failure to tailor interventions to patients and practices. It is therefore essential that those for whom an intervention is being designed are involved in its development. OBJECTIVE This qualitative work explored the views and preferences of young people and healthcare professionals regarding the development of a new computerised BA therapy for young people with low mood/depression to ensure it was suitable for the target user. METHODS Semi-structured focus groups and individual interviews were conducted with young people (both those with experience of accessing support and those without) and healthcare professionals regarding the development of a new computerised BA therapy for young people with low mood/depression. Data were analysed using Thematic Analysis. RESULTS Twenty-seven individuals who were a combination of healthcare professionals and young people participated. Rich information pertaining to the important components of a new therapy including its content, presentation and delivery were collected. CONCLUSIONS Variations in perspectives highlighted the need to adopt a systemic approach in therapy development with the opinions of young people, both with experience of accessing mental health support and those without, and healthcare professionals incorporated.

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Computerised cognitive behaviour therapy for depression in adolescents: study protocol for a feasibility randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2014-006488 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006488 ◽

Cited By ~ 10

Author(s):

Barry Wright ◽

Lucy Tindall ◽

Elizabeth Littlewood ◽

Joy Adamson ◽

Victoria Allgar ◽

...

Keyword(s):

Cost Effectiveness ◽

Randomised Controlled Trial ◽

Young People ◽

Cognitive Behaviour Therapy ◽

Controlled Trial ◽

Behaviour Therapy ◽

Low Mood ◽

Cognitive Behaviour ◽

Randomised Controlled ◽

Mood Depression

IntroductionThe 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant medication is not recommended for initial treatment in young people due to concerns over high side effects, poor efficacy and addictive potential. Evidence suggests that cognitive behaviour therapy (CBT) is an effective treatment for depression and is currently one of the main treatment options recommended in adolescents. Given the affinity young people have with information technology they may be treated effectively, more widely and earlier in their illness evolution using computer-administered CBT (CCBT). Currently little is known about the clinical and resource implications of implementing CCBT within the National Health Service for adolescents with low mood/depression. We aim to establish the feasibility of running a fully powered randomised controlled trial (RCT).Methods and analysisAdolescents aged 12–18 with low mood/depression, (scoring ≥20 on the Mood and Feelings Questionnaire (MFQ)), will be approached to participate. Consenting participants will be randomised to either a CCBT programme (Stressbusters) or accessing selected websites providing information about low mood/depression. The primary outcome measure will be the Beck Depression Inventory (BDI). Participants will also complete generic health measures (EQ5D-Y, HUI2) and resource use questionnaires to examine the feasibility of cost-effectiveness analysis. Questionnaires will be completed at baseline, 4 and 12-month follow-ups. Progress and risk will be monitored via the MFQ administered at each treatment session. The acceptability of a CCBT programme to adolescents; and the willingness of clinicians to recruit participants and of participants to be randomised, recruitment rates, attrition rates and questionnaire completion rates will be collected for feasibility analysis. We will estimate ‘numbers needed’ to plan a fully powered RCT of clinical and cost-effectiveness.Ethics and disseminationThe current trial protocol received a favourable ethical opinion from Leeds (West) Research and Ethics Committee. (Reference: 10/H1307/137).Trial registration numberISRCTN31219579.

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Perceptions and opinions on a computerised Behavioural Activation Programme for the treatment of depression in young people: A Thematic Analysis (Preprint)

Journal of Medical Internet Research ◽

10.2196/19743 ◽

2020 ◽

Author(s):

Lucy Tindall ◽

Paul Toner ◽

Antonina Mikocka-walus ◽

Barry Wright

Keyword(s):

Young People ◽

Thematic Analysis ◽

Behavioural Activation ◽

Treatment Of Depression

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Behavioural activation for overweight and obese adolescents with low mood delivered in a community setting: feasibility study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2019-000624 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000624 ◽

Cited By ~ 1

Author(s):

Bronia Arnott ◽

Charlotte Emma Wray Kitchen ◽

David Ekers ◽

Lina Gega ◽

Paul Alexander Tiffin

Keyword(s):

Young People ◽

Controlled Trial ◽

Community Setting ◽

Diagnostic Interview ◽

Depression Symptoms ◽

Behavioural Activation ◽

Screening Process ◽

Low Mood ◽

Weight Problems

BackgroundMood and weight problems are common in young people, yet few treatments address both conditions concurrently. Behavioural activation (BA) has shown promise as a treatment for adults with comorbid obesity and depression. This study aimed to examine the feasibility and acceptability of a manualised BA treatment targeting weight and mood problems in young people.MethodsYoung people with low mood and weight difficulties were identified via a school-based screening process. Following a diagnostic interview, young people with clinically significant mood problems and concurrent overweight/obesity were invited to participate. A total of 8–12 sessions of BA were delivered by a graduate therapist to eight adolescents (four male) aged 12–15 years. Weight, mood and functioning were assessed before, during and after treatment, and a semistructured qualitative interview was conducted, along with selected outcome measures at 4 months’ follow-up.ResultsLow attrition and positive qualitative feedback suggested the intervention was acceptable. Trends towards a reduction in reported depression symptoms and improved functioning scores were observed at follow-up, with more mixed results for change in body mass index. Of those attending the 4-month follow-up, 57% (4/7) no longer met the screening threshold for major depressive disorder. However, low screening and baseline recruitment rates would pose challenges to executing a larger trial.ConclusionsBA delivered by a graduate therapist in a British community setting is an acceptable, feasible treatment for comorbid mood and weight problems in adolescence, and its effectiveness should be evaluated in an adequately powered randomised controlled trial.

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Co-Design and Open Trial of Starship Rescue, a Cognitive Behavior Therapy, Biofeedback, and Game-Based eHealth Intervention to Treat Anxiety in Children and Young People with Long-Term Physical Conditions (Preprint)

10.2196/preprints.26084 ◽

2020 ◽

Author(s):

Hiran Thabrew ◽

Karolina Stasiak ◽

Harshali Kumar ◽

Tarique Naseem ◽

Christopher Frampton ◽

...

Keyword(s):

Quality Of Life ◽

New Zealand ◽

Young People ◽

Preliminary Evidence ◽

Children And Young People ◽

Physical Conditions ◽

System Usability Scale ◽

Ehealth Intervention

BACKGROUND Approximately 10% to 12% of New Zealand children and young people have long-term physical conditions (also known as chronic illnesses) and are more likely to develop psychological problems, particularly anxiety and depression. Delayed treatment leads to worse physical and mental healthcare, school absence, and poorer long-term outcomes. Recently, electronic health (eHealth) interventions, especially those based on the principles of Cognitive Behavior Therapy (CBT), have been shown to be as good as face-to-face therapy. Biofeedback techniques have also been shown to enhance relaxation during the treatment of anxiety. However, these modalities have rarely been combined. Young people with long-term physical conditions have expressed a preference for well-designed and technologically-based support to deal with psychological issues, especially anxiety. OBJECTIVE This study aimed to co-design and evaluate the (i) acceptability and (ii) usability of a CBT and biofeedback-based, 5-module eHealth game called ‘Starship Rescue’ and (iii) to provide preliminary evidence regarding its effectiveness in addressing anxiety and quality of life in young people with long-term physical conditions. METHODS Starship Rescue was co-designed with children and young people from a tertiary hospital in Auckland, New Zealand. Following this, 24 young people aged 10 to 17 years were enrolled in an open trial, during which they were asked to use the game for an 8-week period. Acceptability of the game to all participants was assessed using a brief, open-ended questionnaire, and more detailed feedback was obtained from a subset of 10 participants via semi-structured interviews. Usability was evaluated via the System Usability Scale (SUS) and device-recorded frequency and duration of access on completion of the game. Anxiety levels were measured prior to commencement, on completion of the game, and 3 months later using the Generalized Anxiety Disorder 7-item scale (GAD-7) and Spence Child Anxiety Scales (SCAS), and at the start of each module and at the end of the game using an embedded Likert/visual analog scale. Quality of life was measured prior to commencement and on completion of the game using the Pediatric Quality of Life Scale (PEDS-QL). RESULTS Users gave Starship Rescue an overall rating of 5.9 out of 10 (range 3-10 and a mean score of 71 out of 100 (SD 11.7; min 47.5; max 90) on the System Usability Scale (SUS). The mean time period for use of the game was just over 11-weeks (78.8 days, 13.5 hours, 40 minutes). Significant reductions in anxiety were noted between the start and end of the game on the GAD-7 (-4.6 (p=0.000)), SCAS (-9.6 (p=0.005)), and the Likert/visual analogue scales (-2.4 (p=0.001)). Quality of life also improved on the PedsQL scale (+4.3 (p=0.042)). All changes were sustained at 3-month follow-up. CONCLUSIONS This study provides preliminary evidence for Starship Rescue being an acceptable, usable and effective eHealth intervention for addressing anxiety in young people with long-term physical conditions. Further evaluation is planned via a more formal randomized controlled trial. CLINICALTRIAL Australian New Zealand Clinical Trials Network Registry (ANZCTR): ACTRN12616001253493p;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371443 (Archived by WebCite at http://www.webcitation.org/6sYB716lf)

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Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000443 ◽

2017 ◽

Vol 46 (2) ◽

pp. 182-194 ◽

Cited By ~ 8

Author(s):

Laura Pass ◽

Carl W. Lejuez ◽

Shirley Reynolds

Keyword(s):

Mental Health ◽

Pilot Study ◽

Young People ◽

Adolescent Depression ◽

Psychological Intervention ◽

Clinical Effectiveness ◽

Evidence Based ◽

Behavioural Activation ◽

Evidence Based Treatments ◽

The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

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A systematic review into healthcare professionals’ attitudes towards self-harm in children and young people and its impact on care provision

Journal of Child Health Care ◽

10.1177/13674935211014405 ◽

2021 ◽

pp. 136749352110144

Author(s):

Lea Raquel Ribeiro Coimbra ◽

Amy Noakes

Keyword(s):

Young People ◽

Healthcare Professionals ◽

Educational Opportunities ◽

Emotional Impact ◽

Valuable Insight ◽

Care Provision ◽

Children And Young People ◽

Positive Attitudes ◽

Self Harm ◽

Impact Patient Care

Self-harming behaviours in children and young people are an alarming reality, with provision of effective treatment historically compromised. The present systematic literature review highlights attitudes displayed by healthcare professionals towards this health problem, providing valuable insight by analysing how these attitudes can impact patient care. Ten studies were included, allowing creation of a narrative synthesis of qualitative, quantitative and mixed-methods evidence. Six themes emerged: negativity, positivity, worry or fear, the emotional impact of working with these patients, professional roles and ward-dependent concerns. Overall, professional negativity towards this patient group, in the form of apprehensiveness, was accentuated by fear of worsening their symptoms. The attitude aforementioned impacts on treatment by hindering creation of meaningful therapeutic relationships. Educational opportunities that increase healthcare professionals’ knowledge of self-harm have the potential to provide invaluable power by promoting positive attitudes.

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‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽

10.1136/bmjopen-2020-041108 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041108

Author(s):

Isabella Joy de Vere Hunt ◽

Abigail McNiven ◽

Amanda Roberts ◽

Himesh Parmar ◽

Tess McPherson

Keyword(s):

Young People ◽

Skin Disease ◽

Healthcare Professionals ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Secondary Analysis ◽

Emotional Impact ◽

Skin Conditions ◽

The Uk ◽

Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

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On the bright side: Young people’s most positive memories of family foster care

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104520978691 ◽

2020 ◽

pp. 135910452097869

Author(s):

Anne Steenbakkers ◽

Steffie van der Steen ◽

Hans Grietens

Keyword(s):

Foster Care ◽

Young People ◽

Family Environment ◽

Thematic Analysis ◽

Normal Family ◽

Traumatic Experiences ◽

Family Foster Care ◽

Continuous Support ◽

Positive Memories ◽

Negative Memories

This study explored what contributes to successful family foster care from the perspective of young people by asking them about their most positive memory of family foster care. Forty-four Dutch adolescents and young adults (aged 16–28) participated in this study and shared their most positive memory in a short interview. Their answers were qualitatively analyzed using reflexive thematic analysis, supplemented with an analysis of the structure of their memories. The thematic analysis resulted in the themes Belongingness, Receiving support, Normal family life, It is better than before, and Seeing yourself grow. The structural analysis showed that young people both shared memories related to specific events, as well as memories that portrayed how they felt for a prolonged period of time. In addition, young people were inclined to share negative memories alongside the positive memories. These results highlight that, in order to build a sense of belonging, it is important that of foster parents create a normal family environment for foster children and provide continuous support. Moreover, the negative memories shared by participants are discussed in light of a bias resulting from earlier traumatic experiences.

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Feasibility study of a new behavioural activation programme for young people with depressed mood

Child and Adolescent Mental Health ◽

10.1111/camh.12474 ◽

2021 ◽

Author(s):

Bernadka Dubicka ◽

Susanne Marwedel ◽

Sabah Banares ◽

Amy McCulloch ◽

Taghrid Tahoun ◽

...

Keyword(s):

Young People ◽

Feasibility Study ◽

Depressed Mood ◽

Behavioural Activation

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Entrepreneurship Narration in Sandiaga Uno’s Instagram (A Study on 2019 Presidential Election Campaign)Entrepreneurship Narration in Sandiaga Uno’s Instagram: A Study on 2019 Presidential Election Campaign)

Jurnal Entrepreneur dan Entrepreneurship ◽

10.37715/jee.v10i1.1639 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Putri Handayani Lubis ◽

Maria Puspitasari

Keyword(s):

Quality Of Life ◽

Qualitative Research ◽

Social Media ◽

Risk Management ◽

Young People ◽

Thematic Analysis ◽

Presidential Election ◽

Election Campaign ◽

Presidential Election Campaign

Entrepreneurship often becomes an alternative profession, while in fact, being an entrepreneur is a strategic choice which is ideally based on strong determination and belief that it is able to change the quality of life. Sandiaga Uno used entrepreneurship narration during the 2019 presidential election campaign in his social media in order to influence the youth. The present study aimed to explore Sandiaga Uno’s entrepreneurship narration on Instagram and to identify the narration in influencing young people during the 2019 presidential election campaign. This study was categorized as qualitative research with thematic analysis. The result of the study found that Uno’s campaign narration focused more on hopes. His narration of entrepreneurship focused on motivating the Millenials without explaining further about the risk of being an entrepreneur and how to fund and maintain a business. Uno utilizes his background as an entrepreneur by motivating his campaign. Uno also invited celebrities and several Actors who have businesses to motivate young people to become entrepreneurs. Risk management needed in an entrepreneur because many entrepreneurs are not prepared to deal with risk so the business that was built cannot last. Likewise, there are still many entrepreneurs who cannot make the most of existing technology to develop its business because of its capacity.

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