Dismantling the relative effectiveness of core components of cognitive behavioural therapy in preventing depression in adolescents: protocol of a cluster randomized microtrial

BMC Psychiatry

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[1] 0000 0001 0835 8259, grid.416017.5, Department of Public Mental Health, Trimbos-institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500, Utrecht, AS, The Netherlands;0000 0004 0435 165X, grid.16872.3a, Department of Clinical, Neuro and Developmental Psychology and Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, PO Box 7057, 1007, Amsterdam, MB, The Netherlands;0000 0001 0835 8259, grid.416017.5, Department of Public Mental Health, Trimbos-institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500, Utrecht, AS, The Netherlands;0000000120346234, grid.5477.1, Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508, Utrecht, TC, The Netherlands;0000000092621349, grid.6906.9, Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands;0000000120346234, grid.5477.1, Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508, Utrecht, TC, The Netherlands;0000000122931605, grid.5590.9, Behavioral Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, Nijmegen, HE, The Netherlands;0000000120346234, grid.5477.1, Methodology and Statistics, University of Utrecht, P.O. Box 80.140, 3508, Utrecht, TC, The Netherlands;

关键词: Prevention;    Depression;    Adolescents;    Cognitive behavioural therapy;    Comparative effectiveness research;    Cost effectiveness;   

DOI  :  10.1186/s12888-019-2168-6

来源: publisher

【 摘 要 】

BackgroundBoth depressive disorder and subclinical depressive symptoms during adolescence are a major public health concern. Therefore, it is important that depression is detected at an early stage and is treated preventively. Prevention based on the principles of Cognitive Behavioural Therapy (CBT) has proven to be the most effective, however research has mainly focused on the effectiveness of “prevention packages” consisting of multiple CBT-components, rather than on the distinct CBT-components. This study will evaluate the relative effectiveness of four core components of CBT (cognitive restructuring (CR), behavioural activation (BA), problem solving (PS) and relaxation (RE)). In addition the relative (cost-)effectiveness of four different sequences of these components will be evaluated: (1) CR – BA – RE – PS, (2) BA – CR – RE – PS, (3) PS – GA – CR – RE and (4) RE – PS – BA – CR.MethodsWe will perform a non-blinded multisite cluster randomized prevention microtrial with four parallel conditions consisting of the four sequences. The four sequences of components will be offered in groups of high school students with elevated depressive symptoms. For each CBT-component a module of three sessions is developed. Assessments will be conducted at baseline, after each CBT-component, prior to each session, at post-intervention and at 6-month follow-up. Potential moderators and mediators will be evaluated exploratively to shed light on for whom the (sequences of) CBT-components are most effective and how effects are mediated.DiscussionThe potential value of the study is insight in the relative effectiveness of the four most commonly used CBT-components and four different sequences, and possible moderators and mediators in the prevention of depression among adolescents. This knowledge can be used to optimize and personalize CBT-programs.Trial registrationThe study is registered in the Dutch Trial Register (Trial NL5584 / NTR6176) on October 13, 2016.

【 授权许可】

CC BY