Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 4:4:1596294.
doi: 10.3389/frcha.2025.1596294. eCollection 2025.

Community-based behavioural activation for depression in adolescents: feasibility study, survey and stakeholder consultations

Lucy Tindall  1 , Emily Hayward  1 , Jinshuo Li  1 , Philip Kerrigan  1 , Susan Metcalfe  2 , Lina Gega  2   3
Affiliations

Community-based behavioural activation for depression in adolescents: feasibility study, survey and stakeholder consultations

Lucy Tindall et al. Front Child Adolesc Psychiatry. .

Abstract

Background: Behavioural activation, a brief psychological therapy for depression across the lifespan lends itself well for delivery in community settings (e.g., non-hospital health services, schools, charities). Ahead of a randomised controlled trial, we wanted to "road-test" our recruitment and assessment processes, intervention materials and data collection tools, and understand (1): how BA can be delivered in community settings and by whom, (2) whether young people will adopt and complete it, (3) whether there are any observed changes in depression and anxiety and (4) whether usual care would be a feasible comparator.

Methods: In three settings-one community-based child and adolescent mental health service, one school, one charity-we offered up to 8 sessions of behavioural activation to 12-18-year-olds with mild-to-moderate depression. Stakeholder consultations helped us develop our research materials and processes. Self-report questionnaires assessing depression, anxiety, quality-of-life and resource use were completed by participants at baseline and 8-weeks. Professionals completed an online questionnaire about usual care for young people with depression in different settings, including types of support and staff delivering it.

Results: Twenty young people (average age 15 years, 17 females) consented; of those, 19 attended behavioural activation sessions (M = 7.4, SD: 1.5) and all 20 completed baseline and follow-up measures. For three-quarters of participants there was a "positive" change in scores (defined as a drop of ≥1 on the RCADS) from baseline to follow-up across all measures. A Resource Use Questionnaire for Adolescents collecting information about use of hospital and community-based health and social care services was developed and tested during the study. Intervention costs were modest at £207 (SD: £79) per participant for just over 5 h (M = 286 min, SD = 63 min) of contact on average with a professional.

Conclusions: Excellent intervention uptake and adherence (implying robust recruitment and assessment processes), retention to follow-up and data completeness, and a positive direction of change across all outcome measures justify the need for a fully powered randomised controlled trial comparing community-based behavioural activation with usual care for adolescents with mild-to-moderate depression. Furthermore, usual care rarely included behavioural activation, which made it a suitable comparator for a future randomised controlled trial.

Trial registration: https://doi.org/10.1186/ISRCTN30483950, identifier (ISRCTN, ISRCTN304839502).

Keywords: low mood; psychological therapy; school interventions; usual care; young people.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Scatterplots and bubble-plots indicating direction of change for each participant based on their RCADS scores (total, depression, anxiety) and transition in clinical status.
Figure 2
Figure 2
Scatterplot and bubble-plot indicating direction of change for each participant based on their CDRS-R raw scores and transition in clinical status.
See this image and copyright information in PMC

References

    1. World Health Organisation. Adolescent mental health: emotional disorders (2021). Available online at: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health (Accessed August 8, 2021).
    1. National Institute for Health and Care Excellence. NG134: Depression in children and young people: identification and management. NICE guideline (2019). Available online at: https://www.nice.org.uk/guidance/ng134 (Accessed July 13, 2021). - PubMed
    1. Clayborne ZM, Varin M, Colman I. Systematic review and meta-analysis: adolescent depression and long-term psychosocial outcomes. J Am Acad Child Adolesc Psychiatry. (2019) 58(1):72–9. 10.1016/j.jaac.2018.07.896 - DOI - PubMed
    1. Crenna-Jennings W, Hutchinson J. Access to Child and Adolescent Mental Health Services in 2019. London: Education Policy Institute; (2020). Available online at: https://epi.org.uk/wp-content/uploads/2020/01/Access-to-CAMHS-in-2019_EP... (Accessed July 13, 2021).
    1. Department of Health and Social Care and Department for Education. Transforming children and young people’s mental health provision: a green paper (2017). Available online at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (Accessed July 19, 2023).