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‘Pesky gNATs’: investigating the feasibility of a novel computerized CBT intervention for adolescents with anxiety and/or depression in a Tier 3 CAMHS setting

Published online by Cambridge University Press:  01 December 2016

Rosanna Chapman*
Affiliation:
University of Bath, Bath, UK
Maria Loades
Affiliation:
University of Bath, Bath, UK
Gary O'Reilly
Affiliation:
University College Dublin, School of Psychology, Newman Building, Belfield, Dublin
David Coyle
Affiliation:
School of Computer Science, Science Centre – East, University College Dublin, Belfield, Dublin
Mags Patterson
Affiliation:
North Somerset Specialist Children's Community Services, The Barn, Clevedon, UK
Paul Salkovskis
Affiliation:
University of Bath, Bath, UK
*
*Author for correspondence: Dr R. Chapman, University of Bath, Claverton Down Road, Bath BA2 7AY, UK (email: rosanna.chapman@nhs.net).

Abstract

Increasingly, evidence suggests that computerized Cognitive Behavioural Therapy (cCBT) is effective at reducing adolescent anxiety and depression for young people in the general population or those ‘at risk’. However, less is known about the acceptability, feasibility and effectiveness of cCBT for adolescents with clinically significant levels of impairment. This study aimed to investigate the feasibility of using a novel cCBT intervention, ‘Pesky gNATs’, with adolescents aged between 13–18 years with anxiety and/or depression who met the criteria for specialist mental health services. Eleven participants were recruited from a Tier 3 child and adolescent mental health service (CAMHS). Recruitment, attendance and retention rates were recorded and qualitative feedback about the benefits and disadvantages of completing cCBT were obtained during the final session. In addition, a number of outcome measures were completed pre- and post- intervention to assess reliable and clinically significant change. The intervention was very brief comprising of just seven sessions. Participants showed high recruitment and retention rates. All participants who started the intervention completed it. All described the programme as useful and the majority identified several benefits. Four of 11 participants demonstrated reliable reductions in symptoms of depression and anxiety and six of 11 showed decreases in parent-reported symptoms of anxiety and depression following the seven-session intervention. This study demonstrates the acceptability and feasibility of using cCBT in a Tier 3 CAMHS setting. Further research is required to investigate the effect of Pesky gNATs on anxiety and depression in other Tier 3 settings.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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References

Recommended follow-up reading

Pennant, ME, Loucas, CE, Whittington, C, Creswell, C, Fonagy, P, Fuggle, P, Kendall, T (2015). Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis. Behaviour Research and Therapy 67, 118.Google Scholar
Stallard, P, Richardson, T, Velleman, S, Attwood, M (2011). Computerized CBT (think, feel, do) for depression and anxiety in children and adolescents: outcomes and feedback from a pilot randomized controlled trial. Behavioural and Cognitive Psychotherapy 39, 273284 CrossRefGoogle ScholarPubMed
Stasiak, K, Fleming, T, Lucassen, MF, Shepherd, MJ, Whittaker, R, Merry, SN (2016). Computer-based and online therapy for depression and anxiety in children and adolescents. Journal of Child and Adolescent Psychopharmacology 26, 235245.Google Scholar

References

Abeles, P, Verduyn, C, Robinson, A, Smith, P, Yule, W, Proudfoot, J (2009). Computerized CBT for adolescent depression (‘Stressbusters’) and its initial evaluation through an extended case series. Behavioural and Cognitive Psychotherapy 37, 151165.Google Scholar
Barrett, PM (2000). Treatment of childhood anxiety: developmental aspects. Clinical Psychology Review 20, 479494.CrossRefGoogle ScholarPubMed
Beck, AT, Haigh, EAP (2014). Advances in cognitive theory and therapy: the generic cognitive model. Annual Review of Clinical Psychology 10, 1, 124.Google Scholar
Bower, P, Gilbody, S (2005). Stepped care in psychological therapies: access, effectiveness and efficiency Narrative literature review. British Journal of Psychiatry 186, 1117.Google Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.Google Scholar
Calear, AL, Christensen, H, Mackinnon, A, Griffiths, KM, O'Kearney, R (2009). The YouthMood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents. Journal of Consulting and Clinical Psychology 77, 10211032.Google Scholar
Chorpita, BF, Moffitt, CE, Gray, J (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy 43, 309322.Google Scholar
Chorpita, BF, Yim, L, Moffitt, C, Umemoto, LA, Francis, SE (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behaviour Research and Therapy 38, 835855.CrossRefGoogle ScholarPubMed
Clarke, G, Kelleher, C, Hornbrook, M, DeBar, L, Dickerson, J, Gullion, C (2009). Randomized effectiveness trial of an Internet, pure self-help, cognitive behavioral intervention for depressive symptoms in young adults. Cognitive Behaviour Therapy 38, 222234.Google Scholar
Compton, SN, March, JS, Brent, D, Albano, A, Weersing, VR, Curry, J (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. Journal of the American Academy of Child & Adolescent Psychiatry 43, 930959.Google Scholar
Costello, E, Erkanli, A, Angold, A (2006). Is there an epidemic of child or adolescent depression? Journal of Child Psychology and Psychiatry 47, 12631271.Google Scholar
Coyle, D, McGlade, N, Doherty, G, O'Reilly, G (2011). Exploratory evaluations of a computer game supporting cognitive behavioural therapy for adolescents. Paper presented at the Proceedings of the SIGCHI Conference on Human Factors in Computing Systems.Google Scholar
Ebesutani, C, Chorpita, BF, Higa-McMillan, CK, Nakamura, BJ, Regan, J, Lynch, RW (2011). A psychometric analysis of the Revised Child Anxiety and Depression Scales – Parent Version in a school sample. Journal of Abnormal Child Psychology 39,173185.Google Scholar
Ellis, LA, Campbell, AJ, Sethi, S, O'Dea, BM (2011). Comparative randomized trial of an online cognitive-behavioral therapy program and an online support group for depression and anxiety. Journal of Cyber Therapy and Rehabilitation 4, 461467.Google Scholar
Fleming, T, Dixon, R, Frampton, C, Merry, S (2012). A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education. Behavioural and Cognitive Psychotherapy 40, 529541.Google Scholar
Ford, T, Goodman, R, Meltzer, H (2003). The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child & Adolescent Psychiatry 42, 12031211.Google Scholar
Friedberg, RD, Wilt, LH (2010). Metaphors and stories in cognitive behavioral therapy with children. Journal of Rational-Emotive & Cognitive-Behavior Therapy 28, 100113.Google Scholar
Gega, L, Marks, I, Mataix-Cols, D (2004). Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directions. Journal of Clinical Psychology 60, 147157.Google Scholar
Jacobson, NS, Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 12.Google Scholar
James, A, Soler, A, Weatherall, R (2007). Cochrane review: cognitive behavioural therapy for anxiety disorders in children and adolescents. Evidence-Based Child Health: A Cochrane Review Journal 2, 12481275.Google Scholar
Karver, MS, Handelsman, JB, Fields, S, Bickman, L (2006). Meta-analysis of therapeutic relationship variables in youth and family therapy: the evidence for different relationship variables in the child and adolescent treatment outcome literature. Clinical Psychology Review 26, 5065.Google Scholar
Kendall, P (1993). Guiding theory for therapy with children and adolescnts. In: Child and Adolescent Therapy (ed. Kendall, P.), pp. 322. NewYork: Guilford.Google Scholar
Khanna, MS, Kendall, PC (2010). Computer-assisted cognitive behavioral therapy for child anxiety: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology 78, 737745.Google Scholar
Law, D (2012). A practical guide to using service user feedback and outcome tools to inform clinical practice in child & adolescent mental health. some initial guidance from the children and young peoples’ Improving access to psychological therapies outcomes-oriented practice (CO-OP) group. Version 1.3. London: IAPT-NHS (http://www.iapt.nhs.uk). Accessed 24 July 2016.Google Scholar
Lenhart, A, Purcell, K, Smith, A, Zickuhr, K (2010). Social Media & Mobile Internet Use among Teens and Young Adults. Washington DC: Pew Internet & American Life Project.Google Scholar
Mackinnon, A, Griffiths, KM, Christensen, H (2008). Comparative randomised trial of online cognitive-behavioural therapy and an information website for depression: 12-month outcomes. British Journal of Psychiatry 192, 130134.Google Scholar
Marks, I, Cavanagh, K (2009). Computer-aided psychological treatments: evolving issues. Annual Review of Clinical Psychology 5, 121141.Google Scholar
Merry, S, Stasiak, K, Frampton, C, Shepherd, M, Fleming, T, Lucassen, M (2012). A randomised controlled non-inferiority trial of the effectiveness of SPARX, a computerised self-help intervention for adolescents seeking help for depression. British Medical Journal 344, e2598.Google Scholar
Miller, SD, Duncan, BL (2000). The Outcome and Session Rating Scales: Administration and Scoring Manual. Chicago: Institute for the Study of Therapeutic Change.Google Scholar
Miller, SD, Duncan, BL, Brown, J, Sparks, JA, Claud, DA (2003). The outcome rating scale: a preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy 2, 91100.Google Scholar
MRC (2008). Developing and Evaluating Complex Interventions: New Guidance. London: Medical Research Council.Google Scholar
NICE (2005). Depression in children and young people: Identification and management in primary, community and secondary care. Clinical Guideline 28 (NICE guideline).Google Scholar
O'Reilly, G, Coyle, D (2015 a). Pesky gNATs: a cognitive behaviour therapy computer game for young people with anxiety or low mood. Bristol: Handaxe Community Interest Company.Google Scholar
O'Reilly, G, Coyle, D (2015 b). The Pesky gNATs app. Bristol: Handaxe Community Interest Company.Google Scholar
Pennant, ME, Loucas, CE, Whittington, C, Creswell, C, Fonagy, P, Fuggle, P, Kendall, T (2015). Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis. Behaviour Research and Therapy 67, 118.Google Scholar
Richards, D, Richardson, T (2012). Computer-based psychological treatments for depression: a systematic review and meta-analysis. Clinical Psychology Review 32, 329342.Google Scholar
Sethi, S, Campbell, AJ, Ellis, LA (2010). The use of computerized self-help packages to treat adolescent depression and anxiety. Journal of Technology in Human Services 28, 144160.Google Scholar
Spence, SH, Donovan, CL, March, S, Gamble, A, Anderson, RE, Prosser, S, Kenardy, J (2011). A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. Journal of Consulting and Clinical Psychology 79, 629642.Google Scholar
Stallard, P, Richardson, T, Velleman, S (2010). Clinicians' attitudes towards the use of computerized cognitive behaviour therapy (cCBT) with children and adolescents. Behavioural and Cognitive Psychotherapy 38, 545560.Google Scholar
Stallard, P, Richardson, T, Velleman, S, Attwood, M (2011). Computerized CBT (think, feel, do) for depression and anxiety in children and adolescents: outcomes and feedback from a pilot randomized controlled trial. Behavioural and Cognitive Psychotherapy 39, 273284.Google Scholar
Stallard, P, Udwin, O, Goddard, M, Hibbert, S (2007). The availability of cognitive behaviour therapy within specialist child and adolescent mental health services (CAMHS): a national survey. Behavioural and Cognitive Psychotherapy 35, 501505.Google Scholar
Stasiak, K, Fleming, T, Lucassen, MF, Shepherd, MJ, Whittaker, R, Merry, SN (2016). Computer-based and online therapy for depression and anxiety in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26, 235245.Google Scholar
Stasiak, K, Hatcher, S, Frampton, C, Merry, SN (2014). A pilot double blind randomized placebo controlled trial of a prototype computer-based cognitive behavioural therapy program for adolescents with symptoms of depression. Behavioral Cognitive Psychotherapy 42, 385401.Google Scholar
Tunney, C, Cooney, P, Coyle, D, O’ Reilly, G (in press). Mindful Gnats: comparing young people's experience of technology-delivered versus face-to-face mindfulness and relaxation. British Journal of Psychiatry.Google Scholar
van der Zanden, R, Kramer, J, Gerrits, R, Cuijpers, P (2012). Effectiveness of an online group course for depression in adolescents and young adults: a randomized trial. Journal of Medical Internet Research 14, e86.Google Scholar
Wuthrich, VM, Rapee, RM, Cunningham, MJ, Lyneham, HJ, Hudson, JL, Schniering, CA (2012). A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety. Journal of the American Academy of Child & Adolescent Psychiatry 51, 261270.Google Scholar
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