Condition category
Mental and Behavioural Disorders
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Background and study aims
We aim of this study is to test whether a school-based depression prevention programme developed in Australia, the Resourceful Adolescent Programme (RAP), is effective at reducing depressive symptoms in high-risk children in the UK.

Who can participate?
Children aged 13-16 from 9-12 mixed comprehensive schools in Bath, Bristol, Nottingham and Swindon

What does the study involve?
Participants complete a questionnaire. Their scores are used to categorise them as either low or high risk of depression or probably depressed. We want to find out what happens to the high risk group (about 20% of each class). Whole classes of children are randomly assigned to receive either the RAP, a placebo (dummy) intervention, or treatment as usual (Personal Health and Social Education - PHSE). For RAP and the placebo intervention each student has a workbook and sessions are led by trained and supervised mental health professionals. We assess children's mood, negative thoughts and self-image before we start and again at 6 and 12 months. This allows us to see whether RAP is effective and if these gains last. We also want to find out whether RAP is good value and so we work out how much it costs and what it saves.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Royal United Hospital (UK)

When is the study starting and how long is it expected to run for?
September 2008 to December 2011

Who is funding the study?
NIHR Health Technology Assessment Programme - HTA (UK)

Who is the main contact?
Prof. Paul Stallard

Trial website

Contact information



Primary contact

Prof Paul Stallard


Contact details

Department of Child and Family Psychiatry
Royal United Hospital
Combe Park
United Kingdom
+44 (0)1225 383860

Additional identifiers

EudraCT number number

Protocol/serial number

HTA 06/37/04

Study information

Scientific title

A single-blind randomised controlled trial to determine the effectiveness of group Cognitive Behaviour Therapy (CBT) in the prevention of depression in high risk adolescents


Study hypothesis

Group based CBT delivered in schools is effective and cost effective in preventing depression in adolescents at high risk of depression.

More details can be found at:
Protocol can be found at:

Ethics approval

University of Bath Ethical Committee: School for Health: School Research Ethics Approval Panel (SREAP), 18/12/2007

Study design

Cluster randomised controlled trial.

Primary study design


Secondary study design

Cluster randomised trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use contact details to request a participant information sheet




Interventions will be provided during the usual Personal, Social and Health Education (PSHE) sessions (1 hour per session, total of 11 sessions over one school term).

Arm A: Group CBT. CBT recognises the importance of negative thoughts and low self-worth/image in the onset and maintenance of depression. These are therefore actively targeted during CBT with core treatment components including psycho education, identifying and challenging negative/dysfunctional thoughts, identifying personal strengths (thereby enhancing self-esteem/image), managing social problems, and learning to problem solve.

Arm B: Attention placebo. The attention placebo intervention will involve similar time and contact with an external group leader but will not include the active components of the CBT intervention. The content will be based upon the PSHE provided in schools but will be provided by leaders from outside of the school. This will therefore control for the non-specific effects of interventions that are considered important in studies of depression.

Arm C: Usual PSHE

Intervention type



Not Specified

Drug names

Primary outcome measure

Changes in depression symptoms as assessed by the short form Mood and Feelings Questionnaire at 12 months follow-up.

Secondary outcome measures

1. Changes in self-image and negative thoughts. These will be assessed at 12 months by the following questionnaires:
1.1. Self Image Profiles (SIP-A). An easily competed 25-item scale for adolescents assesses how they perceive themselves and how they would like to be. Twelve items assess positive attributes (e.g. confident, fun to be with), twelve assess negative attributes (e.g. annoying, moody) and one is neutral (i.e. feel different from others).
1.2. Children's Automatic Thoughts Scale (CATS). This self-completed scale assesses a range of negative self statements in children and young people aged 7-16. For each item the child is asked to rate whether they have had a similar thought over the past week. Each item is rated as "not at all" (scores 0), "sometimes" (scores 1), "fairly often" (scores 2), "often" (scores 3) or "all the time" (scores 4). The 10-item personal failure sub-scale will be used.
2. Cost effectiveness at 12 months

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

All children aged 13-16 attending participating schools (n = 8-12)

Participant type


Age group




Target number of participants

5,000 children of whom 1,000 will be at "high risk" of depression.

Total final enrolment


Participant exclusion criteria

No exclusion criteria

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Royal United Hospital
United Kingdom

Sponsor information


University of Bath (UK)

Sponsor details

School for Health
United Kingdom

Sponsor type




Funder type


Funder name

Health Technology Assessment Programme

Alternative name(s)

NIHR Health Technology Assessment Programme, HTA

Funding Body Type

government organisation

Funding Body Subtype

National government


United Kingdom

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. 2010 protocol in:
2. 2012 results in: (added 08/05/2019)
3. 2013 results in:
4. 2014 cost-effectiveness results in:

Publication citations

  1. Results

    Stallard P, Montgomery AA, Araya R, Anderson R, Lewis G, Sayal K, Buck R, Millings A, Taylor JA, Protocol for a randomised controlled trial of a school based cognitive behaviour therapy (CBT) intervention to prevent depression in high risk adolescents (PROMISE)., Trials, 2010, 11, 114, doi: 10.1186/1745-6215-11-114.

  2. Results

    Stallard P, Phillips R, Montgomery AA, Spears M, Anderson R, Taylor J, Araya R, Lewis G, Ukoumunne OC, Millings A, Georgiou L, Cook E, Sayal K, A cluster randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents., Health Technol Assess, 2013, 17, 47, vii-xvii, 1-109, doi: 10.3310/hta17470.

  3. Anderson R, Ukoumunne OC, Sayal K, Phillips R, Taylor JA, Spears M, Araya R, Lewis G, Millings A, Montgomery AA, Stallard P, Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis., J Child Psychol Psychiatry, 2014, doi: 10.1111/jcpp.12248.

Additional files

Editorial Notes

08/05/2019: Total final enrolment and publication reference were added. 26/05/2016: Plain English summary added. 29/04/2008: due to a delay in ethics approval, the overall trial start and end dates were updated again. The previous dates were: Overall trial start date: 01/01/2008. Overall trial end date: 30/04/2012. 11/01/2008: the overall trial end date was changed from 30/04/2012 to 30/04/2011.