Plain English Summary
Background and study aims
Depression is one of the most common mental health conditions worldwide. The symptoms of depression can vary greatly from person to person, but generally include low mood, problems with sleeping and/or eating, and loss of interest in life. If a person experiences depression during adolescence, it can impact the rest of their life. Adolescent depression is often associated with mental health and social difficulties that often continue into adulthood, including higher social dysfunction, poorer academic performance, more physical ill health complaints and more completed suicides. The aim of this study is to assess the possibility of running a trial of a brief talking therapy in schools for adolescents with symptoms of depression. The study will take place in several secondary schools and sixth form colleges in the UK.
Who can participate?
Adolescents aged 16-18 who are showing signs of depression.
What does the study involve?
Participants are randomly allocated to one of two groups, who each receive a different type of talking therapy. Those in the first group receive an ‘imagery-based cognitive behavioural intervention’ and those in the second group receive ‘non-directive supportive therapy’. Both therapies involve three to four face to face sessions, lasting for up to 90 minutes. Participants in both groups are asked to complete three assessments: one before therapy, one after therapy and one three months later. Each assessment takes around an hour to complete.
What are the possible benefits and risks of participating?
Both talking therapies are likely to have some benefit as both aim to reduce low mood and improve self-esteem. There are no known risks of taking part in the study.
Where is the study run from?
King's College London (UK)
When is the study starting and how long is it expected to run for?
April 2015 to May 2019
Who is funding the study?
1. Health Education England (UK)
2. National Institute for Health Research (UK)
Who is the main contact?
Dr Victoria Pile (public)
A brief early intervention for adolescent depression that targets emotional memories: a feasibility randomised controlled trial
The aim of this study is to establish the practicality and acceptability of implementing a new early intervention for adolescent depression that targets emotional memories, within a school setting.
Psychiatry, Nursing and Midwifery Research Ethics Subcommittee of the College Research Ethics Committee (CREC) at Kings College London, 21/10/2016, ref: HR-16/17-3548
Intreventional feasibility randomised controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Eligible participants will be randomised by the Kings Clinical Trials Unit (KCTU). Participants will be randomised using block randomisation via a web interface. Randomly varying block sizes will reduce the predictability of the sequence. There will be two arms and allocation will be 1:1.
Both interventions will be delivered via individual therapy sessions and consist of three to four sessions, delivered by a clinical psychologist. Sessions will last up to a maximum of 90 minutes, with the possibility of young people taking breaks during the session if needed.
‘Imagery-based cognitive behavioural intervention’ (ICBI): The intervention will combine components of (A) imagery rescripting to reduce the distress associated with negative images and build positive future images and (B) memory specificity training to increase specificity and access to memories. ICBI will follow a treatment manual and will be accompanied by a therapy workbook.
‘Non-directive supportive therapy’ (NDST): NDST will involve planned delivery of individual sessions with an empathic, concerned professional for emotional support and discussion of participant-initiated options for addressing problems. This intervention is designed to control for factors that, other than active components of therapy, could contribute to change such as the passage of time and non-specific aspects of therapy (e.g. speaking to an empathic therapist). NDST will follow treatment guidelines.
Primary outcome measures
Feasibility and acceptability of the intervention is assessed by recording numbers of eligible participants, recruitment rate, retention rate outcome measure completion rate, data completeness, incidence of unexpected adverse events, data on adherence/compliance, and feedback questionnaires.
Secondary outcome measures
Principal clinical outcome
Depression is measured using the Mood and Feelings Questionnaire (MFQ; long version) pre-therapy, post-therapy and 3-month follow-up. (The short version of the MFQ will also be administered at each intervention session.)
1. Anxiety is measured using the Screen for Child Anxiety Related Disorders pre-therapy, post-therapy and 3-month follow-up
2. Symptoms of post-traumatic stress are measured using the Revised Impact of Event Scale: child version pre-therapy, post-therapy and 3-month follow-up
3. Response style is measured using the Children’s Response Style Questionnaire pre-therapy, post-therapy and 3-month follow-up
4. Self-esteem is measured using the Rosenberg Self-Esteem Scale pre-therapy, post-therapy and 3-month follow-up
5. Self-Concept Clarity is measured using the Self-Concept Clarity scale pre-therapy, post-therapy and 3-month follow-up
6. Mental Imagery for future events is measured using the Prospective Imagery Task pre-therapy, post-therapy and 3-month follow-up
7. Memory specificity is measured using the Autobiographical Memory Task pre-therapy, post-therapy and 3-month follow-up
8. Daily mood is measured for seven days using daily mood ratings pre-therapy and post-therapy
9. Emotional response (subjective ratings and heart rate variability) to autobiographical memories is measured using a positive memory recall task pre-therapy and post-therapy
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Aged 16-18
2. Informed consent
3. Willing and able to engage in psychological therapy and complete assessments
4. Scoring above clinical cut-off on Mood and Feelings Questionnaire (MFQ clinical cut-off ≥ 20).
Target number of participants
Participant exclusion criteria
1. Diagnosis of learning disability or significant head injury, neurological disorder or epilepsy
2. Unable to fluently communicate in spoken English
3. Unable to give informed consent
4. Factors contra-indicating imagery rescripting, e.g. high levels of current risk
5. Currently receiving therapy
6. Experiencing psychotic symptoms or depressed in the postnatal period (participants with comorbid physical illness or non-psychotic disorders such as anxiety will not be excluded)
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
King's College London
Institute of Psychiatry, Psychology and Neuroscience
Health Education England
Funding Body Type
Funding Body Subtype
National Institute for Health Research
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
1. Planned publication of trial protocol
2. Planned publication of outcomes to peer-reviewed journal within a year from end of trial.
3. Dissemination via conferences and to NHS services at a local level
IPD Sharing plan:
The datasets generated during and/or analysed during the current study will be available upon request from Dr Victoria Pile (email@example.com)
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting