Randomised controlled trial of the effectiveness and cost-effectiveness of Adolescents and Carers using Mindfulness-Based Cognitive Therapy as a second-line intervention for residual or relapsed anxiety and depression
Background
Depression and anxiety in teenagers knock normal development off course and disrupt family relationships. Even after treatment, many young people still have symptoms, so we need more treatment options for this group who suffer greatly. We have developed a new treatment, ‘Mindfulness for Adolescents and Carers’ (MAC), in which young people and carers learn to recognise unhelpful patterns of thoughts and feelings and to find new ways of dealing with distress. Earlier work shows that carers and young people wanted to attend treatment sessions. They found mindfulness helpful and young people’s symptoms reduced.
Aims
Before we can test whether MAC works and is value for money, we need to answer four questions:-.
1. Who should be trained to deliver mindfulness, and how should they be trained?
Most mindfulness teachers have not worked in Child and Adolescent Mental Health Services (CAMHS) and most CAMHS practitioners have no experience of mindfulness. We therefore need to develop a training programme for suitable for people from either background to deliver MAC and test how best to support them to deliver it to a high, consistent standard.
2. What does ‘usual’ treatment look like for this group of young people?
We will interview young people, carers and therapists in CAMHS and analyse case notes. This will help us understand how this group are currently treated by CAMHS so we can make sure that we target those young people most likely to benefit from mindfulness.
3. How can young people and their carers best be recruited to a study on mindfulness?
We will run one mindfulness group in London and one in Devon with the new therapists we have trained. Young people and carers will be selected at random to either receive mindfulness or not. This will allow us try out ways of inviting people to this kind of research and to understand how many clinics we need to work when we test if MAC is effective.
4. How many young people would agree to provide blood and saliva to test biological changes that explain how the mindfulness treatment works or who is most likely to respond?
What will this study produce?
We will use what we have learned to plan programme of work to test whether MAC works, is value for money, how best can we identify, train and support clinicians to deliver MAC, how MAC might work and for whom it works best so we can target MAC to the young people most likely to benefit.
Involvement of patients
Young people and carers were involved in the design of this study from its conception. They will help us design the interview questions, understand our findings and explain our results to others.
Mindfulness training and children and adolescent mental health services survey
If you are a child mental health practitioner with interest or training in mindfulness-based interventions OR you are a mindfulness teacher with interest or experience in child mental health, please consider doing this short (5 min) survey to help us design teacher training for a new mindfulness-based therapy for depressed adolescents and their carers. This study is led by Professor Tamsin Ford at the Department of Psychiatry, University of Cambridge.
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