Overview
The study is a two-arm comparative effectiveness research trial to that will evaluate the ability of the interventions, Competent Adulthood Transition with Cognitive-behavioral & Interpersonal Training (CATCH-IT) and Teens Achieving Mastery over Stress (TEAMS), to intervene early to prevent depressive illness and potentially other common mental health disorders. Using cluster randomization, 564 participants eligible for the study will be offered one of two different depression prevention programs in multiple sites in Chicagoland, Rockford, IL; Dixon, IL; and Louisville, KY. The study will also assess teens', parents' and providers' experiences with each intervention approach.
Description
The majority of mental, emotional and behavioral (MEB) disorders have an initial onset before age 24, with 20% annual incidence, with major depressive disorder (MDD) being the most common MEB. Health systems, eager to reduce costs, want to transition from the current "wait until sick enough for treatment" model for MDD to a preventive model. However, evidence is needed for (1) the comparative effectiveness of a "scalable intervention" and (2) an implementation model for such a scalable intervention in the primary care setting. This study is a comparative effectiveness trial evaluating the efficacy of two evidence-based cognitive-behavioral prevention (CBP) programs: Teens Achieving Mastery over Stress (TEAMS), the "gold standard," face-to-face, group therapy model, and Competent Adulthood Transition with Cognitive Behavioral, Humanistic and Interpersonal Training (CATCH-IT), a scalable, self-directed, technology-based model. Using cluster randomization, 564 eligible adolescents age 13-18 will be offered one of two different depression prevention programs in multiple sites in urban and suburban Chicago, IL; rural Western Illinois, including Dixon and surrounding towns; and Louisville, KY. The investigators will comprehensively evaluate patient-centered outcomes and stakeholder-valued moderators of effect at 2, 6, 12, and 18 month assessment points. Using a hybrid clinical trial design that simultaneously examines implementation process, the study will also assess adolescents', parents' and providers' experiences (i.e. efficacy, time commitment, cultural acceptability, and implementation cost) with each intervention approach.
Eligibility
Inclusion Criteria:
- Adolescents ages 13 through 18 years, and
- Adolescent must be experiencing an elevated level of depressive symptoms (Patient Health Questionnaire-9 Score = 7-14), and
- Adolescent will be included if they have a past, but not current history of depression.
Exclusion Criteria:
- Outside age range
- A current diagnosis of Major Depression
- DSM-V diagnosis of: schizophrenia, bipolar affective disorder, extreme current drug or alcohol abuse.
- Currently using medication therapy for depression, anxiety, or other internalizing disorders.
- Currently engaged in individual treatment for a mood disorder
- Currently engaged in a cognitive-behavioral group or therapy
- Any past psychiatric hospitalizations
- Any past self-harm attempt with moderate or greater lethality
- Current suicidal thoughts
- Not willing to comply with the study protocol
- Not willing to participate in the TEAMS groups
- Not willing to be audio recorded during TEAMS groups (only for TEAMS clinics)
- Unable to complete the PHQ-9 screening due to cognitive or intellectual impairment
- Did not complete phone assessment with MINI Kid by BCC
- Not affiliated with any of the P2P PCP or school-based clinic sites
- Parent/guardian does not speak English
- Parent/guardian has a cognitive or intellectual impairment.
- Participant Declined/Changed Mind/Uninterested in participating