Principal researchers
Dr Cate Bearsley-Smith, Professor Mark Oakley Browne
Institution
Monash University
Funding
$52,066
Award type
beyondblue Victorian Centre of Excellence
Project completion year
2009
Project brief
This project aimed to determine the impact of clinician training on treatment content and outcomes for adolescents presenting with a depressive disorder to a rural Child and Adolescent Mental Health Service (CAMHS). The study was based in regional Australia, within the CAMHS of a regional hospital. In particular, the impact on treatment and outcomes for patients when clinicians were trained in Interpersonal Psychotherapy for Adolescents (IPT-A) was compared to treatment as usual (TAU).
Stage 1 of the study was to implement a cluster randomisation trial across the service, however this was discontinued due to insufficient recruitment of adolescent patients and their parents.
Stage 2 aimed to describe the prevalence and treatment of depressive symptoms and disorders of 76 adolescents in the CAMHS. It also aimed to investigate the impact of training clinicians in IPT-A on clinical care.
Key findings
The data showed that all adolescents who participated in the trial had improved health as indicated by scores on the Health of the Nation Outcome Scale for Children and Adolescents scores (HoNOSCA), and the Children’s Global Assessment Scale (CGAS) scores.
There was no statistically significant difference between the clinical outcomes of treatment offered by clinicians who had been trained in IPT-A and those who had not. IPT-A training was, however, associated with a large effect size (0.5) in relation to improvement on the HoNOSCA, and a medium effect size (0.3) for the CGAS scores. This could be interpreted as showing a clinically significant relationship between IPT-A training and clinician rated outcomes within this CAMHS.
Implications for policy, practice and further research
It appears that training of CAMHS clinicians in IPT-A can offer a feasible and promising treatment for adolescents with depression, however this training provides no substantial improvement on clinical outcomes compared with TAU.
Adolescent data is needed to test this study’s suggestion that training and support for clinicians to practice IPT-A can benefit adolescents with depression. A further analysis to determine the cost-effectiveness of IPT-A compared with TAU would be beneficial to determine the most appropriate treatment for children and adolescents with a diagnosis of depression. To this end, the Chief Investigator of this research plans to provide IPT-A training in the hospital CAMHS to those clinicians who were not randomly allocated to receive it originally. The already IPT-A trained clinicians will be invited to share their experiences with the new trainees.