Research projects

Evaluating evidence-based treatment of depression in adolescents using Acceptance and Commitment Therapy (ACT) delivered in rural/regional services

Principal researchers

Dr Louise Hayes1,2, Dr Candice Boyd3, Jessica Sewell1, Julie Rowse2, Simone Turner1

Institution

University of Ballarat

Ballarat Health Services

Orygen Youth Health Research Centre, University of Melbourne

Funding

$116,200

Award type

beyondblue Victorian Centre of Excellence

Project completion year

2009

Project brief

Acceptance and Commitment Therapy (ACT) is a form of treatment for depression which has been used with adults and shows promise for adolescents. It engages an individual with new tasks, which allows them to discuss and experience their behaviour in new ways and expand their range of learned thought patterns. ACT aims to increase psychological flexibility, which is important for adolescents who face many changes as they go through life.

This project comprised two separate studies using ACT. The first study involved 38 participants and was conducted within a Child and Adolescent Mental Health service (CAMHS). This study compared the effectiveness of ACT to the usual treatment provided to adolescent clients with moderate to severe depression. The second study involved 66 participants and was conducted within schools. This compared a group therapy program for adolescents with mild to moderate depression to an enhanced waitlist condition who received support and monitoring.

In the mental health services study, participants were randomised to receive either individual ACT or treatment as usual. Participants included adolescents with moderate to severe depressive symptoms, as well as adolescents with co-morbid disorders. 

In the school study, adolescents were randomised to either the ACT Experiential Program or an enhanced waitlist condition. At the time of selection, 35 per cent of the participants were in the clinical range for depression and the remainder were at sub-clinical levels, suggesting that the project was targeting an early intervention group.  Participants were selected by school counsellors. The group ACT program was delivered by the researchers in collaboration with professionals in the service systems.

Key findings

Both studies showed a significant reduction in depression after ACT.

In the mental health services study, participants demonstrated reduced levels of depression at the end of the trial, and the clinical improvement increased at three months follow-up. This is consistent with international ACT studies.

In the school study, adolescents involved in the treatment program were significantly less depressed and showed significantly more psychological flexibility than their counterparts in the enhanced waitlist condition. Qualitative evaluations also showed overwhelmingly that participants found the program beneficial. Participants reported that they enjoyed “not being judged” and “learning that everyone has difficulty with feelings”.

Additionally, training undertaken by public mental health and school-based professionals in a rural and regional setting improved both knowledge and networks.

Implications for policy, practice and further research

These findings show that ACT is effective in the treatment of adolescents with depression, in individuals and in groups, and in community settings. The results also show that a planned program of training and collaboration can be achieved and can deliver innovative treatments to adolescents while demonstrating effectiveness.

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