title: Early intervention for depression and anxiety in 16-18-year-olds: Protocol for a feasibility cluster randomised controlled trial of open-access psychological workshops in schools (DISCOVER).
abstract: Adolescence is a vulnerable period for the development of mental health problems. The DISCOVER intervention aims to provide accessible, acceptable and cost-effective psychological support for stressed adolescents in inner-city secondary schools. The intervention uses age-appropriate cognitive-behavioural therapy (CBT) methods and materials, delivered in an interactive 1-day workshop with additional telephone support. An open-access entry route allows students to self-refer. This protocol describes a feasibility cluster randomised controlled trial (RCT) comparing DISCOVER with a waitlist control condition. The study will run across 10 clusters (secondary schools) in the inner London Boroughs of Southwark and Lambeth. Participants are students aged over 16years who are seeking help with anxiety and/or depressive symptoms. Key feasibility parameters relate to the proportion of students willing to participate in the research following publicity events; the proportion of students who complete the intervention; and response rates for outcome measures. Outcome variance estimates and intra-cluster correlations will be obtained for future power calculations. Qualitative methods will be used to explore the acceptability of the intervention and research procedures for students and school staff. The feasibility of an economic evaluation will also be examined. The results will (i) determine the appropriateness of proceeding to a definitive full-scale trial; and (ii) inform the development of an optimised version of the DISCOVER intervention that can be tested within feasible parameters.
authors.affiliation: CAMHS Research Unit, Dept of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, UK. Electronic address: daniel.m.d.michelson@kcl.ac.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Michelson
authors.affiliation: Southwark CAMHS, Child and Adolescent Mental Health Services Clinical Academic Group, South London & Maudsley NHS Foundation Trust, Mapother House, De Crespigny Park, London SE5 8AZ, UK. Electronic address: Irene.Sclare@slam.nhs.uk.
authors.forename: Irene
authors.initials: I
authors.lastname: Sclare
authors.affiliation: Dept of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Electronic address: daniel.r.stahl@kcl.ac.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Stahl
authors.affiliation: Division of Psychiatry, Faculty of Brain Sciences, UCL, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK. Electronic address: n.morant@ucl.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Morant
authors.affiliation: Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK. Electronic address: e.bonin@lse.ac.uk.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Bonin
authors.affiliation: Dept of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Electronic address: june.brown@kcl.ac.uk.
authors.forename: June S L
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D061345:Early Medical Intervention; D005006:Ethnicity; D005240:Feasibility Studies; D006801:Humans; D008131:London; D008913:Minority Groups; D012572:School Health Services; D013689:Telephone; D014505:Urban Population; D014850:Waiting Lists
keywords: Adolescents; Anxiety; CBT; Depression; Schools