Researchers based in the Department of Health Sciences at the University of York are conducting this work in partnership with Greater Manchester Mental Health NHS Foundation Trust who are the sponsor for the study. The Trial Managers at the University of York are responsible for running the study. This research is part of a 4-year research project that has been organised by The Department of Health Sciences at the University of York and the NHS. It has been paid for by a research grant from the National Institute for Health Research (NIHR). All research must be checked by a research ethics committee before it can go ahead. This makes sure the research is safe and fair.
Depression is a low mood that can last a long time or keep returning, affecting your everyday life. Depression does not only affect adults. Children and young people can get depressed too. It's important to get help early if you think your child may be depressed. The longer it goes on, the more likely it is to disrupt your child's life and turn into a long-term problem.
Symptoms of depression in children often include:
Your child may also:
Some children have problems with anxiety as well as depression. Some also have physical symptoms, such as headaches and stomach aches.
Problems at school and problem behaviour can be a sign of depression in children and young people.
Older children who are depressed may misuse drugs or alcohol.
Feeling down or depressed from time to time is normal. But if these feelings last 2 weeks or more, or start to affect everyday life, this can be a sign of depression.
Depression can develop slowly. Someone who's depressed does not always realise or acknowledge that they're not feeling or behaving as they usually do.
Often it's a partner, family member or carer who first realises that help's needed. They may encourage their friend or relative to see a GP, or find some other source of support.
Tips to help others with depression:
If the person you're worried about expresses suicidal feelings, you or they should contact a GP or NHS 111. If you're worried about any aspect of your child's mental health, you can call the charity YoungMinds' free parents' helpline for advice on 0808 802 5544 from Monday to Friday, 9.30am to 4pm.
Our treatment is based on Behavioural Activation (BA) which aims to improve people’s mood by encouraging them to take part in activities they may have stopped doing that they previously enjoyed, or which gave them a sense of achievement, or closeness to other people. Our BA is made up of 8 sessions each lasting around 40 minutes and delivered weekly, either in the clinic or online. The sessions help young people to identify activities that are meaningful and enjoyable and they are encouraged to take part in these activities, with the support of carers; young people aged 16 and over may sometimes prefer to nominate another adult for support. Young people will be shown how to set goals, use problem solving, learn methods to deal with stress and avoidance and will be taught what to do if they think they may have a relapse (i.e. are feeling better and then see symptoms return). All BA sessions have been developed from previous BA therapies and through discussions with professionals, carers and young people.
Psychoeducation (PE) for this study will be an online leaflet which aims to help young people understand what depression is, what they and others around them can do to help and signposting to support services. This will be distributed to every participant in the study.
We hope that BA helps your child to feel better, and that taking part in the research is valuable and rewarding for them. The research also provides an opportunity for an intervention that your child might otherwise not be able to access through CAMHS. We cannot be sure that BA or the usual care will work. However, we hope that the support that your child receives is useful in helping with their low mood and in learning some skills that they can use in the future if they feel down. By taking part your child will also be able to tell us what they think of the support they have received. This will be helpful in understanding how we can improve support for young people experiencing low mood in the future.
We do not know of any risks of BA, but you might find that your child may feel down whilst taking part in the research or notice that their symptoms have got worse (e.g. having trouble sleeping, change in appetite, irritability, change in ability to concentrate). Therefore, during the research it is very important that you and your child look out for signs of worsening mood. If this happens, we ask that you seek additional support if you feel it necessary. This may include contacting your child’s relevant CAMHS professional or GP. If you have any serious concerns, we ask that you take them to their local A&E department or call 999. If the research team or the CAMHS professional providing support to your child during the research (e.g. the person who provides therapy or signposts them to alternative support) felt that your child no longer had capacity (ability) to take part in the study at any point, they would be withdrawn. However, any data already collected would be kept.
Your child is under no obligation to take part. It is entirely voluntary and they are free to withdraw from the study at any time, without giving a reason.
You will be asked some questions to determine your child’s eligibility , and they will be asked to complete a short questionnaire. If they are suitable for the study and, if you and your child choose to take part, you will be asked to sign a consent form (if your child is aged 11-15). You and your child can withdraw your consent from the study at any time. The data provided up until this point will be retained, unless you ask specifically for this to be deleted.
You will then book in your first appointment with the researcher who will ask you and your child to complete a short questionnaire to see if they are still suitable for the study, and if they are then they will go on to complete the rest of the questionnaires. If we don’t feel your child is suitable at this stage or they do not wish to continue, they will go on to receive treatment as usual from CAMHS. The questionnaires will be in-person ideally at the local CAMHS office or at your home. If needed, it can be over the telephone or using videoconferencing. You will complete a set of questionnaires, and your child will complete a separate set of questionnaires.
To see if our BA is helpful, we would like to compare this to other forms of support that are usually offered to young people experiencing low mood. Therefore, if your child chooses to take part in the research they will either receive BA + PE , as well as CAMHS usual care (e.g. another type of talking therapy, signposting elsewhere, etc), or only PE and CAMHS usual care. This is decided through a process called ‘randomisation’, which is done by a computer and it is like flipping a coin. You and your child will then be informed whether they will receive BA+PE+usual care or PE+usual care.
The BAY study is a randomised control research trial, which means your child will be randomly assigned to one of two groups. It is important to note that the CAMHS treatment will NOT be affected, and regardless of the outcome of the randomisation, the treatment as usual will remain the same.
Your child can withdraw from the study at any point, you just need to let a member of the team know you wish to withdraw and you will be asked a couple of questions regarding the reasons why, these are completely optional to answer.
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