A Hybrid Psychological Intervention for Depression in Adolescents

Hebei Medical University

Status: Completed

Conditions: Adolescent Depression

Treatments: Other: Treatment as Usual (TAU); Behavioral: Resilience-Satir Hybrid Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07104851

2021-S00443

Details and patient eligibility

About

This multi-center, randomized controlled trial was conducted to evaluate the efficacy and long-term effects of a novel hybrid psychological intervention, which combines Resilience Theory with the Satir Model, for adolescents diagnosed with depression. The study compared this intervention to treatment as usual (TAU) to determine its impact on depressive symptoms, psychological resilience, self-esteem, and overall quality of life.

Full description

Adolescent depression is a significant and growing public health concern. Traditional therapies have limitations, highlighting a need for innovative, engaging interventions. This study was designed to address this gap by developing and testing a hybrid model that integrates the strengths-based approach of Resilience Theory with the systemic, humanistic principles of the Satir Model. The study hypothesized that this combined intervention would be more effective than standard care in not only alleviating depressive symptoms but also in building lasting psychosocial resources. A total of 420 adolescents with depression were randomized to either the 12-week hybrid intervention group or a control group receiving treatment as usual. The intervention program was structured in three modules focusing on self-awareness, skill-building, and future-orientation. Outcomes were assessed at baseline, immediately post-intervention (12 weeks), and at a 6-month follow-up to evaluate the sustainability of the effects.

Enrollment: 420 patients

Sex: All

Ages: 13 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of a major depressive episode according to DSM-5 criteria, confirmed by two independent psychiatrists.
• First episode, with a duration of 4 weeks to 12 months.
• Age between 13 and 18 years.
• HAMD-17 score ≥ 17.
• Capable of normal communication.
• Provision of informed consent by both the adolescent and legal guardians.

Exclusion criteria

• Lifetime diagnosis of bipolar disorder, schizophrenia, or other psychotic disorders.
• Depression secondary to a general medical condition or substance use.
• Acute suicidal risk (score ≥ 4 on MADRS item 10) requiring immediate intensive care.
• Currently receiving structured psychotherapy.
• Severe neurological or physical illness that could interfere with participation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

420 participants in 2 patient groups

Experimental: Resilience-Satir Hybrid Intervention Group

Experimental group

Description:

In addition to treatment as usual (TAU), participants received a structured 12-week group nursing intervention program. The program consisted of one 90-minute session per week, co-facilitated by trained psychiatric nurses. The intervention included three modules: Module 1 (Weeks 1-4) focused on safety and identifying emotions using Satir's "Iceberg" metaphor and personal strengths; Module 2 (Weeks 5-8) focused on building skills in problem-solving, cognitive reframing, and congruent communication; Module 3 (Weeks 9-12) focused on integrating skills and future-planning.

Treatment:

Behavioral: Resilience-Satir Hybrid Intervention

Active Comparator: Treatment as Usual (TAU) Group

Active Comparator group

Description:

Participants received standard care, which included regular psychiatric assessments, pharmacotherapy as deemed appropriate by the treating psychiatrist (primarily SSRIs), and routine nursing care. Routine care consisted of general health education, basic supportive communication, and monitoring of symptoms and side effects. No structured psychotherapy was provided.

Treatment:

Other: Treatment as Usual (TAU)