Using a Text-message System to Engage Depressed Adolescents in Cognitive-behavioral Therapy Homework

University of Pittsburgh

Status: Completed

Conditions: Text Messaging; Major Depressive Disorder; Cognitive Behavior Therapy

Treatments: Behavioral: Paper and pen homework; Device: Text message system homework.

Study type: Interventional

Funder types: Other

Identifiers

NCT00919932

ACA-08-001-UPMC

Details and patient eligibility

About

The primary goal of the pilot is to test the feasibility and utility of using a text-messaging system to engage adolescents in improved homework adherence during cognitive-behavioral therapy (CBT) for major depressive disorder.

Full description

Adolescent major depressive disorder leads to recurrent episodes, increased rates of attempted and completed suicides, and persistent social impairment between episodes (Weissman et al 1999). Cognitive behavioral therapy (CBT) is an accepted first-line therapy for mild-moderate depression in adolescents. Integral to CBT is "homework" as it enhances mastery of newly learned coping strategies, facilitates generalization of skills to novel situations, increases self-efficacy, and ultimately reduces vulnerability to relapse (Detweiler et al 1999). Adherence to homework is a recognized problem in adults, and is similarly problematic in adolescents. One method of implementing CBT homework in a manner that is centric to current youth culture is through text messaging. By using a modern modality that many adolescents rely on for daily communication, there is the likelihood that they will find it more engaging than traditional modalities. Thus the potential that a text message system can help improve homework compliance in adolescents is significant, because improved homework adherence may ultimately be linked to improved clinical outcomes for these disorders with high rates of chronic morbidity and mortality.

Enrollment: 9 patients

Sex: All

Ages: 13 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• major depressive disorder
• own a cellular phone with text messaging capabilities

Exclusion criteria

• history of psychosis
• history of mental retardation
• active suicidal ideation or intent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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9 participants in 2 patient groups

Paper and pen homework

Active Comparator group

Description:

Treatment as usual: therapy homework is completed by paper and pen.

Treatment:

Behavioral: Paper and pen homework

Text-message homework

Experimental group

Description:

Experimental treatment: therapy homework is completed by text messaging.

Treatment:

Device: Text message system homework.