A Pilot Study of Therapist Guided Activity Practice for Depressive Symptoms

There is literature to support both the need for and efficacy of brief interventions for depressive symptoms, particularly among college students.Brief behavioral activation interventions (BATD) have gained recognition as efficacious treatments for depression; yet a recent study evidenced a substantial (39%) non-response rate (Kuyken et al., 2017). In accordance with behavioral models of depression, the treatment involves increasing activity and positive experience, to break the negative reinforcement cycle maintaining depressed mood. Thus, strategies that may facilitate increasing activity may improve BATD outcomes. The objective of the current study is to examine whether briefly practicing a target activity during an activity planning session (modified single session of BATD) increases the likelihood of completing the activity during the upcoming week. We hypothesized that guided activity practice may improve self-efficacy within session and activity completion in the upcoming week. We further aim to explore whether activity completion mediates depressive symptom change.

Study Overview

• Status: Completed
• Conditions: Depressive Symptoms
• Intervention / Treatment: Behavioral: Activity Planning; Behavioral: Therapist Guided Activity Practice

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Austin, Texas, United States, 78712
      • University of Texas at Austin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Ages 18-65
• University of Texas at Austin students currently enrolled in Introductory Psychology (PSY 301)
• Score >14 on Beck Depression Inventory during both pre-screening and baseline screen
• Avoidance rating >59 and Distress rating >39 on at least one item of the Avoidance Screen.

Exclusion Criteria:

• Initiated psychotherapy or psychotropic medication in past 6 weeks
• Recent change (past 6 weeks) in psychotropic medication
• Current or past psychosis or mania

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Activity Planning Only	Behavioral: Activity Planning; The therapist will work with the participant to select a challenging, yet rewarding or value-driven activity that he/she can engage in 5x and monitor daily over the upcoming week.
Experimental: Enhanced Activity Planning; Activity planning with therapist guided activity practice.	Behavioral: Activity Planning; The therapist will work with the participant to select a challenging, yet rewarding or value-driven activity that he/she can engage in 5x and monitor daily over the upcoming week.; Behavioral: Therapist Guided Activity Practice; The therapist will work with the participant to plan and carry out a brief in-vivo version of their goal/target activity. The therapist will guide the participant through the activity for approximately 15 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent Activity Completion Between Conditions	Participants will complete daily surveys for seven days following the initial visit. Participants will answer whether or not the activity was completed that day. Data will be collected using Qualtrics survey software. The outcome variable is the percentage of days the participant completed the activity.	Daily for 7 days
Change in Self-Efficacy in Response to Therapist Guided Activity Practice	Following the activity planning portion of the initial visit, participants rate the degree of self-efficacy (confidence in ability to complete the goal) on a scale from 0 (no confidence) to 100 (complete confidence). Participants randomized to Enhanced Activity Practice condition will complete a second rating following the activity practice. The pre-to-post difference score in self-efficacy will be examined as a primary outcome.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive Symptoms	Severity of depressive symptoms will be measured at baseline and 1-week follow-up using the Beck Depression Inventory-II.	Baseline and 1 week follow-up
Experiential Avoidance and Psychological Flexibility	Experiential avoidance and psychological flexibility will be measured at baseline and 1-week follow-up using the Acceptance and Action Questionnaire-II.	Baseline and 1 week follow-up
Multidimensional Experiential Avoidance	Multidimensional experiential avoidance will be measured at baseline and 1-week follow-up using the Multidimensional Experiential Avoidance Questionnaire.	Baseline and 1 week follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Behavioral Activation	Behavioral Activation will be measured at baseline and 1-week follow-up using the Behavioral Activation for Depression Scale.	Baseline and 1 week follow-up
Distress Intolerance	Distress intolerance will be measured at baseline and 1-week follow-up using the Distress Intolerance Index.	Baseline and 1 week follow-up
Anxiety Sensitivity and Distress Intolerance	As an additional measure of distress intolerance, the Anxiety Sensitivity Index will be measured at baseline and 1-week follow-up.	Baseline and 1 week follow-up
Anxiety Symptoms	Anxiety symptoms will be measured at baseline and 1-week follow-up using the Beck Anxiety Inventory.	Baseline and 1 week follow-up

Collaborators and Investigators

• Sponsor: University of Texas at Austin

Study record dates

Study Major Dates

• Study Start (Actual): October 9, 2017
• Primary Completion (Actual): April 5, 2019
• Study Completion (Actual): April 5, 2019

Study Registration Dates

• First Submitted: October 23, 2017
• First Submitted That Met QC Criteria: October 25, 2017
• First Posted (Actual): October 31, 2017

Study Record Updates

• Last Update Posted (Actual): December 10, 2019
• Last Update Submitted That Met QC Criteria: December 6, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 2017-02-0043

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No