The Depression: Online Therapy Study (D:OTS)-A Pilot Study of an Internet-Based Psychodynamic Treatment for Adolescents with Low Mood in the UK, in the Context of the COVID-19 Pandemic

Nick Midgley, Brenda Guerrero-Tates, Rose Mortimer, Julian Edbrooke-Childs, Jakob Mechler, Karin Lindqvist, Susan Hajkowski, Liat Leibovich, Peter Martin, Gerhard Andersson, George Vlaescu, Peter Lilliengren, Annabel Kitson, Pamela Butler-Wheelhouse, Björn Philips, Nick Midgley, Brenda Guerrero-Tates, Rose Mortimer, Julian Edbrooke-Childs, Jakob Mechler, Karin Lindqvist, Susan Hajkowski, Liat Leibovich, Peter Martin, Gerhard Andersson, George Vlaescu, Peter Lilliengren, Annabel Kitson, Pamela Butler-Wheelhouse, Björn Philips

Abstract

Introduction: Face-to-face therapy is unavailable to many young people with mental health difficulties in the UK. Internet-based treatments are a low-cost, flexible, and accessible option that may be acceptable to young people. This pilot study examined the feasibility, acceptability and effectiveness of an English-language adaptation of internet-based psychodynamic treatment (iPDT) for depressed adolescents, undertaken during the COVID-19 pandemic in the UK. Methods: A single-group, uncontrolled design was used. A total of 23 adolescents, 16-18 years old and experiencing depression, were recruited to this study. Assessments were made at baseline and end of treatment, with additional weekly assessments of depression and anxiety symptoms. Results: Findings showed that it was feasible to recruit to this study during the pandemic, and to deliver the iPDT model with a good level of treatment acceptability. A statistically significant reduction in depressive symptoms and emotion dysregulation was found, with large effect size, by the end of treatment. Whilst anxiety symptoms decreased, this did not reach statistical significance. Conclusions: The findings suggest that this English-language adaptation of iPDT, with some further revisions, is feasible to deliver and acceptable for adolescents with depression. Preliminary data indicate that iPDT appears to be effective in reducing depressive symptoms in adolescents.

Keywords: adolescents; depression; internet-based therapy; psychodynamic.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CONSORT diagram. Note. YP = young person. QIDS = Quick Inventory of Depressive Symptomatology. TSW = therapeutic support worker.
Figure 2
Figure 2
Depression self-ratings (QIDS-A17-SR) over the course of treatment (n = 23). Notes: A slight vertical random jitter was applied to make lines distinguishable in the presence of overlapping sections. Improvement is measured as the difference between QIDS-A17-SR score at “pre” minus the last available measurement. screen: Measurement at screening. pre: baseline measurement. 1–9: measurements after sessions 1–9. post: measurement after session 10 (“end of treatment”).
Figure 3
Figure 3
Densities of baseline and end of treatment QIDS-A17-SR ratings. Notes: This graph shows smoothed and trimmed densities estimated from the QIDS-A17-SR distributions at baseline and at the last available measurement (end of treatment or before, if end of treatment measure was not available).

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