Project title:
Evaluation of Interpersonal Counselling (IPC) Pilot
Hypothesis
- Does IPC (delivered by family support workers) lead to a reduction in depressive symptoms in adolescents with low mood?
- Is IPC delivered by youth workers acceptable to adolescents with low mood?
- Do youth workers find IPC an acceptable treatment to train in and deliver?
- What improvements should be made to IPC training and delivery for future trials?
Background
UK Child and Adolescent Mental Health Services (CAMHS) are delivered in a multi-tiered service[1]. NHS specialist CAMHS services are in tiers 3/4. The majority of cases are mild and are treated by tier 1 (universal/local authority/school services), and tier 1 has the majority of funding. Most tier 1 staff have minimal/no training in delivering treatments for people with emotional problems, and there is no evidence base as to what treatments to use. It is not appropriate for them to deliver the same evidence-based treatments as staff in tier 3, due to lower training levels, and relatively long length of treatment courses.
Interpersonal psychotherapy (IPT) is a NICE-recommended 1st line treatment for adults and adolescents with depression[2, 3]. It has been proven to be more effective than standard school counselling in depressed adolescents[4]. Interpersonal counselling (IPC) is an adaptation of IPT with three main differences: it can be delivered by staff without mental health training following a brief training course; it is for clients with sub-threshold/mild depression; it is shorter than IPT. It is thus likely to be appropriate for tier 1 CAMHS staff working with adolescents with sub-threshold/mild depression. A recent RCT proved IPC to be more effective than antidepressants in adults with mild depression in primary care[5].
IPC has not been tested in adolescents. This project will be a small single-arm pilot study of IPC delivered by local authority family support workers, progressing through the stages to a full NIHR-funded RCT (if early study stages suggest efficacy). If effectiveness is demonstrated, this has great potential to improve the services offered by tier 1 CAMHS, at little cost. This may reduce later onsets of moderate-severe depression and reduce referrals to tier 3.
1. NHS_Health_Advisory_Service (1995) Together We Stand: Commissioning, Role and Management of Child and Adolescent Mental Health Services (Stationery Office Books) 2. NICE (2005) Depression in Children and Young People 3. NICE (2009) Depression in adults. The treatment and management of depression in adults 4. Mufson L, et al. (2004) Arch Gen Psychiatry 61(6):577-584 5. Menchetti M, et al. (2014) Br J Psychiatry 204(2):144-150
For further information on this project please contact Dr Paul Wilkinson, Honorary Consultant in Child and Adolescent Psychiatry at pow12@cam.ac.uk
