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New research to combat depression in young people in North Yorkshire – large scale randomised controlled trial for this intervention

7 February 2022

A psychological treatment will be used to combat depression in young people as part of a new five-year research programme.

ComBAT (Community-based Behavioural Activation Training) will develop, implement and evaluate Behavioural Activation, a brief psychological therapy, for young people aged 12-18 years who have mild to moderate depression.

Clinicians and researchers from Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), Hull York Medial School, and the University of York are leading the research, which is being funded by the National Institute for Health Research (NIHR), the research partner of the NHS, public health and social care.

Behavioural Activation (BA) is based on one key principle:

That enjoyable, purposeful and meaningful activities can lift our mood, energise us and stimulate our interest and pleasure in day-to-day life. It helps people with depression re-engage with these activities, so that they can re-experience the emotional rewards of pleasure and achievement that are lost during depression.

The programme of work will take place across the Tees, Esk and Wear Valleys NHS Foundation Trust geographical area, which stretches from Country Durham and Teesside to North Yorkshire, including York. The team will recruit up to 300 young people from schools, third sector organisations and children and adolescent mental health services (CAMHS).

The behavioural activation sessions will guide and support each young person to identify, schedule, complete and monitor day-to-day activities that counteract avoidance and rumination and become sources of enjoyment and achievement.

These activities are a balance between pleasures such as playing music, exercising, reading, fashion or gaming, and necessary tasks or routines such as preparing food, washing, shopping, working, or caring for a family member or a pet.

The activities are tailored to the interests, circumstances, people and goals that are important to each young person. A graded and stepped approach to activities is used to overcome obstacles such as hesitation and tiredness that are to be expected with depression.

Professor Dave Ekers, Clinical Director for Research & Development at TEWV, said:

Behavioural Activation is a well-established and effective therapeutic intervention for adults, and we think it is a very promising intervention for young people, too.

There have been two pilot studies implementing Behavioural Activation in adolescents, but this will be the first large scale randomised controlled trial for this intervention.

ComBAT will adapt Behavioural Activation so that it can be supported by a wider group of professionals in schools and other community settings, such as young people’s charities, youth justice services and social care. As we continue to look closely at the mental health of our young people, we hope that ComBAT will bring us to the point where the key people supporting our youth can deliver a clinically informed intervention to treat depression.


Lina Gega, Professor of Mental Health at Hull York Medical School, University of York, who leads the project on behalf of the TEWV NHS Foundation Trust, said:

The ComBAT programme will evaluate the benefits, acceptability and value for money of Behavioural Activation compared to usual care for young people with mild to moderate depression.

Depression negatively affects young people’s lives, including their personal and academic development, their relationships with others and their sense of self. Schools and community agencies alongside the NHS play an important part in broadening access to clinically informed interventions that can change the trajectory of depression and improve young people’s lives.

Tees, Esk and Wear Valleys NHS Foundation Trust has an excellent track record in supporting and delivering studies in Behavioural Activation for adult populations; it is a great opportunity to build on this experience and expand the remit of this intervention to include adolescents.

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