Youth depression is a serious, impairing condition. Its prevalence increases sharply following puberty, highlighting the public health significance of treatment in early adolescence. Our long-term goal is to develop and refine treatment for youth depression that is effective and deployable in a variety of youth settings. Here we focus on the setting in which evidence suggests most youth mental health care occurs: the school. Efforts to disseminate empirically supported cognitive behavioral therapies (CBTs) to schools have not been very successful to date, perhaps for at least 2 reasons: (a) the design of most CBT programs may have limited user appeal, and (b) CBT programs have not been shown to outperform current school-based interventions, so there is not a compelling logical case for change. In this application, we address both potential problems. To address the user appeal issue, we have drawn from the literature on robust design to restructure our own CBT program--Primary and Secondary Control Enhancement Training (PASCET) as a video-guided treatment. To address the case for change issue, we propose a trial of our video-guided treatment with a commonly used school-based treatment approach as the comparison condition. In the trial, 6th and 7th graders who meet diagnostic criteria for depressive disorders will be randomly assigned to the two conditions, matched for group format and treatment dose, and all treatment will take place in middle schools. Depression and other outcomes will be assessed at post-treatment and a 1-year follow-up.
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