Brian Chu, Ph.D.

Fellow in Child & Adolescent Depression

Project Details

Mentors

John Abela, Ph.D.
Theodore Petti, M.D.


Institution

Rutgers University


Project

The Function of Avoidance in Depressed Behavior and a Pilot of Transdiagnostic Behavioral Activation Therapy


PROJECT TITLE

The Function of Avoidance in Depressed Behavior and a Pilot of Transdiagnostic Behavioral Activation Therapy

Project Summary

This study will develop treatment materials for a transdiagnostic Group Behavioral Activation Therapy (GBAT) and conduct a pilot school effectiveness study with 7th and 8th graders who show elevated co-occurring depression and anxiety. Depression and anxiety co-occur in up to 69-75% of diagnosed teens and intensify functional impairment, academic problems, and service use. Until recently, evidence-based approaches for multiple diagnoses required a therapist to prioritize treatment goals and treat one problem at a time, but this risks client drop-out before receiving essential treatment components. Research suggests that a “transdiagnostic” approach that targets common underlying processes may be more efficient and effective than treating disorders in a serial manner.

Currently, schools are the largest, and often only, provider of youth mental health care. Still, few empirically-supported treatments (ESTs) make it to schools, perhaps because most current ESTs require specialized training and are encoded in complex manualized protocols. The straightforward, pragmatic approach of GBAT can be more acceptable to non-specialized providers and easier to implement in schools. GBAT will be developed directly in schools to take into account factors that would likely impact its ultimate effectiveness, including acceptability to clients, therapist training, clinical supervision and community beliefs.

The second major goal of the project is to understand the functional role of avoidance in depression. Research has identified several cognitive and interpersonal processes that maintain depression, but we know less about the day-to-day behaviors of depressed youth, including the events that trigger a depressive response and the initial behavioral reactions that worsen the episode. The project will use electronic diaries to track day-to-day events, triggers, and child responses related to depressive moods.

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