Abstract
Background
Behavioral activation (BA) interventions are efficacious for depression, yet a substantial minority of patients do not respond to treatment. Strategies that facilitate activity outside of session may improve BA treatment outcomes. The objective of the current study was to examine whether briefly practicing a target activity (guided practice) during a modified single session of BA resulted in (1) higher homework completion and (2) improved self-efficacy compared to activity planning alone (control).
Methods
Participants (n = 100) were college students with depressive symptoms randomized to the guided practice (n = 50) and control (n = 50) conditions (NCT03327259). All participants selected an activity to monitor for 7 days with a goal of completing the activity five times. Self-report questionnaires were completed at baseline and 7-days later.
Results
There was a positive effect of guided practice on activity completion. Participants assigned to the guided practice condition evidenced a higher rate of activity completion relative to those assigned to the control condition. However, participants assigned to the guided practice condition did not evidence a greater improvement in self-efficacy for completing the targeted activity relative to the control condition.
Conclusions
These results support the potential utility of guided practice as a strategy for improving homework compliance in BA.
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Notes
Due to an experimenter error, two different versions of the BDI (I and II) were administered. Given that they are highly correlated and the BDI is validated for use in student samples, we chose not to change versions of the measure part way through the study.
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AS conceived of the study and discussed it with JAJS and CGB. ATS supervised the data collection and conducted the initial analyses. JS assisted with the statistical analyses and writing of the statistical methods and results sections. ATS wrote the manuscript and JAJS, JS, and CGB provided critical feedback throughout the writing process. All authors approved the final manuscript.
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Authors Aliza T. Stein, Jason Shumake, and Christopher G. Beevers declare that they has no conflicts of interest. Jasper A.J. Smits has received monetary compensation for his work as a clinical advisor to Big Health, Ltd.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
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Study procedures were in accordance with the ethical standards of the institutional review board of the University of Texas at Austin.
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Stein, A.T., Shumake, J., Beevers, C.G. et al. Therapist Guided Activity Practice for Depressive Symptoms in University Students: A Randomized Controlled Trial. Cogn Ther Res 44, 499–510 (2020). https://doi.org/10.1007/s10608-020-10095-3
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DOI: https://doi.org/10.1007/s10608-020-10095-3