A Pilot Study of Therapist Guided Activity Practice for Depressive Symptoms

Study Overview
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Brief Summary
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There is literature to support both the need for and efficacy of brief interventions for depressive symptoms, particularly among college students.Brief behavioral activation interventions (BATD) have gained recognition as efficacious treatments for depression; yet a recent study evidenced a substantial (39%) non-response rate (Kuyken et al., 2017). In accordance with behavioral models of depression, the treatment involves increasing activity and positive experience, to break the negative reinforcement cycle maintaining depressed mood. Thus, strategies that may facilitate increasing activity may improve BATD outcomes. The objective of the current study is to examine whether briefly practicing a target activity during an activity planning session (modified single session of BATD) increases the likelihood of completing the activity during the upcoming week. We hypothesized that guided activity practice may improve self-efficacy within session and activity completion in the upcoming week. We further aim to explore whether activity completion mediates depressive symptom change.

Official Title
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A Pilot Study of Therapist Guided Activity Practice for Depressive Symptoms

Conditions
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Depressive Symptoms

Intervention / Treatment
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* Behavioral: Activity Planning
* Behavioral: Therapist Guided Activity Practice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ages 18-65 University of Texas at Austin students currently enrolled in Introductory Psychology (PSY 301) Score >14 on Beck Depression Inventory during both pre-screening and baseline screen Avoidance rating >59 and Distress rating >39 on at least one item of the Avoidance Screen. Exclusion Criteria: Initiated psychotherapy or psychotropic medication in past 6 weeks Recent change (past 6 weeks) in psychotropic medication Current or past psychosis or mania

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Activity Planning Only<br> | Behavioral: Activity Planning<br>* The therapist will work with the participant to select a challenging, yet rewarding or value-driven activity that he/she can engage in 5x and monitor daily over the upcoming week.<br>|
| Experimental: Enhanced Activity Planning<br>Activity planning with therapist guided activity practice. | Behavioral: Activity Planning<br>* The therapist will work with the participant to select a challenging, yet rewarding or value-driven activity that he/she can engage in 5x and monitor daily over the upcoming week.<br>Behavioral: Therapist Guided Activity Practice<br>* The therapist will work with the participant to plan and carry out a brief in-vivo version of their goal/target activity. The therapist will guide the participant through the activity for approximately 15 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent Activity Completion Between Conditions | Participants will complete daily surveys for seven days following the initial visit. Participants will answer whether or not the activity was completed that day. Data will be collected using Qualtrics survey software. The outcome variable is the percentage of days the participant completed the activity. | Daily for 7 days | 
| Change in Self-Efficacy in Response to Therapist Guided Activity Practice | Following the activity planning portion of the initial visit, participants rate the degree of self-efficacy (confidence in ability to complete the goal) on a scale from 0 (no confidence) to 100 (complete confidence). Participants randomized to Enhanced Activity Practice condition will complete a second rating following the activity practice. The pre-to-post difference score in self-efficacy will be examined as a primary outcome. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depressive Symptoms | Severity of depressive symptoms will be measured at baseline and 1-week follow-up using the Beck Depression Inventory-II. | Baseline and 1 week follow-up | 
| Experiential Avoidance and Psychological Flexibility | Experiential avoidance and psychological flexibility will be measured at baseline and 1-week follow-up using the Acceptance and Action Questionnaire-II. | Baseline and 1 week follow-up | 
| Multidimensional Experiential Avoidance | Multidimensional experiential avoidance will be measured at baseline and 1-week follow-up using the Multidimensional Experiential Avoidance Questionnaire. | Baseline and 1 week follow-up |