A computerized self help intervention may help adolescents
who suffer from depression. The specialized computer therapy acts much the same
way as they do from one-to-one therapy with a clinician, according to a study
published on BMJ.
Depression is common in adolescents, but many are reluctant
to seek professional help. So researchers from the University of Auckland, New
Zealand, set out to assess whether a new innovative computerized cognitive behavioral
therapy intervention called SPARX could reduce depressive symptoms as much as
usual care can.
SPARX is an interactive 3D fantasy game where a single user
undertakes a series of challenges to restore balance in a virtual world
dominated by GNATs (Gloomy Negative Automatic Thoughts). It contains seven
modules designed to be completed over a four to seven week period. Usual care
mostly involved face-to-face counseling by trained clinicians.
The research team carried out a randomized controlled trial
in 24 primary healthcare sites across New Zealand. All 187 adolescents
were between the ages of 12 and 19, were seeking help for mild to moderate
depression and were deemed in need of treatment by primary healthcare
clinicians. One group underwent face-to-face treatment as usual and the other
took part in SPARX.
Participants were followed up for three months and results
were based on several widely used mental health and quality of life scales.
Results showed that SPARX was as effective as usual care in
reducing symptoms of depression and anxiety by at least a third. In addition
significantly more people recovered completely in the SPARX group (31/69 (44%)
of those who completed at least four homework modules in the SPARX group
compared with 19/83 (26%) in usual care).
When questioned on satisfaction, 76/80 (95%) of SPARX users
who replied said they believed it would appeal to other teenagers with 64/80
(81%) recommending it to friends. Satisfaction was, however, equally high in
the group that had treatment as usual.
The authors conclude that SPARX is an "effective
resource for help seeking adolescents with depression at primary healthcare
sites. Use of the program resulted in a clinically significant reduction in
depression, anxiety, and hopelessness and an improvement in quality of life."
They suggest that it is a potential alternative to usual care and could be used
to address unmet demand for treatment. It may also be a cheaper alternative to
usual care and be potentially more easily accessible to young people with
depression in primary healthcare settings.