Mind-body skills groups for adolescents with depression in primary care: A pilot study

Purpose
The rates of adolescents experiencing a major depressive episode (MDE) has steadily risen in the past decade. The Center for Mind-Body Medicine (CMBM) has developed a program that incorporates various methodologies (e.g., guided imagery, movement to music, writing and drawing) to help increase self-awareness and self-regulation in depressed individuals. This program has been shown to significantly decrease symptoms of posttraumatic-stress disorder in adolescents living in Gaza, but no study has investigated its effects on a U.S. population of adolescents experiencing depression, or within a primary care setting. Given increased emphasis on integration of mental and physical health care, innovative behavioral interventions that address depression in primary care are warranted. The objective of this pilot study is to establish feasibility and preliminary effectiveness for treating adolescents with depression in a primary care setting.
Methods
This pilot study will include 50 adolescents who attend a primary care clinic at the largest public hospital in Marion County, Indiana. Eligible participants will be between the ages of 13 to 17, have depression, and are willing to attend the mind-body skills groups at a primary care clinic. Referrals for potential participants will typically come from behavioral health clinicians at the primary care clinic. Adolescents who agree to participate (with parental consent) will be screened for depression, and will complete self-report measures during a baseline assessment, post-intervention assessment, and 3-month follow-up. Validated self-report measures will include questionnaires related to depressive symptoms, suicidality, mindfulness, rumination, self-efficacy, hope, and wellbeing. At post-intervention and 3-month follow-up, participants will also complete an acceptability assessment. Participants will attend a 10-week series of mind-body skills groups, run by certified and trained CMBM behavioral health clinicians (8-10 adolescents per group), to learn skills and exercises for coping with depression. Through the 2-year study period, 5-6 groups will complete the 10-week CMBM series.
Results
Current group enrollment includes 19 adolescents, who are primarily female (89.5%), African American (31.6%), and age 15 (x̅ = 15.05 ±1.3). At baseline, participants reported moderately severe depression (PHQ-9 x̅ = 14.9 ± 6.7, where 10 is considered moderately depressed), and 36% of the adolescents reported having suicidal ideation in the past month. On average, participants reported moderate levels of mental wellbeing, self-efficacy, and mindfulness. In addition, participants reported relatively high levels of depressive rumination (CRSQ x̅ = 38.7 ±8.6; 0-52 range), and moderately low levels of hopefulness (hope scale x̅ =21.8 ±5.0; 0-48 range).
Conclusions
This project is in progress and anticipated to be completed by spring 2019.