SPARX: A New and Effective Computerized, CBT Self-Help Intervention for Depression

Cognitive Behavioral Therapy StudyAccording to a recent randomized control trial published in the British Medical Journal, a new computerized cognitive behavior therapy (CBT) intervention, SPARX (Smart, Positive, Active, Realistic, X-factor thoughts), may reduce depressive symptoms in adolescents seeking treatment as much or more than treatment as usual. SPARX, which is similar in presentation to interactive fantasy avatar computer games, provides CBT interventions (e.g., psychoeducation, activity scheduling, behavioral activation, relaxation training, cognitive restructuring, and homework, etc.)  and sets and monitors real-life challenges. (See video demonstration below.)

In the current study, 187 adolescents (ages 12 to 19) with depressive symptoms participated in either the SPARX intervention or face-to-face-treatment as usual, and were followed up for three months. Results showed that symptom reduction among participants in the SPARX group was as great as the usual care group. Furthermore, recovery rates for the SPARX group were higher than usual care when participants completed at least four homework modules. These findings suggest that SPARX is, potentially, a less expensive and more accessible treatment alternative for depressed adolescents in primary care settings where the demand for treatment is often unmet.

Merry, S. N., Stasiak, K., Shepherd, M., Frampton, C., Fleming, T., & Lucassen, M. F. (2012). The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial. British Medical Journal, doi: 10.1136/bmj.e2598.

Adolescents with SSRI-resistant Depression show improved response to treatment that includes CBT

A new study in JAMA reported that approximately 60% of depressed adolescents respond adequately to initial treatments with a selective serotonin reuptake inhibitor (SSRI), but there is a lack of information about subsequent treatment strategies. Four treatment strategies were employed in this study including medication-switching alone (to a different SSRI or to venlafaxine) and medication-switching plus cognitive behavioral therapy (CBT). CBT in this study emphasized cognitive restructuring, behavioral activation, emotion regulation, social skills, and problem solving. Additionally, parent-child sessions emphasized decreasing criticism and improving support, family communication, and problem solving. The authors found that CBT plus a switch to either medication regimen showed a higher response rate than a medication-switch alone (and that there was no difference in response rate between venlafaxine and a second SSRI).

Study authors: D. Brent, G. Emslie, G. Clarke, K. D. Wagner, J. R. Asarnow, M. Keller, et al.