The effect of behavioral activation play therapy in adolescents with depression: a study protocol for a randomized controlled trial

Abstract

Background Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends physical activity to reduce depressive symptoms in this population, compliance with this recommendation is often low. Furthermore, although behavioral activation therapy (BAT) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activities (GPA) can be particularly appealing to adolescents because they are considered to be enjoyable experiences. Thereby, they often have good uptake in adolescent populations. In this study, we integrated BAT and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression. Methods The study is a randomized controlled trial (RCT) with a single-blind, two-arm design, conducted to validate the effectiveness and applicability of BAPT for adolescent depression. On the basis of conventional treatment and care, we will compare the outcomes of BAPT and BAT. The intervention group and control group will receive nine sessions of BAPT or BAT, respectively. The number of adolescents recruited will be 200, with a 1:1 distribution ratio. Discussion This is the first RCT to explore the effectiveness and adaptability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We also hope to assess other possible clinical effects of BAPT. Trial registration: Chinese Clinical Trial Register Center, ChiCTR2300072671. Registered on 20 June 2023.