BEAT-IT: A randomised controlled trial comparing a behavioural activation treatment for depression in adults with learning disabilities with an attention control

The Team Glasgow - Prof Andrew Jahoda (PI), Dr Craig Melville, Prof Anna Cooper, Prof Chris Williams, Dr Alex McConnachie (CTU), Prof Andy Briggs (Health Economics) Bangor/BCUHB - Prof Richard Hastings, Prof Robert Jones Lancaster/Cumbria NHS - Prof Chris Hatton, Prof Dave Dagnan Funding - £1.2 million from NIHR HTA

Background Psychological therapies for people with intellectual disabilities have mainly focused on the adaptation of cognitive behavioural models Yet CBT remains challenging for many people with intellectual disabilities Depression a more enduring problem? A British cohort found 15% of adults with ID compared with 3% of the non-ID population met the criteria for chronic depression (Collishaw et al, 2004).

Behavioural Activation – Why? Behavioural Activation (BA) is recommended as an effective treatment for depression (NICE Guidelines, 2009) Focuses on increasing meaningful activities and re- establishing daily routines to improve mood. Targets inherently reinforcing activity, and activity likely to increase access to other positive reinforcers More accessible for people with ID: less reliant on verbal ability Life circumstances - Socially isolated, often have little meaningful activity in their lives. Withdrawal, loss of motivation, loss of energy = fewer activities and further isolation

Design Participants will be randomised to either: 1) BEAT-IT for depression, or 2) Guided self-help. Chosen because it is a credible and ethical alternative intervention also acting as an attention control condition

Participants: Inclusion criteria Over 18 years old Clinically significant depression Is able to give informed consent to participate Has a family member or paid carer who has supported them for a minimum of six months, is available for weekly-fortnightly treatment sessions with the practitioner, and who currently provides a minimum of 2 hours support per week to the person

Key phases of the study: Wales monthsStudy set up period - started January – 16 months Recruitment of first 22 participants in Scotland From Jan 14Begin identification of 40+ participants in Wales May 14 - Mar 15 BA and guided self-help intervention 30 Sept 2016 Study completed Recruitment - NHS services, third sector organisations, social care providers, possible self/family referral

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