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Computer therapy reduced depression in adolescents

Adolescents seeking help for depression can benefit from computer therapy as much as they do from a live clinician, according to researchers from the University of Auckland.

The researchers investigated whether a computerized behavioral therapy program — SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) — could reduce depressive symptoms in adolescents. SPARX is a fantasy game that offers cognitive therapy treatments through first-person instruction. The patient selects an avatar and performs a series of challenges in a 3-D environment to “restore balance in a fantasy world dominated by GNATs (Gloomy Negative Automatic Thoughts),” according to researchers. The program is delivered on CD-ROM and can run on PCs, they wrote.

In a randomized controlled trial, researchers recruited 187 adolescents aged 12 to 19 years. All patients were seeking help for depression, deemed in need of treatment by their primary care clinicians and were not at major risk of self-harm. Ninety-four patients were randomly assigned to use SPARX, and 93 to in-person, usual treatment at youth clinics and youth-based counseling services.

Patients assigned to SPARX completed seven levels of the game. At the beginning and end of each level a “guide” would help patients conceptualize their progress, such as dealing with emotions, overcoming problems, recognizing helpful thoughts and challenging unhelpful thoughts. Researchers evaluated the primary treatment outcomes of SPARX patients and those assigned to usual treatment using the revised Children’s Depression Rating Scale (CDRS-R). Secondary outcomes were measured using the second edition Reynolds Adolescent Depression Scale (RADS-2) and other screening tools.

Results showed that SPARX was as effective as usual treatment in reducing depressive symptoms. At post-intervention, there was a mean reduction of 10.32 in SPARX patients and 7.59 in those assigned to usual treatment, as measured by the CDRS-R (between group difference, 2.73; 95% CI, –0.31 to 5.77). Remission rates were significantly higher among SPARX patients (43.7%) vs. patients attending usual treatment (26.4%), according to the researchers (difference, 17.3%; 95% CI, 1.6-31.8). Response rates between the two groups were comparable.

The researchers wrote that less than one-fifth of adolescents with depressive disorders receive treatment, in part because they may be reluctant to seek help. According to researcher Sally N. Merry, PhD, computerized behavioral therapy programs such as SPARX provide help for young people, especially for a generation so technologically adept.

“I am excited about our results,” Merry told Healio.com. “So many young people with depression never get help with it.  Many young people don’t want to talk to a therapist, and for those that do, a therapist is not always available. SPARX provides a way to get help for young people that is readily accessible for those who have access to a computer, and can be done at a time and place that suits them.”

Merry said although her research team does not have the funding to make SPARX available for purchase, she is working on distribution of the program.

“We will add a place on our website where people interested in accessing a copy can leave their email addresses and we can get in touch when we manage to find a way to distribute SPARX,” she said.