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Is Behavioural Activation effective in the treatment of depression in young people? A Systematic Review and Meta-Analysis

Researchers from the University of York's Mental Health and Addiction Research Group (MHARG) have conducted a Systematic Review and Meta-analysis to examine whether BA is effective in the treatment of young people with low mood and depression.



Depression is currently the leading cause of illness and disability in young people. Evidence suggests that, Behavioural Activation (BA), a type of talking therapy, is an effective treatment for depression in adults and is included within NICE guidelines as an evidence-based treatment.

Although treatment recommendations and guidelines for individuals experiencing depression differ between adults and young people, given the extensive research supporting the use of BA with adults, we wanted to investigate whether it may be effective in treating young people also.


As part of an Economic and Social Research Council (ESRC) funded PhD, researchers within the University of York’s Department of Health Sciences have conducted a Systematic Review and Meta-analysis to examine whether BA is effective in the treatment of young people with low mood and depression.

Research suggests that young people experiencing depression may be treated more effectively using computerised therapies which have increased availability and accessibility, less stigma and are presented in a format attractive to many young people compared to traditional face-to-face therapies.  We therefore also examined whether any behavioural interventions included within the review had delivered BA in a computerised form.


Our systematic review examined studies that had delivered behavioural interventions to young people (aged 0 to 18 years) experiencing low mood/depression.  The electronic databases searched included the Cochrane Library, EMBASE, MEDLINE, CINAHL Plus, PsychINFO, and Scopus. A meta-analysis employing a generic inverse variance, random-effects model was conducted on included Randomised Controlled Trials (RCTs) to examine whether there were overall effects of BA on the Children’s Depression Rating Scale – Revised (CDRS-R).


Only ten studies met our inclusion criteria (3 RCTs and 7 within participant designs). Across all included studies, regardless of methodology, reductions in depression were evident following BA. At the individual level, several of the findings were statistically significant, and when the RCT studies were combined within the meta-analysis, a statistically significant difference in the CDRS-R scores from pre- to post-treatment was found in favour of BA. None of the included studies were delivered in a computerised format.

What's next?

Following on from our systematic review we are now conducting focus groups and face-to-face interviews with young people and health professionals about what a computerised BA program may look like.  Through combining the information we gather here with the findings of our systematic review we hope to develop a computerised BA program for use with young people (aged 11 to 16 years) experiencing low mood/depression. 

The final stage of the PhD will be to conduct a pilot study to examine the effectiveness of our newly developed computerised therapy.

If you would like more information on the BA Systematic Review and Meta-analysis, contact Lucy Tindall on lucy.tindall@york.ac.uk.

Lucy Tindall, Antonina Mikocka-Walus, Dean McMillan, Barry Wright, Catherine Hewitt and Samantha Gascoyne.

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