DISCOVER Research Group
Adolescence is a key period for the prevention and treatment of depression and anxiety, as half of lifetime mental health problems start by the age of fourteen. However, few evidence-based treatments exist and current services are limited. Additionally, help-seeking is very low, particularly among black and minority ethnic groups.
The prevention and treatment of mental health difficulties in adolescents therefore merits efforts to develop effective and accessible forms of intervention. This research group is therefore exploring the feasibility and acceptability of school-based, open-access workshops for depression and anxiety in older adolescents.
Dr. June Brown
Other Research members
Dr Daniel Michelson
Dr Eva Bonin
Dr Nicola Morant
Dr Daniel Stahl
Lynn McKeague, Postdoctoral Research Worker
Emily Blackshaw, Research Worker
Lisa Fennelly, Research Worker (01/15 onwards)
DISCOVER Clinical team
Dr Irene Sclare
Dr Tessa Crombie
Lisa Fennelly (10/14 - 01/15)
History of the DISCOVER ‘How to Handle Stress’ workshop
Current Research Project
The DISCOVER workshop is based on an open-access service model originally developed by June Brown. This has been used successfully in community settings for adults with anxiety (Brown et al., 1999) and depression (Horrell et al., 2014). Key components are: (1) use of evidence-based cognitive-behavioural therapy (CBT) content; (2) an efficient one-day workshop format; (3) enhanced accessibility through self-referral. Taking the adult model as a starting point, an adapted version (DISCOVER) was produced for 16-18 year olds in a collaboration between clinical psychologists, young people, schools and youth organisations. The resulting DISCOVER ‘How to Handle Stress’ intervention is delivered on school premises by two clinical psychologists, using an interactive and engaging workshop format. The CBT content is specially adapted to address personal, relationship and academic stresses for older teenagers. Like the adult workshops, the intervention is delivered in a single day and can be accessed through self-referral. These arrangements are designed to be convenient for teenagers who are usually busy with school and other activities, while removing referral and waiting list barriers that commonly exist for specialist mental health services.
A pilot study (funded by Guys and St Thomas’ Charity) produced promising findings in terms of the DISCOVER workshop’s outcomes and accessibility. Significant improvements in depression and anxiety were observed when participants were assessed 12 weeks after a workshop, along with high levels of participant satisfaction. In terms of accessibility, there was good uptake from traditionally harder-to-reach groups such as black and minority ethnic students. The pilot also showed that teachers have an important role to play in encouraging young people’s workshop attendance.
The NIHR Research for Patient Benefit (RfPB) programme is funding a new study looking at the feasibility of undertaking a cluster randomised controlled trial of DISCOVER workshops. Consenting sixth-form pupils from ten schools are being randomly allocated to an immediate DISCOVER workshop, or a 3-month waiting list. Assessments of outcomes (anxiety, depression, well-being, quality of life) will be carried out at baseline and 3-month follow-up in order to support sample size calculations for a definitive phase III trial. Rates of data collection will be used to examine feasibility of outcome measures and assessment procedures at baseline and follow-up. Other key feasibility parameters include the proportions of students willing to participate and stay engaged in the study. Qualitative methods are being used to explore the acceptability of the intervention to students and teachers. Finally, the feasibility of a health-economic evaluation is also being explored.
Based on the results of the successful feasibility trial, Dr June Brown and colleagues have recently applied to the NIHR HTA for funds to run a cluster randomised controlled trial in 4 sites in the UK (London, Bath, Northampton and Manchester).
Research on Adult Workshops
Sclare, I., Malpass, E., Michelson, D.,Coster, F.,Brown, J.S.L. (2015) Development of CBT workshops for anxiety and depression in 16-18-year-olds: Early intervention for inner city youth. Child and Adolescent Mental Health, 20(2), 102-106.
Michelson, Daniel, Sclare, Irene, Stahl, Daniel, Morant, Nicola, Bonin, Eva-Maria, Brown, June S.L. (2016) Early intervention for depression and anxiety in 16-18 year olds: protocol for a feasibility cluster randomised controlled trial of open-access psychological workshops in schools (DISCOVER). Contemporary Clinical Trials, 48, 52-58.
McKeague, Lynn, Morant, Nicola, Blackshaw, Emily, Brown, June S. L. (2018)Exploring the feasibility and acceptability of a school-based self-referral intervention for emotional difficulties in older adolescents: Qualitative perspectives from students and school staff. Child and Adolescent Mental Health 23(3), 198-205.
Brown, June S.L., Blackshaw, Emily, Stahl, Daniel, Fennelly, Lisa , McKeague, Lynn, Sclare, Irene, Michelson, Daniel (2019) School-based early intervention for anxiety and depression in older adolescents: A feasibility randomised controlled trial of a self-referral Stress management workshop programme (“DISCOVER”). Journal of Adolescence, 71, 150-161.
Horrell, L., Goldsmith, K.A.,Tylee, A.T., Schmidt, U.H.,Murphy C.L.,Bonin, E-M., Beecham, J. and Brown, J.S.L. (2014) One-day CBT self-confidence workshops for people with depression: randomised controlled trial to assess clinical outcomes and investigate access by difficult to engage groups. British Journal of Psychiatry, 204, 222-233.
Brown, J.S.L., Cochrane, R. and Cardone, D. (1999) Running large-scale stress workshops for the general public: promotion methods, programme content, clients' satisfaction and drop-out rates. Journal of Mental Health, 8(4), 391-402.