Therapist Guided Activity Practice for Depressive Symptoms in University Students: A Randomized Controlled Trial

Abstract

Behavioral activation (BA) interventions are efficacious for depression, yet a substantial minority of patients do not respond to treatment. Strategies that facilitate activity outside of session may improve BA treatment outcomes. The objective of the current study was to examine whether briefly practicing a target activity (guided practice) during a modified single session of BA resulted in (1) higher homework completion and (2) improved self-efficacy compared to activity planning alone (control). Participants (n = 100) were college students with depressive symptoms randomized to the guided practice (n = 50) and control (n = 50) conditions (NCT03327259). All participants selected an activity to monitor for 7 days with a goal of completing the activity five times. Self-report questionnaires were completed at baseline and 7-days later. There was a positive effect of guided practice on activity completion. Participants assigned to the guided practice condition evidenced a higher rate of activity completion relative to those assigned to the control condition. However, participants assigned to the guided practice condition did not evidence a greater improvement in self-efficacy for completing the targeted activity relative to the control condition. These results support the potential utility of guided practice as a strategy for improving homework compliance in BA.