For Professionals

CINIM is a research institute and cannot provide clinical support for depression. Therefore, all participants are required to have a medical doctor and/or mental health therapist. These health care professionals will be notified that their patient is interested in participating, as well as when additional depression support is required or if any follow up recommendations are being made. If a professional is not currently in place, CINIM will help the potential participant find one.

Research and Development Team:
The LEAP Project was created by researchers at The Canadian Institute of Natural and Integrative Medicine (Sabine Moritz, Patricia Paccagnan, Niki Venika Rickhi, Mary Kelly), in collaboration with health care professionals and mental health specialists from Alberta Health Services (Dr. John Toews, Dr. Badri Rickhi, Dr. Jordan Cohen), the University of Calgary (Dr. Hude Quan), Mount Royal University (Dr. Dawne Clark) and Spiritual Directions (John Griffith). The LEAP Project is supported by Ms. Janet Chafe, Director of Adolescent Mental Health (Alberta Health Services, Calgary Zone).

Funding:
The LEAP Project is funded by the Alberta Centre for Child, Family & Community Research, Sick Kids Foundation (Toronto), Alberta Health Services, the Dr. Rogers Prize (awarded to Dr. Rickhi September 2009), Viewpoint Charitable Foundation, and private donors.

Scientific and Ethics Approval:
Scientific approval was granted by the Child Health Research Office at the Alberta Children's Hospital. The LEAP Project received ethics approval from the Conjoint Health Research Ethics Board at the University of Calgary.

Background:
Depression in adolescents and young adults is a prevalent illness in Canada and presents a high burden for those affected and their families. In Canada, depressive disorders are on the rise and their onset is occurring earlier in life. There is a growing body of evidence suggesting that spiritual wellness may play a role in the recovery of depression. Considering the limitations of available treatments for depression and the significant burden of the disease there is a need for new treatment options that are safe, effective, affordable and acceptable to young people. Our previous research gives strong support to the idea of using a spiritually based intervention for depression.

Building on our work with depressed adults, our team has created an Internet-based Depression Treatment Program for young people. To our knowledge, no research has been conducted on using spiritual wellness as a self-study intervention in the management of depression in this population. This program could present an innovative and low cost treatment option for young patients with mild to moderate major depression.

Project Objectives:

  1. To pilot the Internet-based Depression Treatment Program with depressed teens and young adults in Calgary and area by:
    1. Obtaining preliminary estimates on the impact of the program on depression severity, response rates and remission rates to guide sample size estimations for a full size randomized trial.
    2. Evaluating if the suggested research methodology is feasible with respect to recruitment rate, patient burden and clinical implementation to guide design of a full size randomized trial.
  2. To gather feedback from depressed teens and young adults, their families and referral sources in the community (schools, family physicians, mental health outpatient services) on the perceived value of the program and on ways to make it available as a community resource for young people dealing with depression.

Research Questions:
Primary Research Question: Is a spiritual wellness program a potential intervention to reduce unipolar mild to moderate depression in teens and young adults?

Secondary Research Questions.

  1. Is the suggested research methodology feasible?
  2. How do depressed teens and young adults, their families, teachers, school counselors, family physicians and other mental health professionals working in the community assess the value (strengths and weaknesses) of the Internet-based Depression Treatment Program?

Methods:
Study Design: The Internet-based Depression Treatment Program will be pilot tested in a randomized, waitlist controlled trial.

Population: A total of 60 eligible young people (aged 13-24) with major depression of mild to moderate severity will be recruited. Participants must live in Calgary, its surrounding area, or be able to attend study visits in Calgary (4-5 appointments over 6 months)

Intervention: The intervention consists of a self-study, internet based, modular, 8 week program aims to nurture spiritual wellness by guiding participants through an exploration of life values. The program is presented through film clips, music and stories, and includes weekly visualization and relaxation techniques. Participants randomized to the Intervention Group will participate in an 8 week intervention period followed by a 16 week follow-up phase. All participants placed in the Delayed Intervention Group will participate in the Internet-based Depression Treatment Program after an initial 8 week waiting period.

Outcome Measures: The following measures will be taken throughout the pilot trial:

  1. Depression Severity (Children's Depression Rating Scale-Revised or the Hamilton Depression Rating Scale)
  2. Depression Response and Remission Rates (Children's Depression Rating Scale-Revised or the Hamilton Depression Rating Scale)
  3. Self-Rated Psychological Health (2nd Edition of the Piers Harris Children's Self-Concept Scale or the Six Factor Self-Concept Scale)
  4. Spirituality Level (Spiritual Well-Being Scale or the Spiritual Involvement and Beliefs Scale)
  5. Psychological Well Being, for adult participants only (Profile of Mood States)

Analysis: Analysis of the collected quantitative data will be predominantly descriptive and a content analysis will be performed on the qualitative data.

Project Evaluation:
Indicators of success for this project will focus on trial feasibility (recruitment, compliance and drop-out rates), depression reduction (remission rates) and program assessment by study participants and community members (physicians, teachers, school counselors and health professionals from mental health services).

Contact Info:
If you would like additional information, please contact the study coordinator at (403) 220-0022 extension 222 or LEAP@cinim.org.