Team Communication Training for Children's Depression

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Diego

Disqualifiers: Not employed at Rady Children's

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

40 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Team Communication Training for children's depression?

The Family-Focused Treatment for Childhood Depression (FFT-CD) study shows that targeting family interactions can help manage childhood depression, suggesting that improving communication within the family, as in Team Communication Training, may be effective. ^{1 2 3 4 5}

Is Team Communication Training generally safe for use in humans?

The research does not provide specific safety data for Team Communication Training, but it highlights the importance of clear communication and training to reduce errors in clinical trials, which suggests a focus on safety and quality. ^{6 7 8 9 10}

How does Team Communication Training differ from other treatments for children's depression?

Team Communication Training is unique because it focuses on improving communication within the treatment team, which may enhance the overall support and effectiveness of care for children with depression. This approach is different from traditional treatments that primarily focus on the individual child or family dynamics. ^{2 11 12 13 14}

What is the purpose of this trial?

Pediatric depression is a global concern that has fueled efforts for enhanced detection and treatment engagement. While many health systems have implemented components of depression screening protocols, there is limited evidence of effective follow-up for pediatric depression. A key barrier to prompt service linkage is timely team communication and coordination between clinicians and staff across service areas. This project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The implementation strategy will target team mechanisms at the organizational-level and provider-level. Team communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the frequency of depression screening and timely service linkage. Findings are expected to yield better understanding of how to optimize team communication activities and patterns in the pediatric depression screening to treatment cascade. This should also culminate in improved patient engagement and outcomes, which are critical to address the youth mental health crisis.

Research Team

Nicole A Stadnick, PhD, MPH

Principal Investigator

UCSD Associate Professor

Eligibility Criteria

This trial is for healthcare teams within pediatric settings. It's designed to help improve how they talk and work together after a child screens positive for depression. The goal is to make sure kids get the right follow-up care quickly.

Inclusion Criteria

Employed as medical staff and/or a medical or health provider at Rady Children's Hospital San Diego

Experience providing or supporting care to children and adolescents with mental health care needs

Exclusion Criteria

Any individual that does not meet the inclusion criteria will be excluded from study participation.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Team Communication Training

Participants undergo team communication training, including didactic sessions, simulation exercises, and performance feedback.

6 months

Biweekly supervision meetings

Early Identification Universal Depression Screening

Providers and staff receive training in the depression screening tool and orientation to the clinical pathway.

6 months

Regular medical visits

Follow-up

Participants are monitored for safety and effectiveness after training and screening interventions.

6 months

Treatment Details

Interventions

• Team Communication Training

Trial Overview The study tests a team communication training program aimed at bettering the use of existing depression screening protocols in children. By enhancing teamwork, it hopes to increase regular screenings and ensure timely mental health services.

Participant Groups

Group I: Team Communication Training Condition Experimental Treatment 1 Intervention

The team communication training intervention will include: 1. Two initial 2-hour didactic sessions on effective communication between team members (information-based methods) and simulation exercises based on mock clinical cases (practice-based methods) 2. Biweekly performance feedback about intra-team communication in the electronic medical record (demonstration-based methods) provided during regularly scheduled supervision meetings 3. 1-hour booster coaching sessions approximately every 2 months. It is expected that team communication training will take place in the context of weekly or bi-weekly clinical supervision meetings to fit within routine clinical workflows.

Group II: Early Identification Universal Depression Screening Condition Active Control 1 Intervention

In the comparison implementation strategy (early identification universal depression screening), multiple discrete strategies will used including depression screening training in which providers and staff are provided: 1. Training in the depression screening tool (Patient Health Questionnaire) 2. Orientation to the clinical pathway (i.e., screening conducted at every urgent care or emergency department visit and every 30 days for all other medical visits) 3. Expectations for handoff to the next step in the care cascade

Who Is Running the Clinical Trial?

University of California, San Diego

Lead Sponsor

Trials

1,215

Recruited

1,593,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Family-Focused Treatment for Childhood Depression (FFT-CD) was found to be more effective than individual supportive psychotherapy, with 77.7% of children in FFT-CD showing significant improvement in depression symptoms compared to 59.9% in the other group during treatment.

Both treatment groups had similar recovery rates from depressive episodes (around 76-77%), but FFT-CD showed a lower rate of depressive recurrences and suicide attempts at the 9-month follow-up, highlighting the potential long-term benefits of family interventions in managing childhood depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and efficacy of a family-focused treatment for depression in childhood. Tompson, MC., Langer, DA., Asarnow, JR.[2021]

The Integrated Care Pathway (ICP) developed for treating adolescents with depression aims to improve treatment response by following a Clinical Practice Guideline and a measurement-based care framework, with outcomes assessed using the Childhood Depression Rating Scale - Revised (CDRS-R) over a 20-week period.

The study plans to recruit 30 participants at two outpatient sites, with the hypothesis that the ICP will lead to greater reductions in depressive symptoms compared to standard treatment, and if successful, will pave the way for a larger multi-center randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of an Integrated Care Pathway for Adolescents with Depression: A Pilot Clinical Trial Protocol. Courtney, DB., Cheung, A., Henderson, J., et al.[2022]

An Integrated Care Pathway (ICP) for treating adolescents with Major Depressive Disorder (MDD-A) was developed based on high-quality clinical guidelines, ensuring that treatment reflects the best available evidence.

The ICP includes multi-family psychoeducation, a 16-session Group Cognitive Behaviour Therapy, and regular team reviews, aiming to improve treatment consistency and outcomes for adolescents with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Way through the woods: Development of an integrated care pathway for adolescents with depression. Courtney, D., Bennett, K., Henderson, J., et al.[2021]

The Brazilian Portuguese version of the Pediatric Trigger Toolkit was successfully translated and adapted for use in Brazilian hospitals, involving a thorough validation process that included expert consensus and cultural adaptation.

The toolkit demonstrated a positive predictive value of 13.51% for identifying adverse drug events in pediatric patients, with antihistamine triggers being the most effective, indicating its potential utility in improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Brazilian Portuguese version of the Pediatric Trigger Toolkit is applicable to measure the occurrence of adverse drug events in Brazilian pediatric inpatients. Silva, LT., Modesto, ACF., Martins, RR., et al.[2020]

The comprehensive body system review (BSR) in the Safety Monitoring Uniform Report Form (SMURF) identified 129 additional adverse events (AEs) in pediatric patients, significantly more than the 48 AEs from the general inquiry and 16 from the drug-specific inquiry, highlighting its effectiveness in capturing important safety data.

Parents found the detailed BSR acceptable and satisfactory, while clinicians did not share the same level of acceptance, indicating a potential gap in the perceived utility of detailed adverse event reporting methods in pediatric psychopharmacology.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology. Greenhill, LL., Vitiello, B., Fisher, P., et al.[2007]

A systematic review of 130 studies on muscle strengthening training (MST) in youth revealed that only 33.8% reported on adverse events (AEs), highlighting a significant gap in safety monitoring during these interventions.

Among the studies that did report AEs, 40.1% documented at least one adverse event, with over half of the reported events (59.1%) linked directly to the training or testing, indicating a need for better definitions and reporting practices in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting of Adverse Events in Muscle Strengthening Interventions in Youth: A Systematic Review. Mack, DE., Anzovino, D., Sanderson, M., et al.[2023]

Family-Focused Treatment for Childhood Depression (FFT-CD) is a 15-session program that effectively addresses depression in children by enhancing family support and teaching cognitive-behavioral skills, showing positive outcomes in three case studies.

The treatment led to significant reductions in depressive symptoms for the children involved, with improvements maintained for up to 9 months after completing the program, highlighting its potential long-term efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-Focused Treatment for Childhood Depression: Model and Case Illustrations. Tompson, MC., Langer, DA., Hughes, JL., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

A manual-based intervention to address clinical crises and retain patients in the Treatment of Adolescents With Depression Study (TADS). [2019]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Development and efficacy of a family-focused treatment for depression in childhood. [2021]

3. Canada pubmed.ncbi.nlm.nih.gov

Effectiveness of an Integrated Care Pathway for Adolescents with Depression: A Pilot Clinical Trial Protocol. [2022]

4. Australia pubmed.ncbi.nlm.nih.gov

A Way through the woods: Development of an integrated care pathway for adolescents with depression. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Parent and Youth Preferences in the Treatment of Youth Depression. [2023]

6. Brazil pubmed.ncbi.nlm.nih.gov

The Brazilian Portuguese version of the Pediatric Trigger Toolkit is applicable to measure the occurrence of adverse drug events in Brazilian pediatric inpatients. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology. [2007]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Simulation Training to Improve Informed Consent and Pharmacokinetic/Pharmacodynamic Sampling in Pediatric Trials. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Reporting of Adverse Events in Muscle Strengthening Interventions in Youth: A Systematic Review. [2023]

10. Ireland pubmed.ncbi.nlm.nih.gov

Risk factors for near-miss events and safety incidents in pediatric radiation therapy. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Family-Focused Treatment for Childhood Depression: Model and Case Illustrations. [2020]

12. United States pubmed.ncbi.nlm.nih.gov

Developmental Demands of Cognitive Behavioral Therapy for Depression in Children and Adolescents: Cognitive, Social, and Emotional Processes. [2023]

13. India pubmed.ncbi.nlm.nih.gov

Depression in children and adolescents. [2004]

14. Switzerland pubmed.ncbi.nlm.nih.gov

The development of an RDoC-based treatment program for adolescent depression: "Training for Awareness, Resilience, and Action" (TARA). [2021]