RESPOND

A randomised controlled trial to investigate the clinical effectiveness and cost-effectiveness of mindfulness-based cognitive therapy for depressed non-responders to Increasing Access to Psychological Therapies (IAPT) high-intensity therapies.

Start date

01 January 2021

End date

31 December 2022

Overview

Major Depression is a highly common and debilitating disorder. If not treated sufficiently, it tends to take a recurrent or chronic lifetime course that causes a significant burden and puts patients at increased risk for physical and neurodegenerative disorders. Since the introduction of the Increasing Access to Psychological Therapies Services (IAPT) many more patients in the UK are being provided with state-of-the-art psychological treatments for depression. However, about half of those who come to the end of this care pathway, have still not responded sufficiently.

Mindfulness-Based Cognitive Therapy (MBCT), a training combining intensive training in mindfulness meditation and components of cognitive therapy for depression, has previously been shown to be effective in treatment non-responders. However, further research is necessary to provide more definitive evidence. If our study shows that MBCT benefits people who haven’t improved after IAPT, it will justify its use in this context in the National Health Service (NHS) to help more patients with depression recover, an aim that seems particularly pertinent in these times.

Aims and objectives

We want to find out (a) whether MBCT can lead to lasting reductions in depressive symptoms in patients who have previously not responded to intensive psychological therapy in IAPT and (b) whether the treatment could be introduced at a reasonable cost.

In a randomised controlled trial (RCT), we will compare MBCT intervention to treatment-as-usual (TAU). We will work together with IAPT services across the UK to recruit 234 patients, who will be chosen by chance to either participate in MBCT or continue with what would be their usual care.

In order to make sure that the research is conducted safely, the MBCT treatment and all assessments will be delivered via videoconferencing. We will assess changes directly after the end of the treatment period and six months thereafter.

Funder

Team

Project team

Patient and public involvement

We talked to many people who have had MBCT and found great enthusiasm to support its use more widely. People with depression, including some who have experience of MBCT, have been involved at every stage of this project, helping us design the study. They are an integral part of our research team.

 

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Hannah Baber

Devon Partnership NHS Trust, Trial Manager

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Barabara Barrett

King’s College London, Health Economic Assessments and Analyses

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Barney Dunn

University of Exeter, Site Lead, Treatment Delivery and Recruitment, Qualitative Analyses

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TBA - Health Economist

King’s College London

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TBA Health Economist

King’s College London

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Asha Ladwa

University of Exeter, Research Assistant

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Floran Ruths

South London and Maudsley NHS Foundation Trust, Site Lead, Treatment Delivery and Recruitment

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Mary Ryan

Southbank University and Royal College of Psychiatry, Patient Representative

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Frances Stafford-Richardson

Sussex Partnership NHS Foundation Trust, Research Assistant

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Clara Strauss

Sussex Partnership NHS Foundation Trust, Site Lead, Treatment Delivery and Recruitment

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Sarah Walker

University of Exeter Clinical Trials Unit, Statistician

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Fiona Warren

University of Exeter, Clinical Trials Unit, Trial Statistician

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Allan Young

King’s College London, Site Lead, Research Oversight

Mindfulness teachers

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Florian Ruths

South London and Maudsley NHS Foundation Trust, Maudsley Mindfulness Centre

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Janet Wingrove

South London and Maudsley NHS Foundation Trust, Maudsley Mindfulness Centre

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Alison Evans

University of Exeter, Mood Disorders Centre

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Kay Octigan

University of Exeter, Mood Disorders Centre

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Bridgette O'Niell

Sussex Partnership NHS Foundation Trust, Sussex Mindfulness Centre

Collaborating IAPT services

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Grace Wong

Talking Therapies Southwark, South London and Maudsley NHS Foundation Trust

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Hielkje Verbrugge

Lambeth Talking Therapies, South London and Maudsley NHS Foundation Trust

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Jacqueline Ganley

IAPT Lewisham, South London and Maudsley NHS Foundation Trust

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Gabriele Dom

Croydon IAPT Psychological Therapies and Wellbeing Service, South London and Mausdley NHS Foundation Trust

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Juliet Couche

Health in Mind, Sussex Partnership NHS Foundation Trust

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Jackie Allt

West Sussex IAPT Service, Sussex NHS Community Trust

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Sue Pike

Talkworks, Devon NHS Partnership Trust