Learning how to feel good: Development of a novel therapy to target wellbeing and positive mood in depression

The primary focus in CBT for depression has been on down-regulating negative thinking and feeling. However, it is increasingly realised that anhedonia, a reduction in the ability to experience pleasure, is also central to the onset and maintenance of depression and should be paid more attention in treatment. Clients describe the repair of positive mood and broader wellbeing as a critical element of recovery from depression. This talk will review findings from secondary analyses of randomised controlled trials that show neither BA or CBT adequately repair positive mood and that low positive mood at the end of treatment predicts a greater likelihood of subsequent relapse. An overview of Augmented Depression Therapy (ADepT) will then be provided, a novel therapy that explicitly targets wellbeing and positive mood repair in depression. Findings from studies evaluating ADepT to date will be presented, including feasibility, clinical, and cost-effectiveness outcomes from a pilot randomised controlled trial comparing ADepT to high intensity CBT in the treatment of depression of 82 clients recruited predominantly from IAPT waiting lists. Results suggest ADepT is very unlikely to be inferior to, and may be superior to, CBT in repairing anhedonia, treating acute depression and preventing subsequent relapse. Health economic analyses also suggest ADepT has potential to be cost-effective relative to CBT. Next steps in evaluating ADepT, including conducting a definitive randomised controlled trial and adapting it for work with young adults and those with complex trauma will be explored.