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      Perceptions of and Opinions on a Computerized Behavioral Activation Program for the Treatment of Depression in Young People: Thematic Analysis

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          Abstract

          Background

          Depression is one of the leading causes of illness and disability in young people, with approximately 20% having experienced a depressive episode by the age of 18 years. Behavioral activation (BA), a National Institute for Health and Care Excellence–recommended treatment for adults with depression, has shown preliminary support for its use with young people. BA may have the potential to be adapted and delivered in a computerized format to address the barriers often associated with young people accessing support. Despite the benefits of adopting computerized therapy delivery, the limited effectiveness of some programs has been attributed to a failure to tailor interventions to patients and practices. Therefore, while developing new treatments, it is important that target users be involved in the intervention design.

          Objective

          This qualitative study aims to explore the views and preferences of young people and health care professionals regarding the development of a new computerized BA therapy for young people with low mood or depression, to ensure that the therapy was suitable for the target user.

          Methods

          Semistructured focus groups and individual interviews were conducted with young people (those with experience in accessing support and those without) and health care professionals regarding the development of a new computerized BA therapy for young people with low mood or depression. The data were analyzed using thematic analysis.

          Results

          A total of 27 individuals, comprising both health care professionals and young people, participated in this study. Vital information pertaining to the important components of a new therapy, including its presentation, delivery, and content, was collected.

          Conclusions

          Variations in perspectives highlighted the need to adopt a systemic approach in therapy development by considering the opinions of young people with and without experience in accessing mental health support and health care professionals.

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          Most cited references40

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          Using thematic analysis in psychology

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            Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review

            Background Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive are the barriers and facilitators to help-seeking for common mental health problems. Methods Twenty two published studies of perceived barriers or facilitators in adolescents or young adults were identified through searches of PubMed, PsycInfo, and the Cochrane database. A thematic analysis was undertaken on the results reported in the qualitative literature and quantitative literature. Results Fifteen qualitative and seven quantitative studies were identified. Young people perceived stigma and embarrassment, problems recognising symptoms (poor mental health literacy), and a preference for self-reliance as the most important barriers to help-seeking. Facilitators were comparatively under-researched. However, there was evidence that young people perceived positive past experiences, and social support and encouragement from others as aids to the help-seeking process. Conclusions Strategies for improving help-seeking by adolescents and young adults should focus on improving mental health literacy, reducing stigma, and taking into account the desire of young people for self-reliance.
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              Young people's help-seeking for mental health problems

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                April 2021
                13 April 2021
                : 23
                : 4
                : e19743
                Affiliations
                [1 ] Department of Health Sciences University of York York United Kingdom
                [2 ] School of Psychology Queen's University Belfast Belfast United Kingdom
                [3 ] School of Psychology Deakin University Victoria Australia
                Author notes
                Corresponding Author: Lucy Tindall lucy.tindall@ 123456york.ac.uk
                Author information
                https://orcid.org/0000-0002-7486-5037
                https://orcid.org/0000-0001-7801-7636
                https://orcid.org/0000-0003-4864-3956
                https://orcid.org/0000-0002-8692-6001
                Article
                v23i4e19743
                10.2196/19743
                8080144
                33847594
                9be5b715-af46-4d91-a2a5-5231a4c90436
                ©Lucy Tindall, Paul Toner, Antonina Mikocka-Walus, Barry Wright. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.04.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 30 April 2020
                : 13 July 2020
                : 21 July 2020
                : 11 November 2020
                Categories
                Original Paper
                Original Paper

                Medicine
                depression,qualitative,thematic analysis,young people,health care professionals,computerized therapies

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