Adolescents and carers using mindfulness Therapy To END depression (ATTEND): study protocol for a parallel randomised controlled superiority trial of Mindfulness for Adolescents and Carers (MAC) for depression among young people aged 15 to 18 years old with an embedded economic evaluation

@article{ford2026adolescents,
  title = {{Adolescents and carers using mindfulness Therapy To END depression (ATTEND): study protocol for a parallel randomised controlled superiority trial of Mindfulness for Adolescents and Carers (MAC) for depression among young people aged 15 to 18 years old with an embedded economic evaluation}},
  author = {Tamsin Ford and Rachel Childs and Rachel Hayes and Gemma Giove-Hunt and Kimberley Goldsmith and Louise MacGregor and Patrick Smith and Jessica Richardson and Jerry Fox and Thorsten Barnhofer and Vashti Berry and Clara Strauss and Timothy Sweeney and Willem Kuyken and Katrina Nellist and Leonard Farmer and Iain A. Lang and Stephen Morris and The ATTEND Team and Helen Casey and Una Higgins and Katie Buttriss and Ching-Yin Lee and Hélène Bonnici and Harrison Ellis and Gianna Cadorna and Mannat Chopra and Brian Croxford and Efthalia Massou and Owen Williams and Mohammad Karimipour and Claudia Bird and Poppy Beck},
  journal = {Trials},
  year = {2026},
  month = oct,
  doi = {10.1186/s13063-026-09979-8},
  url = {https://link.springer.com/article/10.1186/s13063-026-09979-8},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Adolescents and carers using mindfulness Therapy To END depression (ATTEND): study protocol for a parallel randomised controlled superiority trial of Mindfulness for Adolescents and Carers (MAC) for depression among young people aged 15 to 18 years old with an embedded economic evaluation
AU  - Tamsin Ford
AU  - Rachel Childs
AU  - Rachel Hayes
AU  - Gemma Giove-Hunt
AU  - Kimberley Goldsmith
AU  - Louise MacGregor
AU  - Patrick Smith
AU  - Jessica Richardson
AU  - Jerry Fox
AU  - Thorsten Barnhofer
AU  - Vashti Berry
AU  - Clara Strauss
AU  - Timothy Sweeney
AU  - Willem Kuyken
AU  - Katrina Nellist
AU  - Leonard Farmer
AU  - Iain A. Lang
AU  - Stephen Morris
AU  - The ATTEND Team
AU  - Helen Casey
AU  - Una Higgins
AU  - Katie Buttriss
AU  - Ching-Yin Lee
AU  - Hélène Bonnici
AU  - Harrison Ellis
AU  - Gianna Cadorna
AU  - Mannat Chopra
AU  - Brian Croxford
AU  - Efthalia Massou
AU  - Owen Williams
AU  - Mohammad Karimipour
AU  - Claudia Bird
AU  - Poppy Beck
PY  - 2026
DA  - 2026/10/23
JO  - Trials
DO  - 10.1186/s13063-026-09979-8
UR  - https://link.springer.com/article/10.1186/s13063-026-09979-8
AB  - Background: Mindfulness-based cognitive therapy (MBCT) is a group intervention recommended by NICE for adults who have experienced recurrent depression but is untested for adolescents. MBCT aims to teach people to recognise early indicators of depression, to avoid repetitive thinking patterns that make relapse more likely, and to respond to stressors in ways that protect mental health. We developed Mindfulness for Adolescents and Carers (MAC), a version of MBCT adapted to be more engaging for young people. MAC includes a parallel programme aimed at strengthening family support and parental mental health and may help minimise the developmental impact of functional impairment during the transition to adulthood. The primary aim of this trial is to evaluate the clinical- and cost-effectiveness of MAC in 15- to 18-year-olds at risk of repeated depressive episodes in the UK.  Methods: ATTEND will be a two-arm, pragmatic, parallel-group, superiority, individually randomised controlled hybrid type I trial of clinical and cost-effectiveness. We will randomise 480 15SAP-18-year-olds who have received at least one previous evidence-based intervention for depression or anxiety, yet continue to experience symptoms of depression, to either MAC plus treatment as usual (TAU) or TAU alone. MAC will be delivered by trained professional facilitators to groups of 6 to 14 young people, with a parallel but optional group for parents/carers. The primary outcome will use an area under analysis of the mean difference in the Short Mood and Feelings Questionnaire, which will be collected fortnightly over a 12-month follow-up period. Secondary outcomes will be measured in both young people and their parents/carers, including depression, anxiety symptoms, quality of and coping with life, and the quality of parent-child relationships at baselines, 14 weeks and 12 months post randomisation. Parental mental health will also be measured fortnightly.  After the primary main and mediation analyses have been completed, the de-identified individualised patient data, data dictionaries and statistical analysis code underlying published results will be as accessible to other researchers with a methodologically sound proposal via the ATTEND Core Team using the standard ATTEND Publication Proforma. The protocol and statistical analysis plans will also be available via the study website.  Discussion: This study will provide important information about whether MAC is a clinically and cost-effective intervention to reduce depression symptom severity and chronicity in adolescents.  Trial registration {4}: International Standard Randomised Controlled Trials, identifier: ISRCTN 17687131 . Registered on 15 August 2024.
SN  - 1745-6215
ER  -