Developing a new, co‑produced treatment called Mindfulness for Adolescents and Carers (MAC) to support recovery and prevent relapse among 15–18‑year‑olds who are at risk of recurrent depression.
Why is the research needed?
In the UK, around 140,000 young people aged 15–19 experience depression, with an estimated 35,000 receiving NHS treatment. Around 14,000 do not respond, and a further 8,000 are likely to relapse after initially successful treatment. These young people face increased risks of substance misuse, self‑harm, and difficulties at school or in relationships, as well as poorer mental and physical health in adulthood. Parenting a teenager with depression is highly stressful and can strain family relationships, and teenagers whose parents experience depression are more likely to develop mental health problems later in life.
What are we doing?
To help address these challenges, we are developing a new treatment called Mindfulness for Adolescents and Carers (MAC), which teaches skills to support teenagers’ recovery from depression and helps parents and carers cope more effectively. Mindfulness-based Cognitive Therapy for teenagers is relatively untested. We want to see if MAC supports recovery and prevents relapse amongst 15-18-year-olds who risk developing recurrent depression as adults.
Our research has five parts, including finalising our therapist‑training programme, co‑producing an app to encourage and measure mindfulness practice, and recruiting 480 teenagers and their parents. Half will receive MAC and the other half will receive the standard NHS treatment, allowing us to compare outcomes and costs to determine whether MAC works and is value for money. We will also explore how MAC works and who benefits most by examining changes in how teenagers and parents feel, think and relate to each other, and we will identify how best to embed MAC within mental health services across the NHS.
How are we working with communities, services and organisations?
ATTEND has been co-developed with young people, parents/carers and people with lived experience of adolescent mental health difficulties. Public and Patient Involvement and Engagement (PPIE) is embedded throughout the programme, from study design through to dissemination activities.
The study works closely with NHS mental health services, universities, Applied Research Collaborations (ARCs) across the country, service providers and third-sector partners across multiple regions including Cambridge, London, Devon, Sussex, Nottingham and Oxford.
Young people and carers have contributed to the development of study materials, digital resources, recruitment approaches and communication outputs, including videos and public-facing information.
What will the impact and benefits of this research be?
If effective, ATTEND could provide an evidence-based, scalable treatment option for adolescents who continue to struggle following first-line treatment for depression or anxiety. The findings from the study could improve mental health outcomes for adolescents and reduces relapses, increase support and coping strategies for parents and carers, reduce the long‑term burden on NHS mental health services, strengthen understanding of which young people benefit most from mindfulness‑based approaches, expand access to evidence‑based family‑inclusive interventions, and develop practical implementation resources to support national roll‑out.
The programme will also contribute to wider understanding of adolescent mental health treatment pathways and the role of mindfulness-based interventions within Child and Adolescent Mental Health Services (CAMHS) and related services.
What do we have planned for knowledge mobilisation and implementation?
Alongside evaluating effectiveness, the programme is developing practical resources to support future NHS implementation of MAC if the intervention proves effective. Planned activities include developing a MAC implementation plan and toolkit for NHS services, creating therapist training materials and supervision frameworks, and disseminating findings through conferences, webinars, podcasts, blogs, videos and social media. The team will also share results with clinicians, commissioners, young people, carers and policymakers, and produce accessible outputs tailored for different audiences, including young people and families, alongside academic publications and national and international presentations. In addition, the project team is exploring linkage with administrative health and education data to support longer‑term follow‑up and future research opportunities.
Related papers, outputs and resources
Read the plain English summary
- We are currently producing a series of podcasts for the study
Who is involved?
- Co-Principle Investigator: Professor Tamsin Ford, University of Cambridge
- Co-Principle Investigator: Patrick Smith, King's College London
- Professor Stephen Morris, University of Cambridge
- Ms Gemma Giove-Hunt, University of Cambridge
- Kim Goldsmith, King's College London
- Jessica Richardson, King's College London
- Kat Nellist, Experts by Experience
- Leon Farmer, Experts by Experience
- Rachel Hayes, NIHR ARC South West Peninsula
- Vashti Berry, NIHR ARC South West Peninsula
- Iain Lang, Improvement Academy NIHR ARC Yorkshire and Humber
- Thorsten Barnhofer, University of Surrey
- Willem Kuyken, University of Oxford
- Clara Strauss, Sussex Partnership NHS Foundation Trust
- Tim Sweeny, Nottingham Healthcare NHS Foundation Trust
Get in contact
Email Professor Tamsin Ford at tjf52@medschl.cam.ac.uk.
