Augmented Depression Therapy (ADepT) for treating depression in adults with a history of complex trauma: A qualitative exploration of client’s experiences

Objectives: This study explored the acceptability, perceived impact, perceived processes of change, and factors influencing engagement associated with Augmented Depression Therapy for Complex Depression (ADepT-CD), a wellbeing-focused, recovery-oriented psychological intervention tailored for individuals with depression and emotional and interpersonal difficulties often associated with the experience of early or historic trauma. Design: A semi-structured qualitative interview design was employed, with data analysed using Reflexive Thematic Analysis (RTA). Participants: Twelve participants with complex depression who had received up to 25 sessions of ADepT-CD were sampled from a two-site case series. Setting: Two service settings in the United Kingdom, the Accessing Evidence Based Psychological Therapies (AccEPT) clinic, University of Exeter in Devon, and the Thurrock Psychological Therapy Service in Essex. Interviews were conducted between March 2024 and July 2024. Results: Participants generally found ADepT-CD to be acceptable, particularly valuing the extended treatment length, flexible pacing, tailored content, and the inclusion of booster sessions. The resilience and w005Cellbeing focus was seen as helpful for long-term recovery. However, some participants highlighted the need for greater emphasis on distress validation before shifting to a solution-focused approach. Engagement was facilitated by prior therapy experience and a perceived readiness for change, while external life challenges, comorbid physical and mental health conditions, and limited social support were barriers for some. Negative aspects for some participants included a positive attentional focus at times of greater distress and transitioning to the booster phase before they had fully benefitted from the acute phase. Perceived processes of change included values-based goal setting, present- and future-focused work, increased self-understanding and self-compassion, and an authentic and positive therapeutic relationship. Conclusion: Findings support the acceptability of ADepT-CD for individuals with complex depression and suggest refinements to further enhance therapeutic benefit. These include early emphasis on distress validation, structured promotion of joy and connection, and support for social network development.<p></p>