In the first step all participants receive the same Support and Problem Solving (SPS) therapy for six weeks. For some people, this may be enough and so they will either continue on with monthly sessions, or simply have a ‘check-up’ every now and then to ensure things are still going well. For the remainder of young people, who might not feel better just yet, Step 2 comes next.
This step involves being randomly put into one of two groups. One group will continue with more SPS therapy as this may be all that is required; while the other group will receive a different type of talking therapy, called cognitive behavioural therapy (CBT). Here, the therapist may assist the young person by liaising with their school or work, as well as discuss thinking and behaviour patterns with the participant. This step runs for 4.5 months.
Similar to the first step, if this is enough to help the young person with their symptoms they will finish here and either receive monthly appointments for further SPS or just have a check-up every now and then.
However, some young people will need more help with their symptoms in order to feel better. In the third and final step, the young people will be randomly allocated to two groups. One group will begin to take a common and safe antidepressant called Fluoxetine, and the other will take a placebo, with no active ingredients. Both groups will continue to receive CBT. This step will continue for 6 months.
For those who do not feel better halfway through step 3, an option to add omega-3 or antipsychotic medication will be offered to the participant. If they choose to this option, it will be offered for the remaining 3 months of the treatment part of the study.
Along the way, participants will meet with a research assistant for a follow up interview. These interviews will assess how the participant has been feeling and enquire about any recent experiences they have had. These follow ups will occur when the participant first enters the study, at weeks 4 and 6, and then at months 6, 9, 12, 18 and 24.