Stress Management and Resiliency Training (SMART) Integrated Into Treatment of Major Depression

The investigators propose to conduct an initial feasibility study in a sample of patients in
treatment for major depression using SMART. The intervention will be weekly group therapy
session of SMART for 8 weeks duration. Once enrolled, participants will complete a Structured
Clinical Interview for Diagnosis (SCID). The SCID will primarily serve to confirm a diagnosis
of Major Depressive Disorder. Each study intervention group (3-4 groups) will be composed of
6-8 research participants per group. There will be no comparison group. The investigators aim
to assess adherence with goal of 75% completion of the 8 sessions of SMART and of the
homework assignments. Resilience will be measured with the Connor-Davidson resilience scale.
Secondary outcomes will include subjective and objective clinical rating scales for major
depression.

Inclusion Criteria:

- Attending the Mayo Clinic Depression Center and Behavioral Health Clinic at Mayo
Clinic Health System, Austin, Minnesota

- DSM-V diagnostic confirmation of major depressive disorder (MDD)

- Baseline PHQ-9 scores in the range of ≥6-≤19, and HAMD-17 score 8-18, or QIDS-C16
score of 6-20

- Able to speak English

- Participants will continue taking any prescribed medications from their clinical
treatment team

- Patients with co-morbid secondary diagnoses of persistent depressive disorder and
generalized anxiety disorders will be included in the study.

Exclusion Criteria:

- Participants with bipolar disorder

- Active psychosis

- Active suicidal ideations

- Active substance abuse meeting criteria for substance use disorders except nicotine

- Obsessive compulsive disorder

- Active Panic disorder with agoraphobia, other phobic disorder

- Active Posttraumatic stress disorder

- Active Severe personality disorders.