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A comparison of MEmory Specificity Training (MEST) to education and support (ES) in the treatment of recurrent depression: study protocol for a cluster randomised controlled trial

Tim Dalgleish12*, Anna Bevan12, Anna McKinnon12, Lauren Breakwell1, Viola Mueller1, Isobel Chadwick1, Susanne Schweizer1, Caitlin Hitchcock1, Peter Watson1, Filip Raes3, Laura Jobson45 and Aliza Werner-Seidler12

Author Affiliations

1 Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK

2 Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge Road, Fulbourn, Cambridge CB21 5HH, UK

3 Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Tiensestraat 102, 3000 Leuven, Belgium

4 University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK

5 Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, CB2 7EF Cambridge, UK

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Trials 2014, 15:293  doi:10.1186/1745-6215-15-293

Published: 22 July 2014



Depression is a debilitating mental health problem that tends to run a chronic, recurrent course. Even when effectively treated, relapse and recurrence rates remain high. Accordingly, interventions need to focus not only on symptom reduction, but also on reducing the risk of relapse by targeting depression-related disturbances that persist into remission. We are addressing this need by investigating the efficacy, acceptability and feasibility of a MEmory Specificity Training (MEST) programme, which directly targets an enduring cognitive marker of depression - reduced autobiographical memory specificity. Promising pilot data suggest that training memory specificity ameliorates this disturbance and reduces depressive symptoms. A larger, controlled trial is now needed to examine the efficacy of MEST. This trial compares MEST to an education and support (ES) group, with an embedded mechanism study.


In a single blind, parallel cluster randomised controlled trial, 60 depressed individuals meeting diagnostic criteria for a current major depressive episode will be recruited from the community and clinical services. Using a block randomisation procedure, groups of 5 to 8 participants will receive five weekly sessions of MEST (nā€‰=ā€‰30) or education and support (nā€‰=ā€‰30). Participants will be assessed immediately post-treatment, and at 3- and 6-months post-treatment (MEST group only for 6-month follow-up). Depressive symptoms at 3-month follow-up will be the primary outcome. Secondary outcomes will be change in depressive status and memory specificity at post-treatment and 3-months. The 6-month follow-up of the MEST group will allow us to examine whether treatment gains are maintained. An explanatory question will examine variables mediating improvement in depression symptoms post-treatment and at 3-month follow-up.


This trial will allow us to investigate the efficacy of MEST, whether treatment gains are maintained, and the mechanisms of change. Evidence will be gathered regarding whether this treatment is feasible and acceptable as a low-intensity intervention. If efficacy can be demonstrated, the results will support MEST as a treatment for depression and provide the foundation for a definitive trial.

Trial registration

NCT01882452 (, registered on 18 June 2013.

Depression; Memory specificity training; Autobiographical memory