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Development and Evolution of Cognitive Behavior Therapy for Depressed Adolescents

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Abstract

Since the 1980’s cognitive behavior therapy (CBT) has been developed and tested with adolescents experiencing depression. Early studies demonstrated that CBT was more effective than no intervention for young people with depressive symptoms. Beginning in the 1990’s CBT has been proven to be efficacious for adolescents with diagnosed depressive disorders, specifically Major Depressive Disorder (MDD). A series of increasingly challenging and methodologically rigorous trials showed that CBT was an effective intervention for mild to moderate MDD, and enhanced the benefits of anti-depressant medication, even for those adolescents who had already failed to respond to an initial medication. Simultaneously, some limitations of CBT were suggested by these studies. Results of CBT alone were not encouraging with severely depressed adolescents, and the combination of CBT plus medication was not uniformly supported. As CBT investigators worked with more challenging, complex clinical cases, such as depressed adolescents who were abusing substances or engaging in suicidal or self-harm behaviors, standard components of CBT were augmented by increased emphasis placed on emotion regulation, safety planning, and by more intensive outpatient treatment models. Newer developments include “third wave” models, which have shown initial promise.

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References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders: Third edition (DSM-III). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: Fifth edition (DSM-5). Washington, DC: Author.

    Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

    Google Scholar 

  • Biegel, G. M., Shapiro, S. L., Brown, K. W., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77, 855–866.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Brent, D. A., Kolko, D., Baugher, M., Bridge, J., Holder, D., et al. (2000). Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. Archives of General Psychiatry, 57, 29–36.

    Article  PubMed  Google Scholar 

  • Brent, D. A., Emslie, G., Clarke, G., Wagner, K. D., Asarnow, J. R., Keller, M., et al. (2008). Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: The TORDIA randomized controlled trial. Journal of the American Medical Association, 299, 901–913.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brent, D. A., Holder, D., Kolko, D. J., Birmaher, B., Baugher, M., Roth, C., et al. (1997). A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy. Archives of General Psychiatry, 54, 877–885.

    Article  PubMed  Google Scholar 

  • Brown, G. K., Have, T. T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association, 294, 563–570.

    Article  PubMed  Google Scholar 

  • Civic, D. (2007). Selective serotonin reuptake inhibitors (SSRI’s) and routine specialist care with and without cognitive behavior therapy in adolescents with major depression: randomised controlled trial [British Medical Journal, Rapid Response] Retrieved from http://www.bmj.com/rapid-response/2011/11/01/both-groups-had-combined-treatment.

  • Clarke, G. N., Rohde, P., Lewinsohn, P. M., Hops, H., & Seeley, J. R. (1999). Cognitive-behavioral treatment of adolescent depression: Efficacy of acute group treatment and booster sessions. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 272–279.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Erkanli, A., & Angold, A. (2006). Is there an epidemic of child or adolescent depression? Journal of Child Psychology and Psychiatry, 47, 1263–1271.

    Google Scholar 

  • Curry, J., Rohde, P., Simons, A., Silva, S., Vitiello, B., Kratochvil, C., et al. (2006). Predictors and moderators of acute outcomes in the treatment of adolescents with depression study (TADS). Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1427–1439.

    Article  PubMed  Google Scholar 

  • Curry, J., Silva, S., Rohde, P., Ginsburg, G., Kratochvil, C., Simons, A., et al. (2011). Recovery and recurrence following treatment for adolescent major depression. Archives of General Psychiatry, 68, 263–270.

    Article  PubMed Central  PubMed  Google Scholar 

  • Curry, J. F., & Wells, K. C. (2005). Striving for effectiveness in the treatment of adolescent depression: Cognitive behavior therapy for multi-site community intervention. Cognitive and Behavioral Practice, 12, 177–185.

    Article  Google Scholar 

  • Curry, J. F., Wells, K. W., Lochman, J. E., Craighead, W. E., & Nagy, P. D. (2003). Cognitive behavioral intervention for depressed, substance abusing adolescents: Development and pilot testing. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 656–665.

    Article  PubMed  Google Scholar 

  • Emslie, G. J., Rush, A. J., Weinberg, W. A., Kowatch, R. A., Hughes, C. W., Carmody, T., et al. (1997). A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Archives of General Psychiatry, 54, 1031–1037.

    Article  PubMed  Google Scholar 

  • Esposito-Smythers, C., Spirito, A., Kahler, C. W., Hunt, J., & Monti, P. (2011). Treatment of co-occurring substance abuse and suicidality among adolescents: A randomized trial. Journal of Consulting and Clinical Psychology, 79, 728–739.

    Article  PubMed Central  PubMed  Google Scholar 

  • Goldston, D. B., Curry, J., Wells, K., Kaminer, Y., Daniel, S., Doyle, O., & Sapyta, J. (2011, April). Cognitive behavior therapyRelapse prevention for suicidal, depressed, substance abusing youth. Paper presented at the meeting of the American Association of Suicidology, Portland, OR.

  • Goodyer, I., Dubicka, B., Wilkinson, P., Kelvin, R., Roberts, C., Byford, S., et al. (2007). Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: Randomised controlled trial. British Medical Journal, 335, 142–149.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.

    Article  Google Scholar 

  • Hayes, L., Boyd, C. P., & Sewell, J. (2011). Acceptance and Commitment Therapy for the treatment of adolescent depression: A pilot study in a psychiatric outpatient setting. Mindfulness, 2, 86–94.

    Article  Google Scholar 

  • Hollon, S. D., Garber, J., & Shelton, R. C. (2005). Treatment of depression in adolescents with cognitive behavior therapy and medications: A commentary on the TADS project. Cognitive and Behavioral Practice, 12, 149–155.

    Article  Google Scholar 

  • Kahn, J. S., Kehle, T. J., Jenson, W. R., & Clark, E. (1990). Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 19, 196–211.

    Google Scholar 

  • Kazdin, A. E., & Bass, D. (1989). Power to detect differences between alternative treatments in comparative psychotherapy outcome research. Journal of Consulting and Clinical Psychology, 57, 138–147.

    Article  PubMed  Google Scholar 

  • Kennard, B. D., Clarke, G. N., Weersing, V. R., Asarnow, J. R., Shamseddeen, W., Porta, G., et al. (2009). Effective components of TORDIA cognitive-behavioral therapy for adolescent depression: Preliminary findings. Journal of Consulting and Clinical Psychology, 77, 1033–1041.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kovacs, M. (1996). Presentation and course of major depressive disorder during childhood and later years of the life span. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 705–715.

    Article  PubMed  Google Scholar 

  • Lewinsohn, P., Clarke, G. N., Hops, H., & Andrews, J. A. (1990). Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy, 21, 385–401.

    Article  Google Scholar 

  • Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102, 133–144.

    Article  PubMed  Google Scholar 

  • Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: The Guilford Press.

    Google Scholar 

  • Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Rathus, J. H., & Miller, A. L. (2002). Dialectical behavior therapy adapted for suicidal adolescents. Suicide and Life Threatening Behavior, 32, 146–157.

    Article  PubMed  Google Scholar 

  • Reynolds, W. M., & Coats, K. I. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54(1986), 653–660.

    Article  PubMed  Google Scholar 

  • Ritschel, L. A., Ramirez, C. L., Jones, M., & Craighead, W. E. (2011). Behavioral activation for depressed teens: A pilot study. Cognitive and Behavioral Practice, 18, 281–299.

    Article  Google Scholar 

  • Rohde, P., Clarke, G., Mace, D. E., Jorgensen, J. S., & Seeley, J. R. (2004). An efficacy/effectiveness study of cognitive behavioral treatment for adolescents with comorbid depression and conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 660–668.

    Article  PubMed  Google Scholar 

  • Stanley, B., Brown, G., Brent, D. A., Wells, K., Poling, K., Curry, J., et al. (2009). Cognitive-behavioral therapy for suicide prevention (CBT-SP): Treatment model, feasibility, and acceptability. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 1005–1013.

    Article  PubMed Central  PubMed  Google Scholar 

  • Treatment for Adolescents with Depression Study (TADS) Team. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression. Journal of the American Medical Association, 292, 807–820.

    Article  Google Scholar 

  • Treatment for Adolescents with Depression Study (TADS) Team. (2005). The treatment for adolescents with depression study (TADS): Demographic and clinical characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 28–40.

    Article  Google Scholar 

  • Treatment for Adolescents with Depression Study (TADS) Team. (2007). The treatment for adolescents with depression study (TADS): Long-term effectiveness and safety outcomes. Archives of General Psychiatry, 64, 1132–1144.

    Article  Google Scholar 

  • Wade, T. J., Cairney, J., & Pevalin, D. J. (2002). Emergence of gender differences in depression during adolescence: National panel results from three countries. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 190–198.

    Article  PubMed  Google Scholar 

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Correspondence to John F. Curry.

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Curry, J.F., Hersh, J. Development and Evolution of Cognitive Behavior Therapy for Depressed Adolescents. J Rat-Emo Cognitive-Behav Ther 32, 15–30 (2014). https://doi.org/10.1007/s10942-014-0180-9

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