Psychological Treatments for Depression ERQ

Psychological treatment for depression

Psychological treatment involves talk therapy approaches, with Cognitive Behavioral Therapy (CBT) being the most widely used. CBT helps patients identify and reframe negative thought patterns and behaviors contributing to depression.

Aim of March et al. (2007)

To investigate the effectiveness of CBT, fluoxetine (an SSRI), and combination therapy in treating adolescents with MDD.

Participants in March et al. (2007)

327 adolescents aged 12-17 years diagnosed with MDD, recruited from 13 locations in the USA.

Procedure in March et al. (2007)

Participants were randomly assigned to CBT, fluoxetine, or combination groups. Treatment lasted 36 weeks, with progress tracked using the Children's Depression Rating Scale (CDRS). CDRS > 40 = depression; < 28 = remission.

Results of March et al. (2007)

81% of participants in the CBT group and fluoxetine group showed significant symptom improvement. 86% in the combination group improved. Suicidal ideation was more effectively reduced in the CBT and combination groups than the medication-only group.

Conclusion of March et al. (2007)

All treatments were effective, but CBT combined with medication was most effective. CBT also seemed to reduce suicidal thoughts more than fluoxetine alone.

Strengths of March et al. (2007)

Randomized design with long duration (36 weeks) improves internal validity. Results have high real-world relevance for treating adolescent depression.

Limitations of March et al. (2007)

Combination group makes it hard to isolate whether CBT or medication caused the improvement. No long-term follow-up, so we don't know how effective treatment was over time.

Aim of Clarke et al. (1999)

To investigate the effectiveness of cognitive-behavioural therapy (CBT) in treating major depression in adolescents

Participants in Clarke et al. (1999)

123 adolescents aged 16-19 diagnosed with major depressive disorder (MDD). 

Procedure in Clarke et al. (1999)

Participants were randomly assigned to one of three 8-week conditions:

Adolescent group CBT (16 two-hour sessions)

Adolescent group CBT + parent group (separate parent sessions)

Control group on a waiting list

After the 8-week intervention, participants who completed CBT were randomly reassigned for a 24-month follow-up to one of:

Booster sessions + assessments every 4 months

Assessments every 4 months only

Assessments every 12 months only

Results of Clarke et al. (1999)

Both CBT groups had significantly higher recovery rates (66.7%) than the control group (48.1%).

Both CBT conditions (with or without parents) were equally effective.

Participants in CBT showed greater reduction in self-reported depression.

Recurrence rates over 2 years were lower than typically found in treated adult depression.

Booster sessions did not reduce relapse rates but accelerated recovery among those still depressed after treatment.

Conclusion of Clarke et al. (1999)

CBT is an effective treatment for adolescent depression.

Adding parental sessions does not significantly improve outcomes.

Booster sessions may help with continued recovery but do not prevent relapse.

Early CBT intervention in adolescence may help reduce long-term recurrence compared to adult populations.

Strengths of Clarke et al. (1999)

Preventative approach shows that CBT can help reduce future risk of MDD. Long-term follow-up (12 months) shows CBT has lasting impact.

Limitations of Clarke et al. (1999)

Participants had elevated symptoms but were not clinically diagnosed with MDD, limiting generalizability to diagnosed patients. Group therapy may not suit all individuals; effectiveness may vary depending on group dynamics.

Strength of CBT for treating MDD

CBT is one of the most widely used and evidence-based treatments for depression, and has shown success across a range of age groups and contexts worldwide.

Second strength of CBT

CBT allows treatment to be personalized to the patient's pace, with therapists adapting sessions to individual needs, empowering the client and improving outcomes.

Limitation of CBT

The focus on the 'here and now' may not be suitable for individuals who need to process past trauma or unresolved issues to improve.

Second limitation of CBT

CBT's emphasis on individual responsibility and self-directed change may not align with collectivist cultural values, making it less appropriate in certain cultural contexts.

Treatment approach supported by March et al. (2007)

A combined treatment approach, using CBT with antidepressants, appears to be most effective and safest, especially in adolescents with severe symptoms or suicidal ideation.

Treatment approach supported by Clarke et al. (1999)

Preventative CBT group therapy is effective in reducing depression onset among adolescents at risk, supporting early intervention models of care.