Empirically Supported Psychotherapies for Adolescent Depression and Mood Disorders

Abstract

(create) In this chapter we will review and, to the extent possible, compare empirically supported treatments (ESTs) for adolescent mood disorders, using the criteria developed by Chambless and Hollon (1998). We augment this set of criteria with the consideration of two key methodological issues: whether the treatment has been evaluated relative to a passive or active comparison condition and whether the treatment was analyzed using completer or intent-to-treat (ITT) analyses. In line with a recent meta-analysis by Weisz and colleagues (2006), we view comparison to an active condition using ITT analyses as the most stringent test of a treatment, and comparison to a passive condition using completer analyses as the least stringent test. We review combined psychotherapeutic and medical treatments as well as psychotherapeutic interventions alone. To date, there are two ESTs for adolescent depression and a number of promising treatments for adolescent unipolar and bipolar depressive disorders. Both of the ESTs for adolescent depression, cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT), have demonstrated effectiveness relative to a no-treatment comparison condition in more than one study conducted by different research groups. Of the two interventions, CBT has a broader evidence base and has demonstrated effectiveness using more stringent criteria. IPT has also garnered good support as an intervention for adolescent depression, including one study against an active comparison. Other studies of treatments for adolescent depression have generally used passive control conditions using completer analyses, while studies of treatments for adolescent bipolar disorder have tended to use simple pre- to posttest comparisons. Differences in the evidence base for psychosocial interventions for adolescent unipolar versus bipolar affective disorders reflect the relative maturity of the research fields. The chapter ends with a discussion of the treatment of a 16-year-old female with major depression. (PsycINFO Database Record (c) 2012 APA, all rights reserved)