Cognitive-Behavioural Therapy for Depressed Children: Children's and Therapists' Impressions

Abstract

A randomized trial was conducted of cognitive-behavioural therapy and a non-focused intervention for children and adolescents aged 8–16 years with depression (N = 57) referred to four child and adolescent psychiatry units. Children in both groups showed similar rates of recovery from depression at the end of treatment (cognitive-behavioural therapy: 87% recovery rate; non-focused intervention: 75% recovery rate). This paper addresses the question of how cognitive-behavioural therapy was perceived and used by depressed young sters in clinical settings (N=29). Only seven children (24%) kept a diary for all nine sessions of the CBT programme. Children who had been rated as compliant with CBT tasks were more likely to recover at the end of treatment. Analysis of the content of each cognitive-behavioural session has shown that all children received advice on self-monitoring, positive self-statementing, and social problem-solving, but only 50% actually received advice on cognitive restructuring, since this was scheduled late in the treatment package and most children had recovered by this stage. Children, parents and therapists had a high degree of agreement on the helpfulness of CBT. Children identified several helpful CBT elements, the majority being related to social problem-solving. The treatment programme was explained to parents, who did not actively participate in treatment, but they helped to plan suitable rewards for their children. Recommendations are made for the future use of CBT with referred young people with depressive disorders.