Group and family cognitive behavior therapy for adolescent depression and substance abuse: A case study

Abstract

Cognitive behavior therapy (CBT) has been demonstrated to be an effective acute intervention for adolescent depression. However, studies to date of CBT with depressed adolescents have excluded those with comorbid substance abuse. Treatment of comorbid substance abuse requires that the targets of CBT be expanded to include social cognitive and family factors associated with the substance use disorder. We developed an integrated group and family therapy model of intervention for adolescents with both depression and substance abuse. The case of R.P. illustrates the application of this treatment model. Treatment includes skills training in the context of a closed, mixed-gender, twice-weekly adolescent group and weekly family therapy sessions to apply new skills in the family context. Central clinical issues and core cognitive and behavioral correlates of R.P.'s depression and substance abuse are delineated as they occurred during the course of treatment. Treatment was associated with improvements in mood and reductions in substance use.