Issues in Portability of Evidence-based Treatment for Adolescent Depression

Abstract

Depression is one of the most commonly diagnosed psychiatric disorders among school-aged youth, with high prevalence and far-reaching consequences. However, even though there are two evidence-based practices for treating adolescent depression (Cognitive-Behavioral Therapy and Interpersonal Therapy), most adolescents referred for treatment are unlikely to receive either. In part, this is due to the difficulty of transporting an evidence-based practice from laboratory to real-world setting, and determining how to transport an empirically validated treatment has thus become a focus of concern for social work researchers and practitioners. A host of client, clinician, setting, and treatment delivery variables can influence portability. Taking all these factors into consideration is a daunting task—but less daunting if done at the onset, during the initial process of efficacy research, rather than afterward as a separate stage. The thesis of this paper is that the only solution to the problem of portability is a combined, rather than sequential, approach to treatment development in which effectiveness and application concerns are included in the original research design. A review of suggested approaches, as well as discussion of factors that contribute to variance in outcome, is followed by recommendations for future research.