School-Based Cognitive-Behavioral Therapy for Adolescent Depression

Abstract

The current study evaluated cognitive-behavioral therapy (CBT) for adolescent depression delivered in health clinics and counseling centers in four high schools. Outcomes were benchmarked to results from prior efficacy trials. Fifty adolescents diagnosed with depressive disorders were treated by eight doctoral-level psychologists who followed a manual-guided, 12-session, individual CBT protocol. Referred adolescents presented with high rates of comorbidity, traumatic experiences, and prior suicide attempts. Posttreatment response to school-based CBT (64%) was comparable to results obtained in efficacy trials. On average, symptom reduction in this school-based study was similar to prior efficacy trials, exceeded results from an efficacy trial using the original manual, and exceeded results from a prior school-based CBT trial. Examination of predictors of symptom change and treatment response showed that life stress, trauma history, and depressive symptom severity were negatively associated with outcomes. Results suggest that school-based CBT is a relatively robust treatment for adolescent depression across gender, age, and ethnic groups as well as for adolescents with varied patterns of comorbidity.