Article

The Adolescent Coping With Depression Course: A Cognitive-Behavioral Approach to the Treatment of Adolescent Depression.

Authors:
  • Kaiser Permanente Center for Health Research, Portland Oregon
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Abstract

The goal of this chapter is to describe the authors' program of research evaluating a cognitive-behavioral group treatment approach for adolescent depression. Since 1982, their group has been involved in a major research effort to develop and test the efficacy and effectiveness of the Adolescent Coping With Depression Course (CWD-A). They begin the chapter by briefly reviewing psychosocial treatments for adolescent depression. Next, they review the rationale and theoretical background for their treatment approach, describe the CWD-A course and its companion course for the parents of depressed adolescents, and summarize results from two randomized clinical trials with 24-month follow-up. A clinical vignette is provided to illustrate the changes that have occurred with this intervention. To better understand the mechanisms of therapeutic change in depressed adolescents, they next address several issues related to treatment response. The authors conclude by describing more recent research with the CWD-A intervention and future directions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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... Studies have shown that the CWD-A is effective (Clarke, Rohde, Lewinsohn, Hops, & Seeley, 1999;Rohde, Lewinsohn, Clarke, Hops, & Seeley, 2005) and significant preventative effects have been found (2008), no strong conclusions for the CWD-A can be drawn until further research is conducted utilizing an at-risk population. It is also important to note that Clarke, DeBar, and Lewinsohn (2003) and Clarke et al. (1995) recommended that "outside" researchers further explore the CWD-A because unaffiliated researchers have conducted limited research. ...
... Studies have shown that the CWD-A is effective (Clarke, Rohde, Lewinsohn, Hops, & Seeley, 1999;Rohde, Lewinsohn, Clarke, Hops, & Seeley, 2005) and significant preventative effects have been found . However, the literature has revealed two separate theories regarding the success of the CWD-A with an at-risk for depression group, and no study explored altering the CWD-A curriculum to adapt to the school environment. ...
... The course therefore also includes sessions regarding increasing the engagement in pleasant activities and decreasing the frequency with which punishing events are experienced. The adolescent version of the Coping with Depression course Lewinsohn, Clarke, Rohde, Hops, & Seeley, 1996;Rohde, Lewinsohn, Clarke, Hops, & Seeley, 2005 Efficacy of the CWD. Over the last 30 years, the CWD course has been translated into several languages including Spanish, German, Dutch, and French and is being used in many countries such as the United States, Canada Mexico, Peru, Germany, Finland, and The Netherlands. ...
... 83,84 Individual evaluations of psychoeducation treatments for depressed adolescents demonstrate positive effects. [85][86][87] Practice Implications ...
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Adolescent depression is a prevalent and disabling condition resulting in emotional suffering and social and educational dysfunction. Care for adolescent depression is suboptimal and could be improved through the development and use of quality indicators (QIs). This article reports on the development of a care pathway and QIs for the primary and specialty care management of adolescent depression from case identification through symptom remission. It presents evidence from a review of adolescent clinical practice guidelines and research literature to support QIs at critical nodes in the pathway, and describes implications for practice based on existing evidence. Barriers to measure development are identified, including gaps in empirical evidence, and a research agenda is suggested.
... Cognitive-behavioral therapy (CBT) targets the negative cognitive, coping and problemsolving patterns that are associated with depression in adolescents and adults, enabling individuals to manage difficult experiences both during and after therapy. Many studies have demonstrated CBT's effectiveness in treating depression in adults and adolescents (Compton et al., 2004;Hollon & DeRubeis, 2004;Rohde, Lewinsohn, Clarke, Hops, & Seeley, 2005;Stark et al., 2005). Moreover, CBT may prevent depression from recurring. ...
... One principle of the formulation-based approach is expressed by the saying that " If it ain't broke, don't fix it. " For example, although pleasant event scheduling is an empirically supported intervention for depression (e.g., Rohde, Lewinsohn, Clarke, Hops, & Seeley, 2005), if a depressed client already engages in numerous recreational activities, this technique probably cannot contribute much to his or her treatment. Unrealistically pessimistic thinking is a well-documented characteristic of depression (Beck, 1995), but if careful assessment fails to reveal significant irrational thoughts, cognitive therapy might not have much to offer. ...
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This article reviews the strengths and weaknesses of outcome research and clinical reasoning as bases of treatment planning and presents a synthesis in which these two types of information complement each other. The author proposes that therapy planning should begin with a review of the relevant outcome literature and also that divergence from research-based guidelines might be warranted under several conditions, including (a) when the client is demographically or culturally dissimilar to the study samples, (b) when assessment suggests a mismatch between the etiologies of the client's disturbance and the processes addressed by empirically supported treatments, and (c) when use of such treatments is followed by a lack of progress that signals the advisability of midcourse correction. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... With regard to early intervention for childhood depression, Stark and colleagues reported clinically important outcomes using an approach that incorporates problem-solving training, coping skills, cognitive restructuring, and parent education (e.g., Stark et al., 2005). The "Adolescent Coping with Depression Course" has been effective as a secondary and tertiary prevention tool (Clarke et al., 1995;Rohde, Lewinsohn, Clarke, Hops & Seeley, 2005). ...
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