TY - JOUR
T1 - Cognitive-Behavioral Therapy Versus Usual Clinical Care for Youth Depression
T2 - An Initial Test of Transportability to Community Clinics and Clinicians
AU - Weisz, John R.
AU - Southam-Gerow, Michael A.
AU - Gordis, Elana B.
AU - Connor-Smith, Jennifer K.
AU - Chu, Brian C.
AU - Langer, David A.
AU - McLeod, Bryce D.
AU - Jensen-Doss, Amanda
AU - Updegraff, Alanna
AU - Weiss, Bahr
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2009/6
Y1 - 2009/6
N2 - Community clinic therapists were randomized to (a) brief training and supervision in cognitive-behavioral therapy (CBT) for youth depression or (b) usual care (UC). The therapists treated 57 youths (56% girls), ages 8-15, of whom 33% were Caucasian, 26% were African American, and 26% were Latino/Latina. Most youths were from low-income families and all had Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) depressive disorders (plus multiple comorbidities). All youths were randomized to CBT or UC and treated until normal termination. Session coding showed more use of CBT by CBT therapists and more psychodynamic and family approaches by UC therapists. At posttreatment, depression symptom measures were at subclinical levels, and 75% of youths had no remaining depressive disorder, but CBT and UC groups did not differ on these outcomes. However, compared with UC, CBT was (a) briefer (24 vs. 39 weeks), (b) superior in parent-rated therapeutic alliance, (c) less likely to require additional services (including all psychotropics combined and depression medication in particular), and (d) less costly. The findings showed advantages for CBT in parent engagement, reduced use of medication and other services, overall cost, and possibly speed of improvement-a hypothesis that warrants testing in future research.
AB - Community clinic therapists were randomized to (a) brief training and supervision in cognitive-behavioral therapy (CBT) for youth depression or (b) usual care (UC). The therapists treated 57 youths (56% girls), ages 8-15, of whom 33% were Caucasian, 26% were African American, and 26% were Latino/Latina. Most youths were from low-income families and all had Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) depressive disorders (plus multiple comorbidities). All youths were randomized to CBT or UC and treated until normal termination. Session coding showed more use of CBT by CBT therapists and more psychodynamic and family approaches by UC therapists. At posttreatment, depression symptom measures were at subclinical levels, and 75% of youths had no remaining depressive disorder, but CBT and UC groups did not differ on these outcomes. However, compared with UC, CBT was (a) briefer (24 vs. 39 weeks), (b) superior in parent-rated therapeutic alliance, (c) less likely to require additional services (including all psychotropics combined and depression medication in particular), and (d) less costly. The findings showed advantages for CBT in parent engagement, reduced use of medication and other services, overall cost, and possibly speed of improvement-a hypothesis that warrants testing in future research.
KW - adolescents
KW - children
KW - cognitive-behavioral therapy
KW - depression
KW - youth
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U2 - 10.1037/a0013877
DO - 10.1037/a0013877
M3 - Article
C2 - 19485581
AN - SCOPUS:66949179833
VL - 77
SP - 383
EP - 396
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
SN - 0022-006X
IS - 3
ER -