Psychotherapists treat depression in two primary ways, with medication and through cognitive-behavioral “talking therapy.” Six years ago some therapists went even further; they set up a cognitive-behavioral therapy program for teenagers considered to be at-risk of developing depression. These teens had exhibited prior depressive episodes, and had at least one parent with current or prior episodes of depression. The intervention was considered successful, and when researchers recently revisited the participants, they were pleasantly surprised to find it is still working.
Dr. David A. Brent, of the University of Pittsburgh Medical Center, says:
We have already shown that the intervention was more effective than usual care but it is surprising that we are still finding a difference between groups six years later.
Brent said in a recent interview that young people who had been in the therapy group were still at risk for depression, but they had fewer depressed days, and functioned better in the workplace and in their personal lives.
Between 2003 and 2006, researchers randomly divided 316 of the at-risk teenagers into two groups. Youth in the cognitive-behavioral prevention program participated in eight weekly 90-minute group therapy sessions. They then attended six monthly sessions. There was no intervention from researchers with the other group, although some may have received care initiated by their families.
Some of the teenagers did develop depression while the study was underway, or over the following six years. However, it was less common in the therapy group, according to the study published in JAMA Psychiatry.
For the first nine months of the study, participants in the cognitive-behavioral therapy group were at 36 percent less risk of developing depression than were teens in the comparison group. The authors noted the intervention was most effective with teens whose parents were not actively depressed at the onset of the study.
Irwin Sandler is director of Prevention Research Center at Arizona State University in Tempe. He was not a part of the study, but he explained:
Theoretically, cognitive behavioral therapy works by changing children’s thinking patterns – so that they can challenge negative thoughts and not engage in the kinds of interpretations of events in their lives that lead to depression.
He believes intervention during adolescence is key, because teenagers are actively acquiring new academic and social skills. They can easily fall behind if they are depressed. He also feels the best time to initiate preventive therapy is following treatment of a parent for depression, rather than during treatment. He continued,
By relieving that depression, he or she will catch up to some degree and that could be reflected years later.
Youth who have had a previous episode of depression should receive some ongoing help to keep them well; this is now standard care. Youth who are at risk, and may have some symptoms but not full blown depression would probably benefit from getting (cognitive-behavioral therapy) earlier, prior to developing a full-blown episode.
This study highlights the increased risk for young people whose parents are depressed, as well as the efficacy of cognitive-behavioral therapy for teens. Unfortunately, such programs are still in short supply. Insurance companies do not reimburse for preventive mental health treatment. Group therapy is less expensive than individual, however. Sandler suggested parents look for evidence-based programs in their communities.