Running head: CBT EFFECTIVENESS IN DEPRESSED TEENS 1

Effectiveness of Cognitive Behavioral Therapy in Teens with Depression

Taylor Stout
Ottawa University
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Cognitive behavioral therapy is a tool that is often taught by therapists that helps patients

cope with stressors. Cognitive behavioral therapy is a short-term way for users to problem solve.

Cognitive behavioral therapy focuses on the meaning of an event which causes the reaction,

rather than the event itself. The goal of cognitive behavioral therapy is to change the way a client

feels and reacts to a situation by changing their thought pattern (Martin, 2016). People of all

diagnoses, sexes, and ages benefit from cognitive behavioral therapy. It is useful because the

therapy can be personalized based off the needs and personality of the patient. What will be

researched for this essay is the effectiveness of cognitive behavioral therapy being used on

adolescents with depression. The three main focus points will be the history, the effectiveness,

and the alternative options of care. Comparing cognitive behavioral therapy to other types of

therapy will be assessed, as will the involvement of the patient and the setting of the therapy.

Scholarly articles and their studys data will be used as evidence. Adolescents are different than

other age groups because of the amount of growth that takes place. Children benefit from

cognitive behavioral therapy for different reasons and problems. There is a lot of development,

mentally and physically, in adolescents. Adults are different than the adolescents because of their

life experiences and responsibilities. There is also a difference in diagnoses. Depression cannot

be treated the exact same as anxiety, or an eating disorder. Most of the data that is available

supports cognitive behavioral therapy as a whole, but what needs to be discussed is how it effects

certain subgroups within the pool of patients who seek treatment through therapy.

Aaron Beck, a psychiatrist working at the University of Pennsylvania in the 1960s

developed cognitive behavioral therapy (Wikipedia, 2017). Sigmund Freud theorized that

thoughts were unconscious, they could not be controlled. When Aaron Beck was studying free

association, a concept Sigmund Freud developed, he found that thoughts were conscious. Aaron
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Beck believed that our thoughts or thought patterns were caused by emotional distress. Aaron

Beck began naming the thoughts automatic thoughts (Wikipedia, 2017). The four basic steps of

cognitive behavioral therapy are recognizing critical behaviors, decide if those behaviors are

excess or deficits, evaluate the behavior for occurrence, length, and intensity, and finally if it is

excess, try to decrease the occurrence, length and intensity and if it is deficit, increase it.

Currently, there are four ways in which a person can receive treatment through cognitive

behavioral therapy. Those methods are through a therapist, computerized cognitive behavioral

therapy, self-help reading materials, and group courses that enhance education.

Many studies show that cognitive behavioral therapy is effective. The reasons why or the

factors that come in to play regarding the effectiveness vary. In one study, the researchers were

trying to figure out what helps patients become involve in their cognitive behavioral therapy

sessions. The researcher studied what the therapist did in order to provoke interest in the patient,

and then they researcher studied the patient. The researchers found that an adolescent has a much

higher likelihood of being successful in their treatment process if they are nonresistant to the

treatment. The pattern was also found that when a therapist paid high attention to the patients

home life, symptoms, past, and subjective experiences it aided the patient into treatment

involvement. The patients involvement helps the therapist personalize the cognitive behavioral

therapy concepts (Jungbulth, N.J. & Shirk, S.R. 2009). The more a therapist is able to do that, the

more likely the patient is to stay in treatment and maintain the tools they acquired while seeking

treatment. In a study done in Nigeria, students who met the requirement of an eighteen or above

on the Beck Depression Inventory participated. The Beck Depression Inventory was developed

by the same man who created cognitive behavioral therapy, Aaron Beck. The students went to

weekly meetings with a therapist for five consecutive weeks. The researchers used the Beck
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Depression Inventory, the Short Mood and Feelings Questionnaire, and the Impact Supplement

of the Strengths and Difficulties Questionnaire to find their data (Ani C., Bella-Awusah, T., &

Omigbodun, O. 2016).. They compared their previous scores of the Beck Depression Inventory

to assess whether or not there was an improvement in their depression.

Another study that took place involved a school based therapy program but also involved

parents supported the effectiveness of cognitive behavioral therapy. Allison, a sixteen-year-old,

and her mother both participated. The goal of the program, @school, was to develop treatment

that worked best on children. Allison and her mom met separately and together. They both had

different goals in their individual sessions but used cognitive behavioral therapy to achieve their

goals. Throughout the treatment, Allison began going to school more often, internalizing her

emotions less often, and being more self -efficient (Heyne, D. Ollendick, T. H., Sauter, F. M.,

Westenberg, P. M., & Van Widenfelt B. M. 2014). The two-month follow-up appointment stated

that her improvements were maintained. Not only was cognitive behavioral therapy successful,

but it was successful with Allison and her mother. Family involvement and support tends to

enhance the patients accomplishments. When a parent can implement the tools of cognitive

behavioral therapy in their own life and use them, success is more likely to occur. A second study

that includes family involvement was one about the SAFETY program. SAFETY is meant to be

integrated with emergency services available to youth attempting suicide. SAFETY uses

cognitive behavioral therapy. There was a group who participated in SAFETY and a group that

did treatment as usual. The program trial lasted for twelve weeks and was meant to decrease the

risk of suicide attempts and increase safely through family intervention using cognitive

behavioral therapy. The parents, much like the @school program, had separate sessions and also

group sessions with their child. They learned about skills that used cognitive behavioral therapy
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as a way to prevent suicide and suicide attempts. The researchers used the Diagnostic Interview

Schedule for Children and Adolescents to collect data. The participants took the survey three

months and six months after the treatment had stopped. The most improvement that was found in

the cognitive behavioral therapy group were categories including hopelessness, the social

adjustment scale, and depressive symptoms in the adolescents and their parents (Anderson, N. L.,

Asarnow, J. R., Berk, M., &Hughes, J. L. 2015).

Cognitive behavioral therapy also is effective in the group setting. Researchers went into

a study knowing that cognitive behavioral therapy is effective way to treat adolescents with

depression. What they were wanting to learn more about was the effectiveness in a group setting.

The research took place in an inpatient treatment center where they worked out of the

Manualized Intervention to Cope with depressive symptoms, Help strengthen resources, and

Improve emotional regulation (Fergert, J., Gonzalez-Aracil, I., Koelch, M. Plener, P., Sprober,

N., Straub, J., & Voit, A. 2013). Emotional regulation and moods were improved throughout four

sessions. Group therapy is less expensive so if patients needed to, they could use group therapy

instead of individual.

Having more than one diagnosis is called being transdiagnostic. Cognitive behavioral therapy is

just as effective when providing treatment for one diagnosis as it is when treating for someone

who is transdiagnostic (Charot, P., Garcia-Escalera, J.M., Sadin, B., & Bliente, R. 2016).

Although this study suggested that cognitive behavioral therapy is most effective on adults who

are transdiagnostic, they also stated that adolescents and children still benefited greatly from it.

Based on the evidence above, cognitive behavioral therapy is a reliable way to treat depression in

adolescents. All studies showed improvement. The studies were all published in well known,

psychology journals. Many were also published by the American Psychological Association.
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There is an abundance of information on why cognitive behavioral therapy works for adolescents

with depression. Although a few studies that have been given compare the benefits of cognitive

behavioral therapy with treatment as usual, there need to be a comparison to fully make a

judgement of the true effectiveness.

Clearly, cognitive behavioral therapy is effective, but there are different aspects and tools

within it. This study researches the most effective tools in cognitive behavioral therapy. Most of

the participants thought that the behavioral activation, relationships, and psycho-education was

the most helpful (Bru, L., Isoe, T., & Solholm 2013). There were two components that they did

not has a general agreeance on. Those two were therapy homework assignments and relaxation

techniques. The only negative experience they all had with cognitive behavioral therapy was the

guilt they felt during the intervention for having depression.

There are many different types of therapies. In a study conducted in 2013, researchers

compared group cognitive behavioral therapy to group supportive-expression, assessment only,

and bibliotherapy. Supportive expression is helping the patients feel comfortable with talking

about their experiences and identifying and working through interpersonal relationship

difficulties (EBP Substance Use, 2013). Assessment only is when the participants take an

assessment and then are reassessed later, which is used as the control group for this study. All of

the participants had depressive symptoms and were deemed high-risk. The average age of the

participants was 15.6 years old. Bibliotherapy uses books to treat disorders. Out of all the

disorders, cognitive behavioral therapy had the most improvement (Gau., J. M., Rohde, P.,

Seeley, J. R.., & Stice, E. 2008). Depressive symptoms were reduced in the bibliotherapy and

supportive-expression groups.
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Another study that included more than one other type of treatment involves five hundred

eighteen students. After taking the Childrens Depression Inventory, they were split up into three

groups, one for each treatment type. The groups were cognitive behavioral therapy, nonspecific

control group, and no intervention control group. After weekly appointments for ten weeks, the

participants retook the Childrens Depression Inventory and compared it to the first time they

took it. After four, eight, and twelve months, the researchers compared those results again.

Compared to the other two groups, the cognitive behavioral therapy group significantly lowered

their scores in the Childrens Depression Inventory after just four months (Garber, J., Hautzinger,

M., Martin, N. & Possel, P. 2013).

In conclusion, it is clear that cognitive behavioral therapy is effective in adolescents with

depression. Identifying where the origins of cognitive behavioral therapy is helps researchers

understand its purpose. Aaron Beck created cognitive behavioral therapy and it has since spread

widely enough to where it is used in many treatment centers and self-help books. There are ways

to enhance the treatment. Ways such as having a parent involved and a therapist who is

concerned with the individuals experiences starting with the first session. Generally, there are

tools or components that are included in cognitive behavioral therapy that are more helpful than

the rest. These are behavioral activation, relationships, and psycho-education. Cognitive

behavioral therapy is effective in adolescents with depression when comparing the research

between other therapies and cognitive behavioral therapy. Not only is it just as effective, but as

research has shown, it is more commonly more effective. The research that was found in this

essay was all credible and relevant to the time. The American Psychological Association either

published or has relations with many of the articles that were used. There is much more to be

learned regarding cognitive behavioral therapy and the other therapy types. If researchers can
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harness more information about the aspects that work with cognitive behavioral therapy, and

aspects that are specifically effective from other therapies, many more people will get an even

more reliable treatment.

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References

Aaron T. Beck. (n.d.). In Wikipedia. Retrieved March 14, 2017, from

http://en.wikipedia.org/wiki/Aaron_T._Beck

Anderson, N. L., Asarnow, J. R., Berk, M., & Hughes, J. L., (2015). The SAFETY program: A

treatment-development trial of a cognitive behavioral family treatment for adolescent

suicide survivors Journal of Clinical Child & Adolescent Psychology, 44(1), 194-203.

Ani, C., Ajuwon, A., Bella-Awusah, T., & Omigbodun, O. (2016). Effectiveness of brief school-

based, cognitive behavioral therapy for depressed adolescents in south west nigeria Child

and Adolescent Mental Health, 21(1), 44-50.

Bru, L, Idsoe, T., & Solholm, R. (2013). Participants experiences of an early cognitive

behavioral intervention for adolescents with symptoms of depression Emotional and

Behavioural Difficulties, 18(1), 24-43.

Chorot, P., Garcia-Escalera, J., Reales, J.M., Sadin, B., & Valiente, R. (2016), Efficacy of

transdiagnostic cognitive-behavioral therapy for anxiety and depression in adults,

children, and adolescents: A meta-analysis Revista de Psicopatologia y Psicologia

Clinica, 21(3), 147-175.

Fergert, J., Gonzalez-Aracil, I., Koelch, M., Plener, P., Sprober, N., Straub, J., & Voit, A. (2013).

Innovations in practice: MICI, a brief cognitive-behavioral group therapy for adolescents

with depression- a pilot study of feasibility in an inpatient facility Child and Adolescent

Mental Health, 18(4), 247-250.

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Gau, J. M., Rohde, P., Seeley, J. R., & Stice, E. (2008). Brief cognitive-behavioral depression

prevention program for high-risk adolescents outperforms two alternative interventions:

A randomized efficacy trial Journal of Consulting and Clinical Psychology, 76(4), 595-

606.

Garber, J., Hautzinger, M., Martin, N., & Possel, P. (2013). A randomized controlled trial of a

cognitive-behavioral program for the prevention of depression in adolescents compared

with nonspecific and non-intervention control conditions Journal of Counseling

Psychology, 60(3), 432-438.

Heyne, D., Ollendick, T. H., Sauter, F.M., Westenberg, P. M., & Van Widenfelt, B. M. (2014).

Developmentally sensitive cognitive behavioral therapy for adolescent school refusal:

Rationale and case illustration Clinical Child & Family Psychology Review, 17(2), 191-

215.

Jungbulth, N.J. & Shirk, S.R. (2009). Therapist strategies for building involvement in cognitive-

behavioral therapy for adolescent depression

Martin, B. (2016). In-Depth: Cognitive Behavioral Therapy. Psych Central. Retrieved on April 4,

2017, from https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/

Supportive-Expressive Psychotherapy. (2013, March). Evidence-Based Practice for Substance

Use Disorders. Retrieved from http://lib.adai.washington.edu