Cognitive behavioral therapy can prevent depression in at-risk teens

Therapy is not effective, however, if a teen’s parent is currently suffering from depression

(PORTLAND, Ore.)—Teens at risk for depression are less likely to become depressed if they participate in cognitive behavioral therapy (CBT), which teaches problem-solving skills to identify and restructure negative thoughts. With CBT, one in five at-risk teens developed depression, compared to one in three who did not receive CBT.

These are the findings of a new paper, “Prevention of Depression in At-Risk Adolescents,” published in a special issue on child and adolescent health in this week’s Journal of the American Medical Association. TCHR senior investigator Dr. Greg Clarke is the second author on the study, the largest to date on the subject.

While this four-site national clinical trial confirmed findings of a smaller landmark study led by Dr. Clarke in 2001, researchers made a new discovery. They found that CBT was not effective if a teen has a parent who is currently depressed; this cohort represented nearly half of the 316 teens in the study. In fact, teens with depressed parents are 2–3 times more likely to suffer an episode of depression.

About 20% of American teens will suffer an episode of major depression before they turn 18—and up to half will not receive treatment. “Depression affects a staggering number of young people,” said Dr. Clarke, who is among the nation’s foremost experts on the treatment of teen depression. “The good news is that we have we’ve developed ways to help. Now the challenge is to reach these teens and give them the skills they need to keep unrealistic thinking from snowballing into full-blown depression.”

Dr. Clarke and colleagues estimated that the cognitive behavioral therapy offered in this study prevented one episode of depression for every nine adolescents who were treated—which approximates the risk reduction reported for antidepressants.

Further research is needed to treat current parental depression while either simultaneously or sequentially attempting to prevent youth depression, said Dr. Clarke, who was recently funded to continue to follow this same sample of youth as they age into young adulthood. “We know that CBT helped prevent depression among many of these at-risk teens,” said Dr. Clarke, “and we are eager to study the long-term effects of this therapy.”

Kaiser Permanente’s Center for Health Research, founded in 1964, is a non-profit research institution whose mission is advancing knowledge to improve health. It has research sites in Portland OR; Honolulu, HI; and Atlanta, GA.

Kaiser Permanente is America’s leading integrated health care organization. Founded in 1945, the organization serves the health needs of more than 8.7 million people nationwide. Nearly 480,000 people in Oregon and Southwest Washington receive their health care from Kaiser Permanente.

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