scholarly journals Effectiveness and moderators of individual cognitive behavioral therapy versus treatment as usual in clinically depressed adolescents: a randomized controlled trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yvonne Stikkelbroek ◽  
Gerko Vink ◽  
Maaike H. Nauta ◽  
Marco A. Bottelier ◽  
Leonieke J. J. Vet ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Post Treatment ◽  
Multiple Informants ◽  
Cognitive Behavioral ◽  
Dysthymic Disorder ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Clinically Depressed

Abstract We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care. This multisite Randomized controlled trail included 88 clinically depressed adolescents (aged 12–21 years) randomly assigned to CBT or TAU. Multiple assessments (pre-, post treatment and six-month follow-up) were done using semi-structured interviews, questionnaires and ratings and multiple informants. The primary outcome was depressive or dysthymic disorder based on the KSADS. Completers, CBT (n = 19) and TAU (n = 26), showed a significant reduction of affective diagnoses at post treatment (76% versus 76%) and after six months (90% versus 79%). Intention-to-treat analyses on depressive symptoms showed that 41.6% within CBT and 31.8% within the TAU condition was below clinical cut-off at post treatment and after six-months, respectively 61.4% and 47.7%. No significant differences in self-reported depressive symptoms between CBT and TAU were found. No prediction or moderation effects were found for age, gender, child/parent educational level, suicidal criteria, comorbidity, and severity of depression. We conclude that CBT did not outperform TAU in clinical practice in the Netherlands. Both treatments were found to be suitable to treat clinically referred depressed adolescents. CBT needs further improvement to decrease symptom levels below the clinical cut-off at post treatment.

scholarly journals Internet-Based Cognitive Behavioral Therapy Effect for Improving Nonclinical Depressive Symptoms Among Workers Differs by Time Preference: A Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Kotaro Imamura ◽  
Toshi A Furukawa ◽  
Yutaka Matsuyama ◽  
Akihito Shimazu ◽  
Kazuto Kuribayashi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Time Preference ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Inclusion Criteria ◽  
Control Groups ◽  
Intervention Effect ◽  
Randomized Controlled

BACKGROUND Previous randomized controlled trials (RCTs) have shown a significant intervention effect of internet-based computerized cognitive behavioral therapy (iCBT) on improving nonclinical depressive symptoms among healthy workers and community residents in a primary prevention setting. Time preference is one’s relative valuation for having a reward (eg, money) at present than at a later date. Time preference may affect the effectiveness of cognitive behavioral therapy. OBJECTIVE This RCT aimed to test the difference of intervention effect of an iCBT program on improving nonclinical depressive symptoms between two subgroups classified post-hoc on the basis of time preference among workers in Japan. METHODS All workers in one corporate group (approximate n=20,000) were recruited. Participants who fulfilled the inclusion criteria were randomly allocated to either intervention or control groups. Participants in the intervention group completed 6 weekly lessons and homework assignments within the iCBT program. The Beck Depression Inventory-II (BDI-II) and Kessler’s Psychological Distress Scale (K6) measures were obtained at baseline and 3-, 6-, and 12-month follow-ups. Two subgroups were defined by the median of time preference score at baseline. RESULTS Only few (835/20,000, 4.2%) workers completed the baseline survey. Of the 835 participants, 706 who fulfilled the inclusion criteria were randomly allocated to the intervention or control group. Participants who selected irrational time preference options were excluded (21 and 18 participants in the intervention and control groups, respectively). A three-way interaction (group [intervention/control] × time [baseline/follow-up] × time preference [higher/lower]) effect of iCBT was significant for BDI-II (t1147.42=2.33, P=.02) and K6 (t1254.04=2.51, P=.01) at the 3-month follow-up, with a greater effect of the iCBT in the group with higher time preference. No significant three-way interaction was found at the 6- and 12-month follow-ups. CONCLUSIONS The effects of the iCBT were greater for the group with higher time preference at the shorter follow-up, but it was leveled off later. Workers with higher time preference may change their cognition or behavior more quickly, but these changes may not persist. CLINICALTRIAL UMIN000014146; URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000016466 (Archived by WebCite at http://www.webcitation.org/70o2rNk2V)

Therapists’ Perceived Competence in Trauma-Focused Cognitive Behavioral Therapy and Client Outcomes: Findings From a Community-Based Learning Collaborative

2021 ◽  
pp. 107755952110036
Author(s):  
Hannah C. Espeleta ◽  
Samuel O. Peer ◽  
Funlola Are ◽  
Rochelle F. Hanson
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Posttraumatic Stress ◽  
Behavioral Therapy ◽  
Perceived Competence ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Learning Collaborative ◽  
Implementation Model ◽  
Positive Treatment

This study examined therapists’ perceived competence in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and its association with youth treatment outcomes (posttraumatic stress and depression). Participants included 99 community therapists enrolled in a TF-CBT-focused Learning Collaborative (LC), along with one of their randomly selected TF-CBT training cases. Analyzed data included: 1) caregiver/youth-reported posttraumatic stress and depressive symptoms, pre- and post-treatment, and 2) therapist-perceived competence with TF-CBT components across treatment delivery. Youth- and caregiver-reports indicated large, significant pre- to post-treatment decreases in youth posttraumatic stress ( ds = 1.10–1.30, ps < .001) and depressive symptoms ( d = 1.01, p < .001). Higher therapist-perceived competence with TF-CBT predicted positive treatment responses for posttraumatic stress ( ds = 0.38–0.39, ps = .03) and depression ( d = 0.25), though only the former association was significant ( ps = .03 vs. p = .15). Findings highlight the need to monitor and improve therapists’ competencies to enhance clinical outcomes for trauma-exposed youth and suggest that LCs may be an effective training/implementation model to help achieve those critical goals.

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