4.2 Article

Do specific modules of cognitive behavioral therapy for depression have measurable effects on youth internalizing symptoms? An idiographic analysis

Journal

PSYCHOTHERAPY RESEARCH
Volume 33, Issue 3, Pages 265-281

Publisher

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/10503307.2022.2131475

Keywords

Major depression; child psychopathology; cognitive behavioral therapy; precision medicine

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This study examined the effects of specific cognitive behavioral therapy (CBT) modules on internalizing symptoms among depressed youths. The results showed that some modules were associated with symptom reduction, but others were associated with symptom deterioration. More research is needed to establish an evidence base for specific module effects in order to personalize treatment for youth depression.
Objective Understanding the efficacy of each module of cognitive behavioral therapy (CBT) may inform efforts to improve outcomes for youth depression, but effects of specific modules have been difficult to examine. Idiographic interrupted time series models offer a robust way to estimate module effects on an individual's symptoms. This study examined the association of specific CBT modules for depression on internalizing symptoms among depressed youths who received modular CBT in a randomized trial. Methods Individual models were created for three youths who met study criteria. Youths completed weekly symptom reports, and clinicians completed records of modules delivered. First order auto-regressive models quantified the change in average internalizing symptom severity between pre- and post-module delivery. Results All youths had 1-3 modules that were significantly associated with symptom reduction and 1-3 modules associated with deterioration. The 5 modules associated with improvement in at least one youth also lacked association (engagement, relaxation, cognitive reframing), or were associated with worsening (activity selection, parent psychoeducation) in others. Seven modules showed no measurable benefit, or detriment to any youth. Conclusion This study demonstrated that specific modules have measurable effects, but more work is needed to build an evidence base of specific module effects to inform treatment personalization for youth depression.

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