Cited by 755Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional Development

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A Clinical Psychotherapy Trial for Adolescent Depression Comparing Cognitive, Family, and Supportive Therapy

Brent, David A.·1997·Archives of General Psychiatry

DOI 10.1001/archpsyc.1997.01830210125017

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Abstract

BACKGROUND: Previous studies in nonclinical samples have shown psychosocial treatments to be efficacious in the treatment of adolescent depression, but few psychotherapy treatment studies have been conducted in clinically referred, depressed adolescents. METHODS: One hundred seven adolescent patients with DSM-III-R major depressive disorder (MDD) were randomly assigned to 1 of 3 treatments: individual cognitive behavior therapy, systemic behavior family therapy (SBFT), or individual nondirective supportive therapy (NST). Treatments were 12 to 16 sessions provided in as many weeks. Intent-to-treat analyses were conducted using all follow-up data. RESULTS: Of the 107 patients enrolled in the study, 78 (72.9%) completed the study, 4 (3.7%) never initiated treatment, 10 (9.3%) had exclusionary criteria that were undetected at entry, 8 (7.5%) dropped out, and 7 (6.5%) were removed for clinical reasons. Cognitive behavior therapy showed a lower rate of MDD at the end of treatment compared with NST (17.1% vs 42.4%; P = .02), and resulted in a higher rate of remission (64.7%, defined as absence of MDD and at least 3 consecutive Beck Depression Inventory scores < 9) than SBFT (37.9%; P = .03) or NST (39.4%; p = .04). Cognitive behavior therapy resulted in more rapid relief in interviewer-rated (vs both treatments, P = .03) and self-reported depression (vs SBFT, P = .02). All 3 treatments showed significant and similar reductions in suicidality and functional impairment. Parents' views of the credibility of cognitive behavior therapy improved compared with parents' views of both SBFT (P = .01) and NST (P = .05). CONCLUSIONS: Cognitive behavior therapy is more efficacious than SBFT or NST for adolescent MDD in clinical settings, resulting in more rapid and complete treatment response.

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“, cognitive behavior therapy (CBT) for depression (Brent et al., 1997), parent–child interaction therapy for disruptive behavior disorders (Schuhman, Foote, Eyberg, Boggs, & Algina, 1998), and trauma-focused CBT for child trauma (Cohen, Mannarino, & Knudsen, 2005).”
Background
Preventing depression: A review of cognitive-behavioral and family interventions
Gillham, J. E., Shatté, A. J., & Freres, D. R. (2000) · Applied and Preventive Psychology · doi:10.1016/s0962-1849(00)80007-4 · Cited by 153
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“found CBT and family therapy for depressed adolescents had significant reductions in suicidal ideation compared with supportive therapy post-treatment, but no difference at follow-up.(14) One promising intervention is Attachmentbased Family Therapy (ABFT), the first manualized family therapy specifically designed to t…”
BackgroundMethod
A randomized controlled trial: attachment-based family and nondirective supportive treatments for youth who are suicidal
Diamond, G. S., Kobak, R. R., Krauthamer Ewing, E. S., Levy, S. A., Herres, J. L., Russon, J. M., & Gallop, R. J. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.10.006 · Cited by 147
“In a study of adolescents with major depressive disorder, cognitivebehavioral therapy (CBT) proved more effective than systemic behavior family therapy or NST in decreasing depressive symptoms.(5,11) However, Brent et al.”
Background
Using the Short Mood and Feelings Questionnaire to Detect Depression in Detained Adolescents
Kuo, E. S., Stoep, A. V., & Stewart, D. G. (2005) · Assessment · doi:10.1177/1073191105279984 · Cited by 149
“Furthermore, evidence-based treatments are available (Brent et al., 1997; Emslie & Mayes, 2001; Kahn, Kehle, Jenson, & Clark, 1990; Kazdin & Weisz, 1998; Lewinsohn, Clarke, Hops, & Andrews, 1990; Mufson et al., 2004; Weisz & Jensen, 1999).”
MULTI‐FAMILY PSYCHOEDUCATION GROUPS IN THE TREATMENT OF CHILDREN WITH MOOD DISORDERS
Fristad, M. A., Goldberg‐Arnold, J. S., & Gavazzi, S. M. (2003) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2003.tb01691.x · Cited by 149
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Childhood depression: a place for psychotherapy
Trowell, J. A., Joffe, I., Campbell, J., Clemente, C., Almqvist, F., Soininen, M., Koskenranta-Aalto, U., Weintraub, S., Kolaitis, G. A., Tomaras, V. D., et al. (2007) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-006-0584-x · Cited by 148
“Previous studies have found a response rate in the region of 60% to CBT [5] and 52–56% to Fluoxetine [13, 14] and 71% to CBT and Fluoxetine combined [29].”
BackgroundMethodInfluential
A Randomized Controlled Trial of Fluoxetine and Cognitive Behavioral Therapy in Adolescents With Major Depression, Behavior Problems, and Substance Use Disorders
Riggs, P., Mikulich‐Gilbertson, S. K., Davies, R. D., Lohman, M., Klein, C., & Stover, S. K. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.11.1026 · Cited by 147
Clinical practice. Adolescent depression.
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Self-citation
Individual and group CBT and IPT for Puerto Rican adolescents with depressive symptoms.
Rosselló, J., Bernal, G., & Rivera-Medina, C. (2008) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/1099-9809.14.3.234 · Cited by 197
“Our results are similar to those reported in other trials of CBT (Brent et al., 1997; Lewinsohn, Clarke, & Rohde, 1994; Rosselló & Bernal, 1999) and IPT (Mufson et al., 1999; Rosselló & Bernal, 1999), all of which have documented the efficacy of psychological interventions in reducing depressive…”
Result
Practitioner Review: The effectiveness of systemic family therapy for children and adolescents
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“Following the lead of treatment researchers (Brent et al., 1997; Shaw, 1977), we examined a supportive-expressive group intervention. The goals of nondirective supportive therapy in Brent et al. (1997) were to establish and maintain rapport, provide support, and help the client identify and express their feelings; it…”
BackgroundInfluential
Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up
RENAUD, J., BRENT, D. A., BAUGHER, M., BIRMAHER, B., KOLKO, D. J., & BRIDGE, J. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199811000-00019 · Cited by 139
“The sample has been described in detail in a previous communication (Brent et al., 1997).”
Background
Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality
Spirito, A., Esposito-Smythers, C., Wolff, J., & Uhl, K. (2011) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2011.01.012 · Cited by 140
“In 1 of the first studies, 107 adolescents (13–18 years old) diagnosed with MDDwere randomized into 1 of 3 treatment groups: individual CBT, systematic behavior family therapy (SBFT), or individual nondirective supportive therapy (NST).(32) Each treatment condition consisted of an active phase of 12 to 16 sessions ove…”
Background
ACNP Task Force Report on SSRIs and Suicidal Behavior in Youth
Mann, J. J., Emslie, G. J., Baldessarini, R. J., Beardslee, W. R., FAWCETT, J. A., Goodwin, F. K., Leon, A. C., Meltzer, H. Y., Ryan, N. D., Shaffer, D., et al. (2005) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300958 · Cited by 144
“In adolescent controlled clinical trials, CBT was found to work for most adolescents (Brent et al, 1997).”
Background
Evidence‐based practice in family therapy and systemic consultation
Carr, A. (2000) · Journal of Family Therapy · doi:10.1111/1467-6427.00137 · Cited by 140
Group therapy for adolescents with repeated self harm: randomised controlled trial with economic evaluation
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“For example, Brent et al. (1997) conducted a comparative study of cognitive–behavioral therapy, systematic behavioral family therapy, and nondirective supportive psychotherapy in adolescent suicide attempters.”
Background
Paroxetine Treatment in Children and Adolescents With Major Depressive Disorder: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial
Emslie, G. J., Wagner, K. D., Kutcher, S., Krulewicz, S., Fong, R., CARPENTER, D. J., Lipschitz, A., Machin, A., & Wilkinson, C. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000214189.73240.63 · Cited by 136
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“Moreover, on the basis of outcome differences between those with and without SGs in Tang and DeRubeis’s adult CBT sample, those who did not experience SGs in CBT were expected to show equal endpoint functioning to those in NST and SBFT. Method The data were obtained from a clinical trial of psychosocial treatments for…”
BackgroundMethodInfluentialSelf-citation
The Context of Depression in Clinic-Referred Youth: Neglected Areas in Treatment
HAMMEN, C., RUDOLPH, K., WEISZ, J., RAO, U., & BURGE, D. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199901000-00021 · Cited by 133
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Stice, E., Rohde, P., Gau, J. M., & Wade, E. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020544 · Cited by 131
“In supportive expressive interventions, which have been used in prior depression treatment trials (Brent et al., 1997; Shaw, 1977), the goals are to establish and maintain rapport, provide support, and help the client identify and express emotions.”
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Connell, A. M., & Dishion, T. J. (2008) · Journal of Family Psychology · doi:10.1037/0893-3200.22.3.574 · Cited by 130
“Only one study has examined the effectiveness of family therapy for depression in adolescents, comparing the effects of SBFT, CBT, and a nondirective supportive control condition (Brent et al., 1997).”
Background
The Prevention of Adolescent Depression
Gladstone, T. R. G., Beardslee, W. R., & O’Connor, E. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.11.015 · Cited by 150
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“However, the two completed evaluations of more intensive family interventions for adolescent depression have yielded disappointing results (Brent et al., 1997; Clarke, Rohde, Lewinsohn, Hops, & Seeley, 1999).”
Result
Compliance With Recommendations to Remove Firearms in Families Participating in a Clinical Trial for Adolescent Depression
Brent, D. A., BAUGHER, M., Birmaher, B. B., Kolko, D. J., & Bridge, J. A. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200010000-00007 · Cited by 126
Self-citation
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Hughes, C. W., Emslie, G. J., Crismon, M. L., Wagner, K. D., Birmaher, B. B., Geller, B., Pliszka, S. R., Ryan, N. D., Strober, M. A., Trivedi, M. H., et al. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199911000-00020 · Cited by 121
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Treatment of depression in children and adolescents
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Effective components of TORDIA cognitive–behavioral therapy for adolescent depression: Preliminary findings.
Kennard, B. D., Clarke, G. N., Weersing, V. R., Asarnow, J. R., Shamseddeen, W. A., Porta, G., Berk, M. S., Hughes, J. L., Spirito, A., Emslie, G. J., et al. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0017411 · Cited by 121
“These three interventions—namely, the Coping with Depression for Adolescents Course (CWD-A; Lewinsohn, Clarke, Hops, & Andrews, 1990), the Cognitive Therapy Manual from the Pittsburgh CBT trial (Brent & Poling, 1997; Brent et al., 1997), and the modular CBT manual of the Treatment for Adolescents With Depression Study…”
Self-citation
Contextual Emotion-Regulation Therapy for Childhood Depression: Description and Pilot Testing of a New Intervention
Kovács, M., Sherrill, J. T., George, C. J., Pollock, M., Tumuluru, R. V., & Ho, V. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000222878.74162.5a · Cited by 121
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Vitiello, B., Rohde, P., Silva, S. G., Wells, K., Casat, C. D., WASLICK, B. D., Simons, A. D., Reinecke, M. A., Weller, E. B., Kratochvil, C. J., et al. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000242229.52646.6e · Cited by 114
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“), including findings that it outperforms other psychosocial interventions (family therapy, nondirective therapy) for moderately depressed adolescents within 12 sessions (Brent et al., 1997).”
Background
Randomized, Controlled Trial of Amitriptyline Versus Placebo for Adolescents With “Treatment-Resistant” Major Depression
Birmaher, B. B., Waterman, G. S., Ryan, N. D., Perel, J. M., McNabb, J., BALACH, L., Beaudry, M. B., NASR, F. N., KARAMBELKAR, J., ELTERICH, G., et al. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199805000-00015 · Cited by 114
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Improving Access to Care and Clinical Outcome for Pediatric Behavioral Problems: A Randomized Trial of a Nurse-Administered Intervention in Primary Care
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Group Cognitive-Behavioral Treatment for Depressed Adolescent Offspring of Depressed Parents in a Health Maintenance Organization
CLARKE, G. N., HORNBROOK, M., LYNCH, F., POLEN, M., GALE, J., O’CONNOR, E., SEELEY, J. R., & DEBAR, L. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200203000-00010 · Cited by 110
Depressive Disorders in Childhood and Adolescence: An Overview
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Self-citation
Internet-delivered physical activity intervention for college students with mental health disorders: A randomized pilot trial
Mailey, E. L., Wójcicki, T. R., Motl, R. W., Hu, L., Strauser, D. R., Collins, K. D., & McAuley, E. (2010) · Psychology Health & Medicine · doi:10.1080/13548506.2010.498894 · Cited by 119
“…(Mazure, Keita, & Blehar, 2002; Nemeroff & Owens, 2002), these approaches have several limitations, including negative physical and mental side effects to prescribed medications and an array of barriers (e.g. availability, perceived stigma) to receiving psychotherapy (Brent et al., 1997).”
Background
Recognizing and treating depression in children and adolescents
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“Cumulative evidence on CBT and interpersonal psychotherapy shows that 8–16 weekly sessions are recommended for an optimal outcome.(9,61) Of those who were prescribed medication, 15–18-year old patients were more likely to receive medications than were younger children.”
Background
The Efficacy of Systemic Therapy for Internalizing and Other Disorders of Childhood and Adolescence: A Systematic Review of 38 Randomized Trials
Retzlaff, R., von Sydow, K., Beher, S., Haun, M. W., & Schweitzer, J. (2013) · Family Process · doi:10.1111/famp.12041 · Cited by 117
“Mood disorders and suicidality Brent et al. (1997) demonstrated that CBT was more effective than Systemic Behavioral Family Therapy (SBFT) or supportive individual therapy at end of treatment — but contrary to the hypotheses of the researchers, at the 2-year follow-up there were no differences in…”
Result
Double-blind fluoxetine trial in comorbid MDD-CUD youth and young adults.
Cornelius, J. R., Bukstein, O. G., Douaihy, A. B., Clark, D. B., Chung, T. A., Daley, D. C., Wood, D. S., & Brown, S. J. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.05.010 · Cited by 105
Alliance and Outcome in Cognitive-Behavioral Therapy for Adolescent Depression
Shirk, S. R., Gudmundsen, G. R., Kaplinski, H. C., & McMakin, D. L. (2008) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410802148061 · Cited by 106
“…depression comes from results showing similar outcomes for CBT (Brent et al., 1997), family therapy (Diamond, Reis, Diamond, Siqueland, & Isaacs, 2002), and supportive therapy (Brent et al., 1997), although the speed (trajectory) of symptom reduction appears to vary across treatment types.”
ResultInfluential
Depression in Children and Adolescents
Emslie, G. J., & Mayes, T. L. (1999) · CNS Drugs · doi:10.2165/00023210-199911030-00003 · Cited by 106
Childhood depression: a place for psychotherapy
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Effectiveness of cognitive-behavioral therapy on depressive symptomatology, stress and coping strategies among Jordanian university students
Hamdan-Mansour, A. M., Puskar, K., & Bandak, A. G. (2009) · Issues in Mental Health Nursing · doi:10.1080/01612840802694577 · Cited by 105
“Also in other studies (Birmaher et al., 2000; Brent et al., 1997), using CBT has been associated with a short and rapid improvement in depressive symptoms.”
BackgroundResult
Depression, suicide and deliberate self-harm in adolescence
Harrington, R. (2001) · British Medical Bulletin · doi:10.1093/bmb/57.1.47 · Cited by 102
Depression and Bipolar Support Alliance Consensus Statement on the Unmet Needs in Diagnosis and Treatment of Mood Disorders in Children and Adolescents
COYLE, J. T., Pine, D. S., Charney, D. S., Lewis, L., Nemeroff, C. B., Carlson, G. A., Joshi, P. T., Reiss, D., Todd, R. D., & Hellander, M. (2003) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200312000-00017 · Cited by 103
“Recent studies (Brent et al., 1997; Clarke et al., 1999; Jayson et al., 1998; Kazdin, 2000), both of cognitive-behavioral therapy and interpersonal psychotherapy (Curry, 2001), as well as of selective serotonin reuptake inhibitors (SSRIs) (Emslie and Mayes, 2001; Emslie et al., 1997; Keller et al.,…”
Background
A Pilot Study of Adjunctive Family Psychoeducation in Adolescent Major Depression: Feasibility and Treatment Effect
Sanford, M., Boyle, M., McCleary, L., Miller, J. L., Steele, M. M., Duku, E., & Offord, D. R. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000198595.68820.10 · Cited by 103
“, 1998), cognitive-behavioral therapy (CBT; Brent et al., 1997; Wood et al., 1996), and interpersonal therapy (Mufson et al.”
Background
Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta‐analysis
Tindall, L., Mikocka‐Walus, A. A., McMillan, D., Wright, B., Hewitt, C. E., & Gascoyne, S. (2017) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12121 · Cited by 114
“…treatments not meeting the criteria to be regarded as BA (n = 15; Bilek & Ehrenreich-May, 2012; Brent, Kolko, Birmaher, Baugher, & Bridge, 1999; Brent et al., 1997, 1998; Chu, Hoffman, Johns, Reyes-Portillo, & Hansford, 2015; Dundon, 2010; Esposito, 2005; Ettelson, 2003; Kauer et al., 2011;…”
An International, Multicenter, Placebo-Controlled Trial of Paroxetine in Adolescents with Major Depressive Disorder
Berard, R. M. F., Fong, R., Carpenter, D. J., Thomason, C., & Wilkinson, C. (2006) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2006.16.59 · Cited by 102
School-Based Cognitive-Behavioral Therapy for Adolescent Depression
Shirk, S. R., Kaplinski, H. C., & Gudmundsen, G. R. (2008) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426608326202 · Cited by 100
“This finding is consistent with previous results from some CBT trials for adolescent depression (Clarke et al., 1992; Rohde, Lewinsohn, & Seeley, 1994) but not others (Brent et al., 1997).”
BackgroundMethodResultInfluential
Trends in the Use of Antidepressants in a National Sample of Commercially Insured Pediatric Patients, 1998 to 2002
Delate, T., Gelenberg, A. J., Simmons, V. A., & Motheral, B. R. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.4.387 · Cited by 101
Psychological treatment of depression in children and adolescents
Harrington, R., Whittaker, J., & Shoebridge, P. (1998) · British Journal of Psychiatry · doi:10.1192/bjp.173.4.291 · Cited by 114
Depression in Youth: Psychosocial Interventions
Asarnow, J., Jaycox, L., & Tompson, M. (2001) · Journal of Clinical Child Psychology · doi:10.1207/s15374424jccp3001_5 · Cited by 102
“%) refusing randomization in the Brent et al. (1997) study did so because they did not want family treatment, an observation that is consistent with results from our pilot study indicating that families preferred a brief as opposed to more extended family intervention.”
BackgroundResultInfluential
Impact of Comorbid Anxiety in an Effectiveness Study of Interpersonal Psychotherapy for Depressed Adolescents
Young, J. F., Mufson, L. H., & Davies, M. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000222791.23927.5f · Cited by 100
Ten Ways to Improve the Use of Statistical Mediation Analysis in the Practice of Child and Adolescent Treatment Research
Maric, M., Wiers, R. W., & Prins, P. J. M. (2012) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-012-0114-y · Cited by 97
“A fourth possibility is to include a treatment comparison condition which is devoid of specific elements of the treatment such as cognitive restructuring and behavioral techniques in the case of CBT, while still providing a supportive environment (Brent et al. 1997; Last et al. 1998).”
BackgroundMethod
The effectiveness of simple psychological and physical activity interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial
Parker, A. G., Hetrick, S. E., Jorm, A. F., Mackinnon, A. J., McGorry, P. D., Yung, A. R., Scanlan, F., Stephens, J., Baird, S., Moller, B., et al. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.043 · Cited by 94
“Control groups with comparable intensity and duration of exposure to the active treatment are essential in order to conclude that the therapy is effective over and above the non-specific therapeutic effects of compassion, attention, empathic listening and support [37,42].”
Background
Cognitive behavioral therapy for depression in youth.
Weersing, V., & Brent, D. A. (2006) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2006.05.008 · Cited by 95
“The TADS investigation combined elements of CWD-A and the Brent program into a new CBT protocol , and we review the TADS findings separately from these other investigations.”
BackgroundMethodInfluentialSelf-citation
Which depressed patients respond to cognitive-behavioral treatment?
Jayson, D., Wood, A., Kroll, L., Fraser, J., & Harrington, R. (1998) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/00004583-199801000-00014 · Cited by 101
Parents' perceptions of pharmacological and cognitive-behavioral treatments for childhood anxiety disorders
Brown, A. M., Deacon, B. J., Abramowitz, J. S., Dammann, J., & Whiteside, S. P. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.04.010 · Cited by 94
“Research with depressed adolescents suggests that treatment outcome may be enhanced when parents positively perceive their child’s treatment (e.g., Brent et al., 1997).”
Depressive disorders in childhood and adolescence
Brent, D. A., & Maalouf, F. (2015) · Wiley eBooks · doi:10.1002/9781118381953.ch63 · Cited by 95
Self-citation
Emergent Suicidality in a Clinical Psychotherapy Trial for Adolescent Depression
Bridge, J. A., Barbe, R., Birmaher, B. B., Kolko, D. J., & Brent, D. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.11.2173 · Cited by 92
Self-citation
Attachment-based family therapy: Theory, clinical model, outcomes, and process research
Diamond, G., Diamond, G. M., & Levy, S. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.07.005 · Cited by 91
Passive Versus Active Parental Permission: Implications for the Ability of School‐Based Depression Screening to Reach Youth at Risk*
Chartier, M., Stoep, A. V., McCauley, E., Herting, J. R., Tracy, M., & Lymp, J. F. (2008) · Journal of School Health · doi:10.1111/j.1746-1561.2007.00278.x · Cited by 91
Self-efficacy as a predictor of treatment outcome in adolescent substance use disorders
Burleson, J. A., & Kaminer, Y. (2005) · Addictive Behaviors · doi:10.1016/j.addbeh.2005.07.006 · Cited by 91
“Coping skills training techniques have also been found effective with youth delinquency (Kazdin, 1995), anxiety disorders (Kendall et al., 1997), depression (Brent et al., 1997), and suicidal behavior (Rotheram-Borus, Piacentini, Miller, Graae, & Castro-Blanco, 1994).”
Background
Family Intervention Effects on Co-occurring Early Childhood Behavioral and Emotional Problems: A Latent Transition Analysis Approach
Connell, A. M., Bullock, B. M., Dishion, T. J., Shaw, D. S., Wilson, M. N., & Gardner, F. E. M. (2008) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-008-9244-6 · Cited by 94
“Less research has examined family interventions for internalizing difficulties, although several such interventions have been shown to reduce emotional distress in school-age children and adolescents (e.g., Asarnow et al. 2002; Brent et al. 1997; Diamond et al. 2002).”
The Role of Perfectionism and Depressive Cognitions in Understanding the Hopelessness Experienced by Adolescent Suicide Attempters
Donaldson, D. L., Spirito, A., & Farnett, E. (2000) · Child Psychiatry & Human Development · doi:10.1023/a:1001978625339 · Cited by 91
Risk for Suicide and the Role of Family
Frey, L. M., & Cerel, J. (2013) · Journal of Family Issues · doi:10.1177/0192513x13515885 · Cited by 91
“Similar to its effect on the development of suicidal behavior, family conflict also can be harmful to the treatment of risk for suicide (Brent et al., 1997; Sun et al., 2008).”
Background
Assessment of Suicidal Behaviors and Risk Among Children and Adolescents
Goldston, D. B., Nottelmann, E. D., Asharali, A., Daniel, S. S., Frazier, P. A., HARRIS, A. E., Longino, L., Manno, J. E., Reboussin, B. A., & Lewinsohn, P. M. (2000) · Cited by 89
Preventive Interventions for Youth Suicide: A Risk Factor-Based Approach
Burns, J. M., & Patton, G. C. (2000) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2000.00738.x · Cited by 89
“Cognitive–behavioural therapy (CBT) has been the principal treatment for adolescent depression with both individual and group approaches having been described [7–12].”
A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders
Sburlati, E. S., Schniering, C. A., Lyneham, H. J., & Rapee, R. M. (2011) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-011-0083-6 · Cited by 94
Family therapy for depression
Henken, T., Huibers, M. J. H., Churchill, R. C., Restifo, K., & Roelofs, J. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006728 · Cited by 89
Interventions for Adolescent Depression in Primary Care
Stein, R. E. K., Zitner, L., & Jensen, P. S. (2006) · PEDIATRICS · doi:10.1542/peds.2005-2086 · Cited by 87
Randomized efficacy trial of two psychotherapies for depression in youth with inflammatory bowel disease
Szigethy, E., Bujoreanu, S. I., Youk, A. O., Weisz, J., Benhayon, D., Fairclough, D., Ducharme, P., Gonzalez-Heydrich, J., Keljo, D., Srinath, A., et al. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.04.014 · Cited by 86
“, history of abuse), it has been found to be more efficacious than CBT.(21,43) We cannot rule out factors common to both therapies (e.”
Influential
Counselling in UK secondary schools: A comprehensive review of audit and evaluation data
Cooper, M. (2009) · Counselling and Psychotherapy Research · doi:10.1080/14733140903079258 · Cited by 86
Effectiveness of Cognitive-Behavioral Therapy for Adolescent Depression: A Benchmarking Investigation
Weersing, V. R., Iyengar, S., Kolko, D. J., Birmaher, B. B., & Brent, D. A. (2006) · Behavior Therapy · doi:10.1016/j.beth.2005.03.003 · Cited by 87
“…were drawn from two sources: (a) the patient database and medical records system of the STAR Center, an outpatient clinic providing treatment to depressed and suicidal adolescents, and (b) the research data file of the Brent et al. (1997) clinical trial of CBT for adolescent depression.”
BackgroundMethodResultInfluentialSelf-citation
A Clinical Trial for Adolescent Depression: Predictors of Additional Treatment in the Acute and Follow-up Phases of the Trial
Brent, D. A., Kolko, D. J., Birmaher, B. B., BAUGHER, M., & Bridge, J. A. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199903000-00012 · Cited by 83
Self-citation
Can cognitive-behavioral therapy increase self-esteem among depressed adolescents? A systematic review
Salisbury, T. T., & Montgomery, P. (2007) · Children and Youth Services Review · doi:10.1016/j.childyouth.2007.01.010 · Cited by 86
Real-World Affect and Social Context as Predictors of Treatment Response in Child and Adolescent Depression and Anxiety: An Ecological Momentary Assessment Study
Forbes, E. E., Stepp, S. D., Dahl, R. E., Ryan, N. D., Whalen, D. J., Axelson, D., Birmaher, B. B., & Silk, J. S. (2012) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2011.0085 · Cited by 92
“CBT was provided at Western Psychiatric Institute and Clinic, and it was tailored to each participant and guided by techniques developed by Brent and colleagues (Brent et al. 1997).”
Method
A Group Adaptation of Interpersonal Psychotherapy for Depressed Adolescents
Mufson, L., Gallagher, T., Dorta, K. P., & Young, J. F. (2004) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2004.58.2.220 · Cited by 107
Suicidality and Its Relationship to Treatment Outcome in Depressed Adolescents
Barbe, R., Bridge, J. A., Birmaher, B. B., Kolko, D. J., & Brent, D. A. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.1.44.27768 · Cited by 82
Self-citation
Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents
Cox, G. R., Callahan, P., Churchill, R., Hunot, V., Merry, S. N., Parker, A. G., & Hetrick, S. E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008324.pub2 · Cited by 70
Evidence for the Management of Adolescent Depression
Lewandowski, R. E., Acri, M. C., Hoagwood, K., Olfson, M., Clarke, G. N., Gardner, W. P., Scholle, S. H., Byron, S. C., Kelleher, K. J., Pincus, H. A., et al. (2013) · PEDIATRICS · doi:10.1542/peds.2013-0600 · Cited by 85
Characteristics of Anxious and Depressed Youth Seen in Two Different Clinical Contexts
Ehrenreich, J. T., Southam‐Gerow, M. A., Hourigan, S. E., Wright, L. R., Pincus, D. B., & Weisz, J. R. (2010) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0328-6 · Cited by 81
Caregiver-Therapist Ethnic Similarity Predicts Youth Outcomes From an Empirically Based Treatment.
Halliday‐Boykins, C. A., Schoenwald, S. K., & Letourneau, E. J. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.808 · Cited by 83
Advancing Science Through Collaborative Data Sharing and Synthesis
NIMH Collaborative Data Synthesis for Adolescent Depression Trials Study Team including:, Perrino, T., Howe, G. W., Sperling, A., Beardslee, W. R., Sandler, I. N., Shern, D. L., Pantin, H. M., Kaupert, S., Cano, N. M., et al. (2013) · Perspectives on Psychological Science · doi:10.1177/1745691613491579 · Cited by 79
“Randomized controlled trials have established that there are efficacious interventions to prevent and treat adolescent depression (Beardslee, Gladstone, Wright, & Cooper, 2003; Brent et al., 1997; Clarke et al., 2001; Compas et al., 2009; Dishion, Kavanagh, Schneiger, Nelson, & Kaufman, 2002; Garber et al., 2009; Gill…”
Background
Double-blind placebo-controlled trial of fluoxetine in adolescents with comorbid major depression and an alcohol use disorder
Cornelius, J. R., Bukstein, O. G., Wood, D. S., Kirisci, L., Douaihy, A. B., & Clark, D. B. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.03.008 · Cited by 79
“The Cognitive Behavior Therapy for depression used in this studyutilized the widely used techniques of cognitive therapy that have been adapted for treatment of adolescent depression, as described by Brent et al. (1997).”
Method

Authors: Brent, D. A.
Corresponding author: Brent, David A.
ORCID: Brent, David A.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1997-09-01
Volume: 54
Issue: 9
Pages: 877
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1997.01830210125017
OpenAlex: W1993925129
Cited by: 753
References: 58
Citations by year: 2025: 4 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 24 · 2020: 12 · 2019: 9 · 2018: 17 · 2017: 11 · 2016: 16 · 2015: 32 · 2014: 31 · 2013: 22 · 2012: 35
FWCI: 35.77
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01mh046500-07)
National Institute of Mental Health (MH 46500)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: adolescent depression, major depressive disorder, cognitive behavioral therapy, supportive therapy, family therapy, treatment efficacy, remission, suicidality, functional disability, parental attitudes
MeSH terms: Adolescent, Age Factors, Attitude to Health, Depressive Disorder, Family Therapy, Female, Humans, Male, Person-Centered Psychotherapy, Parents, Patient Dropouts, Social Class, Suicide, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome

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A Clinical Psychotherapy Trial for Adolescent Depression Comparing Cognitive, Family, and Supportive Therapy

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