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

The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.

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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“Specifically, reviews of psychotherapy for the treatment of adolescent depressive disorders provide empirical support for the benefits of cognitive behavioral therapy (CBT) in treating depression among children and adolescents (Brent et al., 1997; Clarke et al., 1995; Reinecke, Ryan & DuBois, 1998). (See Hays, 2009, f…”
Background
Adapted dialectical behavior therapy for adolescents with a high risk of suicide in a community clinic: A pragmatic randomized controlled trial
Santamarina‐Perez, P., Mendez, I., Singh, M. K., Berk, M., Picado, M., Font, E., Moreno, E., Martínez, E., Morer, A., Borràs, R., et al. (2020) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12612 · Cited by 67
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“…et al., 2021; Connell & Dishion, 2008; Diamond et al., 2010; Kogan et al., 2016; Mason & Spoth, 2012), while others have involved comparisons to a different type of individual intervention (Brent et al., 1997; Dakof et al., 2015; Lock et al., 2010; Slesnick et al., 2013; van der Pol et al., 2018).”
Background
A review of the role of serotonin receptors in psychiatric disorders
Naughton, M., Mulrooney, J. B., & Leonard, B. E. (2000) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/1099-1077(200008)15:6 · Cited by 257
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“…concealment Blinding of outcome assessment Incomplete outcome data Goodyer, 2017 L L H L McCauley, 2016 L L L L Takagaki, 2016 L L H L Brent, 1997 L U U L Burton, 2007 L U U L Clarke, 1999 L U U L Deady, 2016 L L NA L Ip, 2016 L L U L Kobak, 2015 U U U H Lewinsohn, 1990 U U U H…”
Background
A Review of Mood Disorders Among Juvenile Offenders
Ryan, E. P., & Redding, R. E. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.12.1397 · Cited by 65
Acute Time to Response in the Treatment for Adolescents With Depression Study (TADS)
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Children and Adolescents in Cognitive–Behavioral Therapy: Some Past Efforts and Current Advances, and the Challenges in Our Future
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“…mood include a focus on at-risk children (e.g., Garber & Robinson, 1997; Hammen & Goodman-Brown, 1990), applications in groups in schools (Stark et al., 2000), efforts to prevent dysphoric mood (Lewinsohn, Clarke, Hops, & Andrews, 1990), and family applications of CBT (e.g., Brent et al., 1997).”
Background
The effects of C hinese five‐element music therapy on nursing students with depressed mood
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“, 2007) and psychotherapy (Brent et al., 1997), with their combination being most effective (March et al.”
Background
Parental validation and invalidation predict adolescent self-harm.
Adrian, M. C., Berk, M. S., Korslund, K. E., Whitlock, K. B., McCauley, E., & Linehan, M. M. (2018) · Professional Psychology Research and Practice · doi:10.1037/pro0000200 · Cited by 60
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“To achieve this end, we developed a brief, 4-session cognitive-behavioral therapy (CBT) intervention to reduce depressive symptoms because prevention and treatment interventions for adolescent depression that focus on negative cognitions appear to be highly effective interventions (29-31).”
Method
Delineating the trajectories of social and occupational functioning of young people attending early intervention mental health services in Australia: a longitudinal study
Iorfino, F., Hermens, D. F., Shane, P. C., Zmicerevska, N., Nichles, A., Badcock, C., Groot, J., Scott, E. M., & Hickie, I. B. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020678 · Cited by 63
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“Treatment studies focusing on other mental health disorders, such as depression, demonstrate that adolescents are reluctant to have family involved in treatment (Brent et al., 1997).”
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Wright, B., Tindall, L., Littlewood, E., Allgar, V. L., Abeles, P., Trépel, D., & Ali, S. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-012834 · Cited by 59
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Method
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Method
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“However, such evidence of efficacy primarily comes from trials of cognitive-behavioural therapies (CBT), and generally within a group format.”
BackgroundInfluential
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BackgroundMethodResultInfluential
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Self-citation
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Method
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Self-citation
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“…antidepressants and/or CBT or IBT, we could expect about two-thirds of these individuals to have a substantial reduction in depressive symptoms (Brent et al., 1997; Gibbons, Hur, et al., 2012), compared to about a third of these experiencing a reduction in symptoms as a consequence of the…”
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BackgroundSelf-citation
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Webb, C. A., Auerbach, R. P., & DeRubeis, R. J. (2012) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.704842 · Cited by 60
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Waraan, L., Siqveland, J., Hanssen‐Bauer, K., Czjakowski, N. O., Axelsdottir, B., Mehlum, L. I., & Aalberg, M. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221125005 · Cited by 56
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BackgroundResultInfluential
Practitioner Review: Adolescent alcohol use disorders: assessment and treatment issues
Perepletchikova, F., Krystal, J. H., & Kaufman, J. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01934.x · Cited by 55
Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents
Cox, G. R., Fisher, C. A., De Silva, S., Phelan, M., Akinwale, O. P., Simmons, M. B., & Hetrick, S. E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007504.pub2 · Cited by 48
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“, 2000), though inferior outcomes at end of intervention (Brent et al., 1997).”
BackgroundResult
University students' suicidal thoughts and influencing factors
Engin, E., Gürkan, A., Dülgerler, Ş., & Arabacı, L. B. (2009) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2008.01377.x · Cited by 49
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“Depression is recognized as a considerable mental health problem (Brent et al., 1997; Kovacs & Bastiaens, 1995).”
Background
Was wirkt in der Therapie von Depression bei Kindern und Jugendlichen wirklich?
Groen, G., & Petermann, F. (2008) · Kindheit und Entwicklung · doi:10.1026/0942-5403.17.4.243 · Cited by 49
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“The prevalence of mental disorders in youth is substantial (Brent et al., 1997); however, these disorders often go unrecognized by parents and those closest to them (Wu et al.”
Child and adolescent mood disorders—experience with serotonin-based therapies
Ryan, N. D., & Varma, D. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00163-2 · Cited by 49
Toward the Design of Evidence-Based Mental Health Information Systems for People With Depression: A Systematic Literature Review and Meta-Analysis
Wahle, F., Bollhalder, L., Kowatsch, T., & Fleisch, E. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7381 · Cited by 48
“These included (1) psychotherapy (eg, cognitive behavioral therapy [22], interpersonal therapy [23], problem-solving therapy [24], supportive therapy [25]), (2) psychoeducation [26], and (3) exercise/physical activity [27] which showed results on par with a pharmacological treatment.”
Background
How do adolescents with bulimia nervosa rate the acceptability and therapeutic relationship in family-based treatment?
Zaitsoff, S. L., Doyle, A. C., Hoste, R., & Grange, D. L. (2008) · International Journal of Eating Disorders · doi:10.1002/eat.20515 · Cited by 53
CHILDHOOD BEHAVIORAL AND EMOTIONAL DISORDERS
Northey, W. F., Wells, K. C., Silverman, W. K., & Bailey, C. E. (2003) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2003.tb01693.x · Cited by 48
Child Psychiatric Disorder
Rutter, M. L. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830210021002 · Cited by 48
Cognitive Behavioral Therapy with Children and Adolescents
Henin, A., Micco, J. A., Schoeller, M., Boudreaux, A., & Hirshfeld‐Becker, D. R. (2015) · Springer eBooks · doi:10.1007/978-1-4939-2605-3_19 · Cited by 48
Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults Living With HIV
Brown, L. K., Kennard, B. D., Emslie, G. J., Mayes, T. L., Whiteley, L., Bethel, J., Xu, J., Thornton, S., Tanney, M. R., Hawkins, L. A., et al. (2015) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000803 · Cited by 48
“This scale has been shown to predict dropout from psychosocial treatment and poorer treatment response(37) and has been used with adolescent psychiatric outpatients.(38) Life satisfaction was”
Method
Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: An initial effectiveness trial.
Shirk, S. R., DePrince, A. P., Crisostomo, P. S., & Labus, J. S. (2013) · Psychotherapy · doi:10.1037/a0034845 · Cited by 48
“A prior comparative outcome study showed that client-centered therapy produced reductions in depressive symptoms among adolescents (Brent et al., 1997).”
Result
Adolescent depression: an update and guide to clinical decision making.
Cook, M. N., Peterson, J., & Sheldon, C. (2009) · PubMed Central · Cited by 47
Comorbid adolescent substance use and major depressive disorders: a review.
Kaminer, Y., Connor, D. F., & Curry, J. F. (2007) · PubMed Central · Cited by 46
Subsyndromal depression in adolescents after a brief psychotherapy trial: course and outcome
Brent, D. A., Birmaher, B. B., Kolko, D. J., BAUGHER, M., & Bridge, J. A. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00189-0 · Cited by 46
Self-citation
Family involvement in psychotherapy for depression in children and adolescents: Systematic review and meta‐analysis
Dippel, N., Szota, K., Cuijpers, P. J., Christiansen, H., & Brakemeier, E. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12392 · Cited by 45
Use of Selective Serotonin Reuptake Inhibitors for the Treatment of Childhood Panic Disorder: A Pilot Study*
Renaud, J., Birmaher, B., Wassick, S., & Bridge, J. (1999) · Journal of child and adolescent psychopharmacology · doi:10.1089/cap.1999.9.73 · Cited by 39
“Fortunately, two of the common comorbid disorders, depression and other anxiety disorders, may also respond to SSRIs and/or CBT (Birmaher et al. 1994; Brent et al. 1997; Emslie et al. 1997).”
Assessing Childhood Psychopathology and Developmental Disabilities
Matson, J. L., Andrasik, F., & Matson, M. L. (2008) · Springer eBooks · doi:10.1007/978-0-387-09528-8 · Cited by 48
“Five studies have compared CBT to other psychosocial treatments, and it has been shown to be superior to systemic family therapy, supportive therapy (Brent et al., 1997), relaxation training (Wood, Harrington, & Moore, 1996), and life skills training (Rohde, Clarke, Mace, Jorgensen, & Seeley, 2004).”
Background
Mirtazapine in the Treatment of Adolescents with Major Depression: An Open-Label, Multicenter Pilot Study
Haapasalo‐Pesu, K., Vuola, T., Lahelma, L., & MARTTUNEN, M. J. (2004) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/1044546041649110 · Cited by 45
“…of suicide and , Finland. of adolescent major 176 mild and moderate depression in youth studies have found cognitive-behavioral therapy and interpersonal psychotherapy to be efficacious in the treatment depression (Brent et al. 1997; Clarke et al. 1999; Mufson et al. 1999; Rossello et al. 1999).”
Child and adolescent depression in the family.
Stark, K. D., Banneyer, K. N., Wang, L. A., & Arora, P. G. (2012) · Couple and Family Psychology Research and Practice · doi:10.1037/a0029916 · Cited by 43
Antidepressants in child and adolescent depression: where are the bugs?
Moreno, C., Arango, C., Parellada, M., Shaffer, D., & Bird, H. (2006) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2006.00951.x · Cited by 44
“Evidence-based psychotherapeutic treatments, such as CBT (98, 99) and Interpersonal Therapy (IPT) (100, 101), have been tested in moderately depressed adolescents and proven efficacious, and are among the first-line treatments for this population.”
BackgroundInfluential
Treatment of depression in adolescents with cognitive behavior therapy and medications: A commentary on the TADS project
Hollon, S. D., Garber, J., & Shelton, R. C. (2005) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(05)80019-7 · Cited by 43
Pharmacological Treatment of Depression in Children and Adolescents
Findling, R. L., Reed, M. D., & Blumer, J. L. (1999) · Pediatric Drugs · doi:10.2165/00128072-199901030-00002 · Cited by 43
Clinical Assessment and Diagnosis in Social Work Practice
Corcoran, J., & Walsh, J. A. (2006) · Cited by 43
The Adolescent Community Reinforcement Approach (A-CRA) as a Model Paradigm for the Management of Adolescents with Substance Use Disorders and Co-Occurring Psychiatric Disorders
Godley, S. H., Smith, J. E., Passetti, L. L., & Subramaniam, G. (2014) · Substance Abuse · doi:10.1080/08897077.2014.936993 · Cited by 42
Adjunctive Sleep Medications and Depression Outcome in the Treatment of Serotonin-Selective Reuptake Inhibitor Resistant Depression in Adolescents Study
Shamseddeen, W. A., Clarke, G. N., Keller, M. B., Wagner, K. D., Birmaher, B. B., Emslie, G. J., Ryan, N. D., Asarnow, J. R., Porta, G., & Brent, D. A. (2012) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2011.0027 · Cited by 42
“A mong adolescents with major depression, at least 40% do not show an adequate clinical response to ﬁrst-line intervention, and only one-third show complete symptomatic remission to acute treatment (Brent et al. 1997; Emslie et al. 1997; March et al. 2004; Kennard et al. 2006; Rush et al. 2006).”
Self-citation
Diagnosis and Treatment of Dysthymia in Children and Adolescents
Nobile, M., Cataldo, M. G., Marino, C., & Molteni, M. (2003) · CNS Drugs · doi:10.2165/00023210-200317130-00001 · Cited by 45
Continuation and Maintenance Therapy of Early-Onset Major Depressive Disorder
Emslie, G. J., Mayes, T. L., & Ruberu, M. (2005) · Pediatric Drugs · doi:10.2165/00148581-200507040-00001 · Cited by 45
Treating adolescents with eating disorders in the family context
Lock, J. (2002) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(01)00009-8 · Cited by 42
“Various CBT treatments have been applied successfully to children and adolescent psychiatric disorders, most notably depression and anxiety disorders [2,5,6,8,22,23,28,31,32,47].”
Background
Current Status of Family Intervention Science
Diamond, G. S., & Siqueland, L. (2001) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(18)30051-8 · Cited by 43
Expanding Behavioral Activation to Depressed Adolescents: Lessons Learned in Treatment Development
McCauley, E., Schloredt, K. A., Gudmundsen, G. R., Martell, C. R., & Dimidjian, S. (2011) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2010.07.006 · Cited by 43
Outcome studies of family therapy in child and adolescent depression
Cottrell, D. J. (2003) · Journal of Family Therapy · doi:10.1111/1467-6427.00258 · Cited by 41
“This is the study by Brent and colleagues (Birmaher et al., 2000; Brent et al., 1997) who compared three different interventions: cognitive behavioural therapy (CBT), systemic-behavioural family therapy (SBFT) and non-directive support treatment for 107 adolescents, two-thirds of whom were clinically referred (the rem…”
Background
Depression in children and adolescents
Lagges, A. M., & Dunn, D. W. (2003) · Neurologic Clinics · doi:10.1016/s0733-8619(03)00008-2 · Cited by 41
Back to basics: could behavioural therapy be a good treatment option for youth depression? A critical review
Hetrick, S. E., Cox, G. R., Fisher, C. A., Bhar, S. S., Rice, S. M., Davey, C. G., & Parker, A. G. (2015) · Early Intervention in Psychiatry · doi:10.1111/eip.12142 · Cited by 39
“This is in contrast to two other key studies that included CBT and showed much better results.(41,42) The TADS treatment manual was adapted from the treatment manuals used in these positive studies.”
Result
Telemedicine of family-based treatment for adolescent anorexia nervosa: A protocol of a treatment development study
Anderson, K. E., Byrne, C. E., Goodyear, A. M., Reichel, R., & Grange, D. L. (2015) · Journal of Eating Disorders · doi:10.1186/s40337-015-0063-1 · Cited by 42
The treatment of adolescent depression in the era of the black box warning
Richmond, T. K., & Rosen, D. S. (2005) · Current Opinion in Pediatrics · doi:10.1097/01.mop.0000166347.53102.e7 · Cited by 40
Family-focused Treatment for Childhood-onset Depressive Disorders: Results of an Open Trial
Tompson, M. C., Pierre, C. B., Haber, F. M., Fogler, J., Groff, A., & Asarnow, J. R. (2007) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104507078474 · Cited by 39
Enhancing the Developmental Appropriateness of Treatment for Depression in Youth: Integrating the Family in Treatment
Tompson, M. C., Boger, K. D., & Asarnow, J. R. (2012) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2012.01.003 · Cited by 42
Social problem solving among depressed adolescents is enhanced by structured psychotherapies.
Dietz, L. J., Marshal, M. P., Burton, C. M., Bridge, J. A., Birmaher, B. B., Kolko, D. J., Duffy, J. N., & Brent, D. A. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035718 · Cited by 42
“The current study investigated changes in adolescents’ interpersonal behavior during mother-child interactions in a previously described sample of depressed adolescents who were randomized to receive one of three psychosocial treatments (Brent et al., 1997): CBT, systemic behavior family therapy (SBFT), and nondirecti…”
InfluentialSelf-citation
Effekte pharmakologischer und psychotherapeutischer Interventionen auf Depressionen bei Kindern und Jugendlichen
Pössel, P., & Hautzinger, M. (2006) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917.34.4.243 · Cited by 39
Depression Among Pregnant Adolescents: An Integrated Treatment Approach
Szigethy, E., & Ruiz, P. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.1.22 · Cited by 39
“Controlled clinical trials among nonpregnant depressed adolescents have demonstrated that cognitive behavior therapy and interpersonal therapy are safe and efficacious in the treatment of depression (8, 18).”
Background
Treatment of depressed mothers of depressed children: Pilot study of feasibility
Verdeli, H., Ferro, T., WICKRAMARATNE, P. J., Greenwald, S., Blanco, C., & Weissman, M. M. (2004) · Depression and Anxiety · doi:10.1002/da.10139 · Cited by 38
Development and Depression
Garber, J. (2000) · Springer eBooks · doi:10.1007/978-1-4615-4163-9_25 · Cited by 39

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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