Computerized CBT for Adolescent Depression (“Stressbusters”) and its Initial Evaluation Through an Extended Case Series
Abstract
BACKGROUND: "Stressbusters" is an interactive computer software programme based on a clinically effective face-to-face CBT protocol for young people with depression. It was designed for teenagers with mild to moderate depression, and comprises eight 45-minute sessions. METHOD: Twenty-three young people (aged 12-16; mean age 14.87 years) with symptoms of depression were recruited from CAMHS teams in Manchester and London, and received the Stressbusters treatment (range 1 - 8 sessions, mode 8 sessions). RESULTS: On the K-SADS at initial assessment, 95% met diagnostic criteria for a depressive disorder, with a high group mean score of 35.48 (SD 9.84) on the MFQ. Post-treatment, 22% of young people met criteria for a depressive disorder, with the group mean score on the MFQ falling significantly below clinical cut-off to 20.32 (SD 11.75). These gains were maintained at 3-month follow-up. Significant improvements were also found in the adolescents' global functioning (CGAS), self-reported anxiety (RCMAS), depressive cognitions and attributions (ATQ and CTI-C), and in adolescent- and parent-reported emotional and behavioural difficulties (SDQ). CONCLUSIONS: Taken together, these results provide promising preliminary data for the clinical efficacy of Stressbusters as a valid form of CCBT for adolescents with depression.
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In that case series, at initial assessment, 95% of the sample met diagnostic criteria for a depressive disorder, with a high group mean score (34.48, SD 9.84) on the MFQ.
“At initial assessment, 95% of the sample met diagnostic criteria for a depressive disorder, with a high group mean score (34.48, SD 9.84) on the Moods and Feelings Questionnaire (MFQ).”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
In a previous sequential case series, only 15 participants out of 28 identified (54%) completed all eight sessions of CCBT.
“In a previous sequential case series only 15 participants out of 28 identified (54%) completed all eight sessions of CCBT.16”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
Sample size calculations were based on case study work using the Stressbusters CCBT programme in 23 young people.
“Thus we have based our sample size calculations on case study work using the Stressbusters CCBT programme in 23 young people.16”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
In that case series, post-treatment, the proportion meeting diagnostic criteria fell to 22% and the group mean MFQ score fell significantly below clinical cut-off (20.32, SD 11.75).
“Post-treatment, this figure had fallen to 22% with the group mean score on the MFQ falling significantly below clinical cut-off (20.32, SD 11.75).”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
In a case series, Stressbusters was successfully used with over 30 adolescents, 70% of whom completed the full eight sessions.
“The programme has had a very encouraging case series where the programme was successfully used with over 30 adolescents, 70% of whom completed the full eight sessions.16”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
In that case series, gains were maintained at 3-month follow-up.
“These gains were maintained at 3-month follow-up.”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [16]
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Richardson, T., Stallard, P., & Velleman, S. (2010) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-010-0069-9 · Cited by 272 · see citing works
“The depression programme evaluated by Abeles et al. (2009), and the anxiety intervention used by Spence et al. (2006) were self-delivered without professional input.”
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BackgroundRainbow SPARX: A Novel Approach to Addressing Depression in Sexual Minority Youth
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“Most of these CCBT programs are delivered online and two, like SPARX (i.e., “Stressbusters” and “Think, Feel, Do”), have been provided via CD-ROM (Abeles et al., 2009; Stallard et al.).”
BackgroundMethodInfluentialA systematic review of mental health outcome measures for young people aged 12 to 25 years
Kwan, B., & Rickwood, D. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0664-x · Cited by 120 · see citing works
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“The effects of professional support and supervision is complicated, with some work with cCBT for children and adolescents finding that improvements can be made with limited or no supervision (Abeles et al., 2009; March et al., 2009; Spence et al., 2006).”
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“Thus far, much research has focused on the delivery of CBT in this form (e.g., Abeles et al., 2009; Spence, Holmes, March, & Lipp, 2006; Spence et al., 2008; Wright et al., 2014), with computerized CBT (CCBT) representing an alternative form of therapy delivery that can be administered at a lower…”
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“…and adolescents have been developed for the treatment of anxiety disorders (Khanna and Kendall, 2008; Cunningham, Rapee and Lyneham, 2006; Spence et al., 2006), with only one cCBT programme being targeted at depression (Abeles et al., 2009) and one for general emotional problems (McCusker, 2008).”
BackgroundComputerised CBT for depressed adolescents: randomised controlled trial
Smith, P., Scott, R., Eshkevari, E., Jatta, F., Leigh, E., Harris, V., Robinson, A., Abeles, P., Proudfoot, J., Verduyn, C., et al. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.07.009 · Cited by 93 · see citing works
“Both have shown promising results in a case series design (Stressbusters, Abeles et al. 2009), and in a quasiexperimental design (Think-Feel-Do; Stallard et al., 2011).”
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BackgroundParticipatory design of an online therapy for youth mental health
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BackgroundMethodResultInfluentialProcesses of Change in CBT of Adolescent Depression: Review and Recommendations
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ResultAttwood, M., Meadows, S., Stallard, P. N., & Richardson, T. H. (2011) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2011.00627.x · Cited by 45 · see citing works
“:3) for adolescent depression (Abeles et al., 2009).”
Internet‐Based Psychotherapy for Adult Depression: What About the Mechanisms of Change?
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“That this study was a preliminary case series with a small sample size, the appropriateness of significance-testing of statistical comparisons is questionable with different approaches taken in prior studies, (Abeles et al. 2009; Bechor et al. 2014; Blackwell and Holmes 2010; Rozenman et al. 2011).”
ResultOnline CBT Is Effective in Overcoming Cultural and Language Barriers in Patients With Depression
Alavi, N., Hirji, A., Sutton, C., & Naeem, F. (2016) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000119 · Cited by 34 · see citing works
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BackgroundMethodResultInfluentialNew Methods of Service Delivery for Children's Mental Health Care
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BackgroundPsychometric Properties of the Children’s Automatic Thoughts Scale (CATS) in Chinese Adolescents
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“En general, se destaca que las intervenciones vía internet obtienen resultados alentadores (Abeles et al., 2009; Gladstone et al., 2015; Kauer et al., 2012; Marasinghe et al., 2012; Martínez et al., 2014; Matthews & Doherty, 2011; Pramana et al., 2014; Reid et al., 2011; Stallard et al., 2011;…”
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A guide to what works for depression in young people
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Efficacy of an Internet-based Intervention Targeted to Adolescents with Subthreshold Depression
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Developing and evaluating QueerViBE : an online intervention to empower trans and non-binary youth
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- Authors
- Abeles, P., Verduyn, C., Robinson, A., Smith, P., Yule, W., & Proudfoot, J.
- Affiliations
- Royal Manchester Children's Hospital (GB)
- Corresponding author
- Abeles, Paul
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-01-06
- Volume
- 37
- Issue
- 2
- Pages
- 151-165
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2123440047
- Cited by
- 82
- References
- 35
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 8 · 2015: 10 · 2014: 7 · 2013: 9 · 2012: 4
- FWCI
- 7.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- adolescent depression, mild to moderate depression, youth, clinical efficacy, maintenance of treatment gains, depressive cognitions, emotional and behavioral problems, self-reported anxiety, child and adolescent mental health services
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Depressive Disorder, Female, Humans, Male, Severity of Illness Index, Social Behavior, Software, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Mood Disorders
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