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Cognitive-Behavioral Therapy for Adolescent Depression: A Meta-Analytic Investigation of Changes in Effect-Size Estimates
Open accessAbstract
Objective To explicate differences between early and recent meta-analytic estimates of the effects of cognitive-behavioral therapy (CBT) for adolescent depression.Method Meta-analytic procedures were used to investigate whether methodological characteristics moderated mean effect sizes among 11 randomized, controlled trials of CBT focusing on adolescents meeting diagnostic criteria for unipolar depression.Results Cumulative meta-analyses indicated that effects of CBT have decreased from large effects in early trials, and confidence intervals have become narrower. Effect sizes were significantly smaller among studies that used intent-to-treat analytic strategies, compared CBT to active treatments, were conducted in clinical settings, and featured greater methodological rigor based on CONSORT (Consolidated Standards of Reporting Trials) criteria. The mean posttreatment effect size of 0.53 was statistically significant.Conclusions Differences in estimates of the efficacy of CBT for depressed adolescents may stem from methodological differences between early and more recent investigations. Overall, results support the effectiveness of CBT for the treatment of adolescent depression.
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“The type of control condition selected in an outcome trial is known to significantly affect the effect size observed (Klein, Jacobs, & Reinecke, 2007).”
From A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology (2016) · cites this paper as Klein, Jacobs, & Reinecke, 2007
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“This magnitude of change compares favorably with those reported in meta–analysis of clinical trials of standard cognitive-behavioral therapy (CBT) or antidepressant drugs (TADS; Kratochvil et al., 2006; ADAPT: Wilkinson et al., 2009), as well as reviews by Klein et al. (2007) and Weisz et al. (2006).”
From A hope intervention for adolescents: a randomized controlled trial delivered by paraprofessionals (2025) · cites this paper as Klein et al., 2007
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Scioli, A., MacPherson, N., Murphy, R., Gooding, T., Love, M., Lyons, K. D., & Adachi-Mejia, A. M. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1528504 · Cited by 4
Hearn, B., Biscaldi, M., Rauh, R., & Fleischhaker, C. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1426844 · Cited by 4
Klein, I., van de Loo, K. F. E., Hoogeboom, T. J., Janssen, M. C. H., Smeitink, J. A. M., van der Veer, E., Verhaak, C. M., & Custers, J. A. E. (2021) · Trials · doi:10.1186/s13063-021-05126-7 · Cited by 3
Korean Medication Algorithm Project for Depressive Disorder 2021 (III): Child and Adolescent
Yang, C.-M., Shim, S.-H., Bahk, W., Woo, Y. S., Jeong, J., Wang, S., Kim, W., Seo, J. S., Lee, J. G., Park, Y., et al. (2021) · 신경정신의학 · doi:10.4306/jknpa.2021.60.3.193 · Cited by 2
Coetzee, B., Loades, M. E., Human, S., Gericke, H., Loxton, H., Laning, G., Myburgh, N., & Stallard, P. N. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01035-x · Cited by 3
Literature study on the Efficacy of antidepressants with CBT in the treatment of depression
Menon, S., & Bhagat, V. (2022) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2022.00465 · Cited by 3
Emotional Development and Depression
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Cognitive Behavioral Therapy with Depressed Youth
Lawrence, H. R., Buffie, M. L., Schwartz‐Mette, R. A., & Nangle, D. W. (2020) · Neuromethods · doi:10.1007/978-1-0716-0700-8_2 · Cited by 3
Concurrent Treatment of Depression in Parents and Adolescents: A Case Example
Wolff, J. C., Jandasek, B. N., Michel, B. D., Becker, S. J., & Spirito, A. (2016) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.02.001 · Cited by 3
Exercise as an Adjunct in the Treatment of Adolescent Depression
Radovic, S., Melvin, G. A., & Gordon, M. S. (2017) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2017.1362328 · Cited by 3
Evidence-Based Psychosocial Treatments of Depression in Adolescents
Curry, J. F., & Meyer, A. E. (2020) · Issues in clinical child psychology · doi:10.1007/978-3-030-44226-2_9 · Cited by 3
Emmelkamp, J., Wisman, M. A., Beuk, N., Stikkelbroek, Y. A. J., Nauta, M. H., Dekker, J., & Christ, C. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04291-6 · Cited by 6
ARSR: Committed to Quality and Breaking New Ground
van Lankveld, J. J. D. M. (2011) · The Journal of Sex Research · doi:10.1080/00224499.2011.560536 · Cited by 3
Hearn, B., Biscaldi-Schäfer, M., & Fleischhaker, C. (2024) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a001002 · Cited by 2
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“There is good evidence from high-income countries (HICs) that interventions based on cognitive behaviour therapy (CBT) are effective in treating anxiety and depression in children (Creswell et al., 2014; Klein et al., 2007; Reynolds et al., 2012; Weisz et al., 2006).”
BackgroundHuang, X., Chen, Y., Luo, J., Wang, D., Yang, C., Luo, W., & Zhou, Y. (2024) · PLoS ONE · doi:10.1371/journal.pone.0304084 · Cited by 3
“Many guidelines recommend psychotherapy as an evidence-based treatment for adolescents with depression [58, 59].”
Desarrollo y evaluación de una terapia cognitivo conductual para adolescentes que se autolesionan
Tejeda, M. M. (2013) · Universidad Nacional Autónoma de México, Facultad de Psicología eBooks · doi:10.22201/dgpyfe.9786070253263e.2013 · Cited by 2
Zinck, S., Bagnell, A. L., Bond, K., & Newton, A. S. (2009) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.439 · Cited by 2
Metadata
- Authors
- KLEIN, J. B., JACOBS, R. H., & REINECKE, M. A.
- Affiliations
- Northwestern University (US)
- Corresponding author
- KLEIN, JESSE B.
- ORCID
- JACOBS, RACHEL H.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-11
- Volume
- 46
- Issue
- 11
- Pages
- 1403-1413
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC2270481
- OpenAlex
- W2074331965
- Cited by
- 254
- References
- 43
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 6 · 2023: 10 · 2022: 13 · 2021: 13 · 2020: 25 · 2019: 18 · 2018: 16 · 2017: 9 · 2016: 20 · 2015: 19 · 2014: 13 · 2013: 22 · 2012: 10
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (F31MH075308)
- 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 › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, adolescent depression, major depressive disorder, treatment efficacy, effect size heterogeneity, methodological quality, intention-to-treat analysis, clinical trial design
- MeSH terms
- Adolescent, Major Depressive Disorder, Humans, Cognitive Behavioral Therapy, Treatment Outcome
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