Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course

Idsøe, Thormod; Keles, Serap; Olseth, Asgeir Røyrhus; Ogden, Terje

doi:10.1186/s12888-019-2134-3

Cited by 17 publications

(15 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ACDC sessions not only focus on encouraging participants to learn and practice new skills taught in the sessions, but also to show enactment of specific skills through role playing. In the effectiveness evaluation of the intervention, we found changes in cognitive styles such as perfectionism and rumination after the intervention (Idsoe et al, 2019) and these findings may also indirectly support the acquisition and enactment of the participants' skills. On the other hand, during intervention delivery, 6% of the intervention facilitators never provided homework.…”

Section: Treatment Designmentioning

confidence: 63%

“…This paper was a part of the evaluation of an RCT of the ACDC intervention that aims to decrease depressive symptoms among upper secondary school students (Idsoe & Keles, 2016;Idsoe et al, 2019;Keles & Idsoe, 2021). We applied the comprehensive fidelity model developed by the NIH's Behavior Change Consortium to examine how the implementation of the ACDC intervention met the fidelity strategies under five categories: study design; training; intervention delivery; receipt of the intervention; and enactment of intervention skills.…”

Section: Discussionmentioning

confidence: 99%

“…Data came from a two-arm (ACDC-Adolescent Coping with Depression Course vs. UC-Usual Care) parallel cluster randomized controlled trial (RCT), with course leaders as the unit of allocation and youth participants as the unit of analysis. Further details regarding study design, recruitment, inclusion/exclusion criteria, intervention content, attrition, and missing data mechanisms have been extensively described in elsewhere (Idsoe & Keles, 2016;Idsoe et al, 2019), and will therefore only briefly be summarized throughout the text (see also Appendix for more details). Figure 1 shows the participant flowchart in the original trial.…”

Section: Methodsmentioning

confidence: 99%

“…The "Adolescent Coping with Depression Course" (ACDC), which was developed for the Norwegian context, is a CBT-based group course for adolescents with subclinical or mild to moderate depression (Børve, 2010). The ACDC intervention has recently been evaluated using an RCT design (Idsoe & Keles, 2016;Idsoe et al, 2019). The results showed a small to medium reduction in depressive symptoms for the ACDC group compared to the usual care (UC) control group (d = − 0.31).…”

mentioning

confidence: 99%

“…This study is a part of the evaluation of the ACDC intervention (Idsoe & Keles, 2016;Idsoe et al, 2019). It is necessary to assess implementation fidelity to gain a comprehensive evaluation of an intervention.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Assessing Fidelity to and Satisfaction with the “Adolescent Coping with Depression Course” (ACDC) Intervention in a Randomized Controlled Trial

Keles

Bringedal

Idsøe

2021

J Rat-Emo Cognitive-Behav Ther

Self Cite

View full text Add to dashboard Cite

This paper aims at describing the process for assessing the intervention fidelity of a randomized controlled trial (RCT) of an “Adolescent Coping with Depression Course” (ACDC) and to assess the participants’ satisfaction with the intervention. We applied the comprehensive fidelity model developed by the National Institutes of Health’s Behavior Change Consortium to examine how our intervention met the fidelity requirements under five categories. Data came from a two-arm parallel cluster RCT. Both qualitative and quantitative analyses of the ACDC intervention using the comprehensive fidelity model indicated that the level of fidelity in this study did not reach 100%. However, it was approaching a high level of treatment fidelity. Participants also expressed high levels of satisfaction (M = 3.65, SD = .95). This analysis is important to show how appropriately the intervention was implemented, areas for improvement to increase its fidelity, and to ensure the internal and external validity of the findings. Trial Registration: ISRCTN registry ISRCTN19700389. Registered 6 October 2015. https://doi.org/10.1186/ISRCTN19700389. Full Protocol: 10.1186/s12888-016-0954-y

show abstract

Section: Treatment Designmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Assessing Fidelity to and Satisfaction with the “Adolescent Coping with Depression Course” (ACDC) Intervention in a Randomized Controlled Trial

Keles

Bringedal

Idsøe

2021

J Rat-Emo Cognitive-Behav Ther

Self Cite

View full text Add to dashboard Cite

show abstract

A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Bjornstad,

Sonthalia,

Rouse

et al. 2024

Campbell Systematic Reviews

View full text Add to dashboard Cite

BackgroundDepression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities.ObjectivesThe primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability).Search MethodsThe Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand‐searching of two databases.Selection CriteriaRandomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10–19 years with clinically relevant symptoms or diagnosis of depression were included.Data Collection and AnalysisScreening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self‐help, and unguided self‐help. Effect on depressive symptom score was estimated across validated self‐report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow‐up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta‐analyses were conducted using random effects models where there were two or more head‐to‐head trials. Network analyses were conducted using random effects models.Main ResultsSixty‐eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty‐two RCTs (representing 6435 participants) were included in the pairwise and network meta‐analyses for post‐intervention depressive symptom score at post‐intervention. All pre‐specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self‐help (SUCRA 83%) and unguided self‐help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta‐analyses for 6 to 12 month follow‐up depressive symptom score. Neither guided self‐help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6‐ to 12‐month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self‐help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self‐help and individual CBT, respectively. Sixty‐two RCTs (7347 participants) were included in the pairwise and network meta‐analyses for intervention acceptability. All pre‐specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta‐analytic findings were similar to those of the network meta‐analysis for all analyses. There may be age‐based subgroup effects on post‐intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre‐specified sensitivity analyses separating out the type of placebo and excluding cluster‐RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations.Authors' ConclusionsAt posttreatment, all active treatments (group CBT, individual CBT, guided self‐help, and unguided self‐help) except for remote CBT were more effective than no treatment. Guided self‐help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16–19 years). Moreover, the studies of guided self‐help vary in the type and amount of therapist support provided and longer‐term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6‐ to 12‐month outcomes. Although unguided self‐help was the lowest‐ranked active intervention at post‐intervention, it was the highest ranked at follow‐up. This suggests the need for further research into whether interventions with self‐directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long‐term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost‐effective would be particularly useful.

show abstract

Cognitive Behaviour Therapy for Adolescents

Borah¹

2022

Adolescence in India

View full text Add to dashboard Cite

Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course

Cited by 17 publications

References 53 publications

Assessing Fidelity to and Satisfaction with the “Adolescent Coping with Depression Course” (ACDC) Intervention in a Randomized Controlled Trial

Assessing Fidelity to and Satisfaction with the “Adolescent Coping with Depression Course” (ACDC) Intervention in a Randomized Controlled Trial

A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Cognitive Behaviour Therapy for Adolescents

Contact Info

Product

Resources

About