Counseling Outcomes From 1990 to 2008 for School-Age Youth With Depression: A Meta-Analysis

A randomized controlled trial of an adapted group cognitive-behavioral therapy for burned-out teachers

OBJECTIVE

Reports regarding experienced teacher burnout in public schools are becoming a concerning issue. Although several therapeutic interventions have been proposed to alleviate burnout symptoms, CBT programs appear to be more practical with large effects on burnout. However, there is limited research investigating the effects of an adapted group-based CBT program on teacher burnout.

METHODS

The Maslach Burnout Inventory-Educators Survey was administered to 201 teachers working in public schools in Iran. Initial analyses indicated burnout symptoms in 66 teachers, who were randomly assigned to either a CBT treatment program or a waitlist group. The treatment group attended an adapted group therapy program with various therapeutic coping strategies, cognitive restructuring techniques, and applied relaxation training to facilitate cognitive and behavior change. Multilevel modeling was used to estimate treatment effects on teachers' burnout symptoms.

RESULTS

The results indicated the positive effects of the treatment program in improving teachers' emotional exhaustion, depersonalization, and reduced personal accomplishment, which remained significantly elevated at a 6-month follow-up of the intervention. However, treatment effects and improvements in outcome measures were larger for novice teachers. Accordingly, teaching experience moderated the relationship between the group conditions and burnout levels.

CONCLUSIONS

The findings from the study suggest this culturally-adapted CBT intervention may contribute to overcoming occupational stressors and reducing teachers' burnout, which is critically important for sustaining the workforce.

Six- and Twelve-Month Follow-up Results of a Cluster Randomized Controlled Trial of a CBT-Based Group Course

In the current study, we examined the durability of intervention gains over a 6- and 12-month follow-up period after the implementation of a CBT-based group intervention "Adolescent Coping with Depression Course" (ACDC) for adolescents with subclinical or mild-to-moderate depression. Data were collected from 228 youth, 133 of whom were allocated to the 14-week ACDC intervention and 95 to the usual care (UC) control condition. Analyses for the main outcome variable of depressive symptoms were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time on an intention-to-treat basis. Results revealed that the reduction in depressive symptoms achieved during the intervention phase continued across the follow-up period for both ACDC and UC (i.e., depressive symptoms showed a significantly decreasing trend in both groups in intervention and follow-up phases); however, no differential effects between conditions were found during the follow-up phase. The direct and indirect effects of the intervention on the other outcome variables' follow-up results were also presented. ISRCTN registry ISRCTN19700389. Registered 6 October 2015. https://doi.org/10.1186/ISRCTN19700389 . Full Protocol: https://doi.org/10.1186/s12888-016-0954-y.

The Impact of an Adolescent Depressive Disorders Clinical Pathway on Healthcare Utilization

Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions. Understanding which care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.

Sources of Social Support and Mental Health Among LGB Youth

Disparities in psychosocial adjustment have been identified for lesbian, gay, and bisexual (LGB) youth, yet research that explores multiple sources of social support among subgroups of LGB youth is sparse. Social support theory is used as a framework to analyze the ways that different sources of support might promote better psychosocial adjustment for LGB youth. Data from a diverse sample among LGB youth (N = 835) were used to understand how social support from a close friend, teachers, classmates, and parents might be differently associated with depression and self-esteem. We found that parent support and its importance to the participant were consistently related to higher self-esteem and lower depression for all youth, except for lesbians for whom no forms of social support were associated with self-esteem. Teacher and classmate support influenced some subgroups more than others. These results provide parents, clinicians, and schools a roadmap to assist youth navigate supports.

Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage

Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

MICHI–eine Gruppen-Kurzzeitpsychotherapie zur Behandlung von Depressionen bei Jugendlichen

Kognitive Verhaltenstherapie (KVT) gilt als Mittel der Wahl bei der Behandlung von Depressionen im Jugendalter wobei bis dato noch kein deutsches Behandlungsmanual in einem randomisierten, kontrollierten Design untersucht wurde. 38 depressive Jugendliche (M=15,86, SD=±1,70 Jahre alt; 78,9 % weiblich) wurden randomisiert entweder der Kontrollgruppe (KG), die Behandlung wie üblich erhielt (TAU), oder Interventionsgruppe (IG), welche an einer ambulanten Gruppen-Kurzzeit-KVT (MICHI-Manual) teilnahm, zugeordnet. Als Effektivitätsmaße dienten die CDRS-R und das BDI-II. Die Interaktion aus Gruppe und Messzeitpunkt war sowohl für die CDRS-R (p=,02), mit einer mittleren Effektstärke (dkorr=,75), als auch für den BDI-II (p=,04), mit einer kleinen Effektstärke (dkorr=,39), signifikant. Die Gruppen-Kurzzeit-KVT entsprechend dem MICHI Manual ist verglichen mit TAU wirksam.

[Cognitive behavior therapy for depression in children and adolescents - procedure, effects, and developments]

Cognitive behavior therapy offers a theoretically and empirically valid therapeutic approach for children and adolescents suffering from depression. It can be recommended according to present guidelines and efficacy studies. Further research and conceptual development, however, is necessary especially regarding the small to moderate effect sizes as well as the lack of long-term efficacy and effect factors. This article gives a short overview of the basics and contents of cognitive behavior therapy for depressive children and adolescents. It furthermore presents the latest findings and an assessment of its efficacy and relevant developments and perspectives.