The relation between problem-solving interventions in cognitive-behavioral therapy and depression in early adolescent girls
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Depression in youth is a serious mental health concern affecting many different domains of functioning. Currently, cognitive behavioral therapy (CBT) is the most extensively studied psychosocial treatment for depression; however, there is limited research on how the specific components of CBT function to produce effective treatment outcomes. In addition to identifying the components responsible for effective treatment outcome, it is also important to investigate the changes in youth with depression that account for the reduction of symptomatology. Problem-solving is one of the effective CBT strategies used to improve depressive symptoms. The purpose of the current study was to investigate the association between problem-solving interventions and depression. The current study also sought to investigate if depressive symptoms are mediated through changes in the view of the future. Participants were 40 girls, aged 9 to 14, who completed a manualized CBT protocol for depression in a group format. Participants completed a diagnostic interview for depression and self-report measures assessing the view of the future dimension of the cognitive triad. Group therapy sessions were coded for problem-solving interventions using an investigator developed coding system. The results indicated that the level of problem-solving intervention implemented by the therapist failed to predict a decrease in depressive symptoms, after controlling for the girls’ initial levels of depression severity. Level of problem-solving intervention was significantly related to positive future views on the cognitive triad, after controlling for initial levels of the future subscale on the cognitive triad. Results also indicated that participants with a more positive view of their future were less depressed at post-treatment. Treatment specificity could not be conducted because the relation between problem-solving interventions and treatment outcome was not significant. An exploratory analysis was conducted with additional control variables. After controlling for mastery of problem-solving skills, level of expectancies for change, and initial level of depression, problem-solving intervention was a significant predictor of treatment outcome. Exploratory analysis also concluded that levels of consequential thinking and levels of brainstorming were related to treatment outcome. Implications, limitations, and recommendations for future research are presented.