Specific psychotherapies for childhood and adolescent depression.

Specific psychotherapies for childhood or adolescent depression have been tested against control or comparative conditions. In school-age children with elevated depressive symptoms, cognitive behavioral therapies (CBT) administered in school settings have proven superior to no treatment or to waiting-list controls in almost all studies. One child study suggests that CBT is superior to alternative psychosocial intervention during acute treatment but not at longer term follow-up. No one type of CBT for children has proven more efficacious than others. Studies with adolescents have included subjects with diagnosed depressive disorders, primarily major depression. Seven of nine efficacy studies indicate that CBT is more efficacious than a waiting-list condition or than a non-CBT alternative psychotherapy at the end of acute intervention. Longer term follow-up indicates high rates of remission or recovery among depressed adolescents and no superiority of CBT over other psychotherapies in this regard; however, CBT is associated with more rapid remission of symptoms than is family or supportive therapy. Interpersonal psychotherapy has been demonstrated to be more efficacious than a waiting-list condition or minimal contact clinical management in two acute treatment studies. Research is needed to assess the comparative efficacy of psychotherapeutic interventions, antidepressant medication, and their combination and to develop optimal strategies for facilitating remission and preventing relapse.