Developmental Demands of Cognitive Behavioral Therapy for Depression in Children and Adolescents: Cognitive, Social, and Emotional Processes

Abstract

Although some treatments for depression in children and adolescents have been found to be efficacious, the effects sizes have tended to be modest. Thus, there is considerable room to improve upon existing depression treatments. Some children may respond poorly because they do not yet have the cognitive, social, or emotional maturity needed to understand and apply the skills being taught in therapy. Therefore, treatments for depression may need to be tailored to match children’s ability to both comprehend and implement the therapeutic techniques. This paper outlines the steps needed for such developmental tailoring: (1) specify the skills being taught in depression treatments; (2) identify what cognitive, social, and emotional developmental abilities are needed to attain these skills; (3) describe the normative developmental course of these skills, and how to determine a child’s developmental level; and (4) use this information to design an individualized treatment plan. Possible approaches to intervening include: alter the therapy to meet the child’s level of development, train the child on the skills needed to engage in the therapy, or apply a dynamic assessment approach that integrates evaluation into treatment and measures children’s potential as well as their current abilities.

A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behaviour therapy

“…Furthermore, CBT is the gold standard treatment for many psychopathologies for children without ID from early childhood through to late adolescence such as anxiety and depressive disorders (e.g., Cartwright-Hatton, Roberts, Chitsabesan, Fothergill, & Harrington, 2004;Compton et al, 2004). The need to adapt CBT according to age as well as developmental level has been recognized for typically developing children (Garber, Frankel, & Herrington, 2016;Grave & Blissett, 2004). Consideration of a child's cognitive, social, and emotional development is crucial prior to undertaking therapy, in order to effectively tailor to the child's needs.…”

Emotional Granularity Effects on Event-Related Brain Potentials during Affective Picture Processing

“…Growing evidence reveals the importance of this individual difference for emotion regulation (Barrett et al, 2001), decreasing aggressive behavior (Pond et al, 2012), and mental health (Demiralp et al, 2012; Kashdan et al, 2015). Indeed, training individuals to recognize one’s emotions as discrete and specific is a core aspect of many cognitive psychotherapies (Garber et al, 2016). However, no research to date has explored the neural mechanisms underlying individual differences in emotional granularity during affective stimulus processing.…”

Neuropsychological changes in patients with substance use disorder after completion of a one month intensive outpatient treatment program

“…One way to address the disparity between the demands of treatment and the cognitive abilities of patients with SUD could be to, firstly, assess EF of patients entering treatment and attempt to tailor/adapt treatment to match the patient's abilities. This has been common practice when using CBT for children with developing EF, but less data exists evaluating such an approach for patients with SUD and EF impairments. In the few studies employing cognitive remediation therapy, a form of therapy that utilizes cognitive exercises to repair impaired functioning, patients receiving cognitive rehabilitation in addition to standard SUD treatment exhibited improvements in overall cognitive functioning Notably, these interventions are virtually non‐existent in standard programs for patients with SUD.…”