Depression and Adolescence

Adolescence is the period in life when people transition from childhood to maturity. People between the ages of 13 and 19 are classified as adolescents. However, psychological and physical changes may begin before the age of nine. In human existence, it is the stage of bewilderment and discovery. Individuals begin to encounter issues of self-identity and independence during this period, and they may face difficult choices regarding sexuality, drugs, schooling, social life, and alcoholism. Adolescents begin to naturally increase the importance of having romantic interests, looks, and developing peer networks as they progress from childhood to maturity. Adolescence is a critical stage in the life with several characteristics problems and needs adjustments. Each satisfaction of particular needs of individuals is necessary to enhance continuity of physical and other development aspects. A need is something that brings tension in organisms which must be fulfilled for its well-being. Individuals would experience satisfaction when a need is satisfied, and the pressure is released (Qin, 2008). In the adolescent stage, people would experience various needs that their satisfactions is essentials for their psychological well-being.

Security is a critical need for teens. The individuals in this transitional stage would need social, emotional, economic and the physical safety. The people in this juncture will become maladjusted if they lack the feeling of security. The desire of humans for gregariousness is associated with the need for social security (Shechtman, 2007). During the adolescent phase, love or affection is one of the primary psychological need. The individuals would develop strong desire love other people and also feel being loved. In the case where an individual feels that he (she) is not loved, one would begin to develop deep concepts and attitudes conceding his (her) worthiness. The feeling of security in individuals informally strengthens by having proper love.

Approval is the other need that individual adolescents would require for them to reach their psychological wellbeing. The ego adolescents would feel satisfied if they approved and recognized (D'agostino et al., 2011). The desire for this age group is to be the central attraction for the opposite sex and recognition of their intelligence, capacities, and abilities by other people in the society. In school, the teachers tend to help students who are at the adolescent stage to earn admiration from others by directing them to careers where they can be successful.

Further, there is a need for Freedom and independence among the adolescents. The Adolescence stage is when individuals struggle to wean themselves from the authority of their parents and elders (Shechtman, 2007). They demand the right to express their emotions, feelings, and ideas about sensitive matters that is concerning their lives. Imposing restrictions on the individuals in this stage of life would make them develop the feel unpleasant and annoyed.

Moreover, the self-expression and achievement form part of the psychological needs of adolescents. Individual adolescents possess inherent desires to express their potentialities in life. They might have particular talents of being a painter or a musician that is hidden in them, and they would need equal chance to showcase their capabilities (D'agostino et al., 2011). The individuals in this group would experience depressions and frustrations when they failed when denied an opportunity to express their potentialities and feel satisfied in case they have succeeded.

Review Focus

The literature review will focus on the two different interventions or therapists concerning Cognitive Behavioral Therapy (CBT) and Behavioral Activations (BA). The review will be done on the five research articles that address the effectiveness of CBT and BA on addressing the psychological needs of the adolescents. The materials were selected based on their relevance to the research topic and recent time range of 5 years.

Search Strategy

Key terms and the range of years are strategies that have been used to retrieve the research articles to be reviewed. Effectiveness, CBT, and BA, addressing, psychological needs and adolescents are the keywords that were used to retrieve the research articles that are relevant to the topic specifically. The primary purpose of using keywords in searching was to improve the search results where specific research articles that address the issue. It was necessary to find more recent literature materials so that to access updated information about the research topic.

Organization of Literature Review

Different methodologies have been used to examine the effectiveness of CBT and BA in the addressing of the adolescent’s psychological needs. Meta-analyses, individuals, and review of other literature materials that are related to researched topic. The survey was also used to get the data where clinical interviews were conducted to obtain data from the adolescents and their parents. Systematic reviews were done by the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis). The results achieved by the three methodologies will be compared.

Evaluation of primary articles

Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 37(1), 156-183.

This articles conducted an analysis of the psychosocial treatment of the children and adolescents between 1993 and 2007 that have been affected by traumatic events in the past. The researchers were testing the effectiveness of using Trauma-Focused Cognitive Behavioral Theory (TFCBT) on the treatment of the adolescent suffering from trauma (Silverman et al., 2008). The research materials were written and approved by the professional psychologists to determine the efficacy interventions or therapists that could be used to satisfy the psychological needs of the survivors of life-threatening events (Silverman et al., 2008). The target audience of this article are the teachers, home care, guardians and the well –wishers, and psychiatrists who might be having the responsibility of either raising the children and adolescents that are traumatized. This source will have a significant contribution in my research to the feasibility of CBT to treat the traumatized adolescent population.

Jacob, M., L Keeley, M., Ritschel, L., & Craighead, W. E. (2013). Behavioral activation for the treatment of low‐income, African American adolescents with major depressive disorder: a case series. Clinical psychology & psychotherapy, 20(1), 87-96.

This article intends to establish that Behavioral Activation can be used to treat adolescents that are suffering from depression effectively. The research was initiated to provide a report on how the Behavioral Activation (BA) can be used to treat depression among adolescents from the low-income African Americans effectively (Jacob et al., 2013). The authors consist of remarkable scholars who have made a great contribution in the psychological, educational development both in the United States (U.S) and internationally. The target audience is the low –income African Americans and other low-income families across the world that are having depressed adolescents that might need affordable treatment (Jacob et al., 2013). The previous citation discusses how the CBT can be used to treat traumatized adolescents while this research explains how to use BA to as a cost saving mechanism. This article will be helpful to my research to get insights of how BA can be used effectively to reduce treatment cost.

Lynch, F. L., Hornbrook, M., Clarke, G. N., Perrin, N., Polen, M. R., O’Connor, E., & Dickerson, J. (2005). Cost-effectiveness of an intervention to prevent depression in at-risk teens. Archives of General Psychiatry, 62(11), 1241-1248.

The primary purpose of this article is to provide information on how CBT can be used as a cost-effective intervention to treat depressed parents and their adolescent offspring. The author is a professional medical researcher officer dealing with psychological illness in Portland, U.S. This article deals with the cost-effectiveness of CBT to treat depression while the previous material covered using BA as a low-cost treatment option (Lynch et al., 2005).Therefore, they both are concerned with the reduction of cost the target audience of this literature material are caregivers and the psychiatrists. This article will be helpful in the prospective research as it would make me understand how the CBT can be used as a cost-effective intervention for depression in adolescents.

Gillham, J. E., Reivich, K. J., Brunwasser, S. M., Freres, D. R., Chajon, N. D., Kash-MacDonald, V. M., ... & Seligman, M. E. (2012). Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: A randomized effectiveness trial. Journal of Clinical Child & Adolescent Psychology, 41(5), 621-639.

The article was aimed at assessing the effectiveness of the Penn Resiliency Program for Adolescents as an intervention that is based on school group to treat cognitive behavioral risk factors for depression (Gillham et al., 2012). The authors of this articles are drawn from the psychological field and the school establishment which makes the literature material to reflect their experience and profession in the target environment. The article is written to provide insights to teachers and the school administrators on the management of behavioral disorders in schools. This article would help to provide additional information that would assist facilitate comprehensive research on the phenomena to encompass the school setting.

Ritschel, L. A., Ramirez, C. L., Cooley, J. L., & Edward Craighead, W. (2016). Behavioral activation for major depression in adolescents: Results from a pilot study. Clinical Psychology: Science and Practice, 23(1), 39-57.

This article deals with the evaluation of the impact of Behavioral Activation (BA) to the majorly depressed disorders (Ritschel et al., 2016). The authors are the famous professional psychologist that deals with a broad range of cognitive disorders that affects the youths. This literature material focuses more on the application of clinical psychology to treat depressed adolescents as compared with other primary articles. Further, this research has involved a significant number of the stakeholders in the process of study as compared to the articles that are entirely focused on the target group (Ritschel et al., 2016). This research material will provide background information on the topic that is essential for completion of the intended study.

Evaluation of Research Articles

All the research articles selected are showing positive results regarding the effectiveness of the CBT and BT in the addressing the psychological challenges that adolescents group are facing. Further, the articles are trying to test the efficiency of the phenomenon in different environments. For example, one article is testing it in a mental institution while the other one is using a group of adolescents that have been affected with life threating events such as natural calamities.

Despite having broad similarities, some articles are indicating that the effectiveness of the phenomena under investigation would not be effective as it is being claimed by other researchers. For instance, there one article stating that viability of Trauma –Focused Cognitive –behavioral theory (TF-CBT) in the treatment of patients that are trauma as a form of the psychological disorder should seek for a well-covered care plan in either public or private health institution (de Arellano et al., 2014). It is a contradiction with the results of other researchers who are stating that therapist’s sessions can be administered to patients in any convenient place as long as it is effective. Some research articles use multiple designs to achieve the outcome. For instance, one study used randomized controlled trials (RCTs) alongside other designs.

Further, some research articles test the effectiveness of the CBT and BT in the treatment of depression alongside other disorders that might affect the population under study. For example, in the study of examining the effectiveness of initial treatment of a BA on depressed adolescents, measurement of depression was taken alongside the activation, avoidance and global functioning (Dimidjian and McCauley, 2016). Furthermore, in the study of using RCT to determine the effectiveness of CBT in the treatment of the phenomena that is affecting the target population (Stikkelbroek et al., 2013).The researcher also tested its cost-effectiveness in the under rigorous circumstances in the mental health facilities.

The results in the articles indicate that CBT is capable of reducing symptoms of posttraumatic stress disorder. However, some articles do not vividly demonstrate the effectiveness of CBT in minimizing the behavioral problems (Dahlqvist and Landstedt, 2015). Besides being effective in the treatment of depression in adolescents, CBT is also cost effective as compare to the Treatment As Usual (TAU). Furthermore, there the use of Internet-CBT is proving to be the viable option of treating adolescent with some anxiety and depression who had requested for the modality. There was a significant improvement of using BA from the pretreatment stage to the end of treatment in behavioral depression among the adolescent groups (McCauley et al., 2016). From the various groups that were being tested as a sample, there was no significant disparity in the conditions of treatments. It is an indication that BA being an effective treatment for depression in the adolescents.

Discussion

Depression is a psychological disorder that needs an efficient and evidence-based intervention that is cost-effective and time to make it more accessible treatment for adolescents (Sturmey,2009).Behavioral activation and Cognitive-behavioral are the popular forms of depression intervention that is used to treat suffering adolescents (March et al., 2007). Further, their effectiveness has been an essential component for the achievement of a viable low –intensity in the treatment of moderate to mild depression in adolescents

Conclusion

. CBT and BT are the forms of treatment that are used to relieve the depressed adolescents from the pain. However, they have been questioned about their effectiveness. From the critical evaluation of the researched articles, it is evident that CBT and BA interventions are the effective treatment of depression in adolescents because of their low-intensity viability nature when well administered. Therefore, CBT and BA are the effective treatment for depressed adolescents.

References

D'agostino, N. M., Penney, A., & Zebrack, B. (2011). Providing developmentally appropriate psychosocial care to adolescent and young adult cancer survivors. Cancer, 117(S10), 2329-2334.

Dahlqvist, H. Z., Landstedt, E., & Gådin, K. G. (2015). What students do schools allocate to a cognitive-behavioural intervention? Characteristics of adolescent participants in Northern Sweden. International journal of circumpolar health, 74.

de Arellano, M. A. R., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., ... & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents: Assessing the evidence. Psychiatric Services, 65(5), 591-602.

Dimidjian, S., & McCauley, E. (2016). Modular, Scalable, and Personalized: Priorities for Behavioral Interventions for Adolescent Depression. Clinical Psychology: Science and Practice, 23(1), 58-61.

Gillham, J. E., Reivich, K. J., Brunwasser, S. M., Freres, D. R., Chajon, N. D., Kash-MacDonald, V. M., ... & Seligman, M. E. (2012). Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: A randomized effectiveness trial. Journal of Clinical Child & Adolescent Psychology, 41(5), 621-639.

Jacob, M., L Keeley, M., Ritschel, L., & Craighead, W. E. (2013). Behavioural activation for the treatment of low‐income, African American adolescents with major depressive disorder: a case series. Clinical psychology & psychotherapy, 20(1), 87-96.

Lynch, F. L., Hornbrook, M., Clarke, G. N., Perrin, N., Polen, M. R., O’Connor, E., & Dickerson, J. (2005). Cost-effectiveness of an intervention to prevent depression in at-risk teens. Archives of General Psychiatry, 62(11), 1241-1248.

March, J. S., Silva, S., Petrycki, S., Curry, J., Wells, K., Fairbank, J., & Severe, J. (2007). The Treatment for Adolescents with Depression Study (TADS): long-term effectiveness and safety outcomes. Archives of general psychiatry, 64(10), 1132-1143.

McCauley, E., Gudmundsen, G., Schloredt, K., Martell, C., Rhew, I., Hubley, S., & Dimidjian, S. (2016). The adolescent behavioral activation program: Adapting behavioral activation as a treatment for depression in adolescence. Journal of Clinical Child & Adolescent Psychology, 45(3), 291-304.

Qin, D. B. (2008). Doing well vs. feeling well: Understanding family dynamics and the psychological adjustment of Chinese immigrant adolescents. Journal of Youth and Adolescence, 37(1), 22-35.

Ritschel, L. A., Ramirez, C. L., Cooley, J. L., & Edward Craighead, W. (2016). Behavioral activation for major depression in adolescents: Results from a pilot study. Clinical Psychology: Science and Practice, 23(1), 39-57.

Shechtman, Z. (2007). Group counseling and psychotherapy with children and adolescents: Theory, research, and practice. Lawrence Erlbaum Associates Publishers.

Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 37(1), 156-183.

Stikkelbroek, Y., Bodden, D. H., Deković, M., & van Baar, A. L. (2013). Effectiveness and cost effectiveness of cognitive behavioral therapy (CBT) in clinically depressed adolescents: individual CBT versus treatment as usual (TAU). BMC psychiatry, 13(1), 314.

Sturmey, P. (2009). Behavioral activation is an evidence-based treatment for depression. Behavior Modification, 33(6), 818-829.