Therapists' Techniques in the Treatment of Adolescent Depression

• Published in: Journal of psychotherapy integration 2018-12, Vol.28 (4), p.413-428
• Main Authors: Midgley, Nick, Reynolds, Shirley, Kelvin, Raphael, Loades, Maria, Calderon, Ana, Martin, Peter, O'Keeffe, Sally
• Format: Article
• Language: English
• Subjects: Adolescent Psychotherapy; Brief Psychotherapy; Cognitive Behavior Therapy; Female; Human; Major Depression; Male; Psychodynamic Psychotherapy; Psychotherapeutic Techniques
• ISSN: 1053-0479; 1573-3696
• DOI: 10.1037/int0000119

When comparing the relative effectiveness of different psychological treatment approaches using clinical trials, it is essential to establish fidelity to each manualized therapy, and differentiation between the treatment arms. Yet few psychological therapy trials include details about the assessment of treatment integrity and little is known about the specific techniques used by therapists, or to what degree these techniques are shared or distinct across different therapeutic approaches. The aims of this study were to (a) establish the fidelity of two established psychological therapies, cognitive-behavior therapy (CBT) and short-term psychoanalytic psychotherapy (STPP), in the treatment of adolescent depression; and (b) examine whether they were delivered with adherence to their respective treatment modalities, and if they could be differentiated from each other and from a reference treatment (a brief psychosocial intervention; BPI). The study also aimed to identify shared and distinct techniques used within and across the three treatments. Audiotapes (N = 230) of therapy sessions collected as part of a trial were blind double-rated using the Comparative Psychotherapy Process Scale (Hilsenroth, Ackerman, Blagys, Baity, & Mooney, 2003; Hilsenroth, Defife, Blake, & Cromer, 2007), which includes subscales for Cognitive-Behavioral and Psychodynamic-Interpersonal techniques. The treatments were delivered with reasonable fidelity and there was clear differentiation in the use of CBT and STPP, and between these two established psychological therapies and BPI. An item-level analysis identified techniques used across all three treatments, techniques that were shared between BPI and CBT, and techniques that were unique to CBT and STPP. Prototipo de expertos clínicos de un tratamiento ideal en psicoterapia dirigida a la regulación para niños (RFP-C) Existen pocos estudios sobre el proceso de psicoterapia psicodinámica infantil. Este estudio investiga el proceso de psicoterapia dentro de la psicoterapia centrada en la regulación para niños (RFP-C; por sus iniciales en inglés; Hoffman, Rice y Prout, 2016). RFP-C es un tratamiento psicodinámico manualizado para niños con conductas disruptivas. Tres clínicos expertos usaron Psicoterapia infantil Q-Set para desarrollar un prototipo de RFP-C, que se puede utilizar en futuros estudios para medir la adherencia en sesiones reales de RFP-C. Como se esperaba, el RFP-C prototipo se asoció con prototipos establecidos de psicoter