New clinical trial investigating comparatively the efficacy of rational-emotive & cognitive-behavior therapy (REBT/CBT) and medication (sertraline) in youth depression

Results of a new clinical trial investigating comparatively the efficacy of rational-emotive & cognitive-behavior therapy (REBT/CBT) and medication (sertraline) in youth depression have been accepted for publications in the prestigious journal Psychiatry Research. A preview – already presented over the time at various scientific conferences – of the results/conclusions is presented below. The details will/can be found in the full article; we will keep you updated about its publication.

 I. REBT/CBT for Major Depression in Youth. Results of a New Clinical Trial.

Introduction: Eighty-eight (N=88) depressed youths (i.e, major depressive disorder patients) were randomly allocated to one of the three treatment arms (i.e., randomized clinical trial/RCT): (1) group Rational Emotive Behavior Therapy (REBT) (i.e., a form of cognitive-behavior therapy/CBT; 16 weekly group sessions); (2) pharmacotherapy/medication (i.e., sertraline), and (3) group REBT/CBT plus pharmacotherapy.

Clinical REBT/CBT Protocol: Group REBT/CBT used behavior activation and cognitive restructuring techniques to address the core irrational beliefs (i.e., demandingness and self-depreciation, but also catastrophizing/awfulizing and frustration intolerance, if they appeared) and restructure them into rational beliefs (e.g., flexibility in the form of preference/acceptance rather than demandingness; self-acceptance rather than self-depreciation). Indeed, group REBT/CBT was focused on: (a) restructuring particularly the irrational beliefs of demandingness and self-depreciation; (2) developing unconditional self-acceptance; and (3) secondary problems like depression about depression (i.e., meta-emotions). Negative automatic thoughts were not specifically targeted first in psychotherapy (as in other CBT strategies), but they were identified, analyzed, and used to access and then change core irrational beliefs.

Results: The results – for details see below the Figure 1 – showed that all outcomes (i.e., subjective – depressed symptoms and general distress; cognitive – negative automatic thoughts; and biological – serum serotonin and norepinephrine) significantly change from pre- to post-treatment in all treatment conditions, with no difference among conditions at post-treatment. Remission rate at post-treatment was defined as scores lower that 19 on the CDI (Children’s Depression Inventory), meaning that the patients do not meet the criteria for clinical depression anymore; we found the following remissions rates: 67.85% for group REBT/CBT, 60.60% for pharmacotherapy, and 53.84% for group REBT/CBT plus pharmacotherapy (there were no significant differences among groups). Suicidal ideation significantly decreased from pre to post-treatment (p < .05), but there were no differences across groups (p > .05). General distress (Profile of Mood States/POMS-SV) was similarly reduced in all three conditions, thus potentially impacting the improvement of the quality of life/social functioning of the participants. Consistent to REBT/CBT theory, pre-mid (8 weeks) changes in negative automatic thoughts (ATQ – Automatic Thoughts Questionnaire) were prospectively associated to the pre-post changes in depressive symptoms (CDI): r = 0.22, p = 0.026.

Conclusions and implications: To our knowledge, this is the first RCT comparing psychotherapy (i.e., group REBT/CBT), pharmacotherapy/medication, and their combination for depressed youth, assessing multi-level outcomes (e.g., subjective – depressive symptoms and general distress; cognitive – negative automatic thoughts; and biological outcomes: serum serotonin and norepinephrine) in the same RCT design. At a theoretical level, the results of our RCT indicate that administering group REBT/CBT, sertraline, or a combined intervention for depressed youth generates similar results (i.e., in terms of subjective, cognitive, and biological markers of depression); this opening interesting questions about clinical strategies, mechanisms of change, and cost-effectiveness. At a practical level, group evidence-based REBT/CBT protocols are now available to mental health professionals dealing with depression in youth; therefore, children with depression, their families, and clinical professionals have now even more treatment options to choose for depression.

Results

II. OTHER RELATED INFO.

 II.1. REBT and depression in adults:

II.2. Meta-analysis about the evidence-based status of REBT/CBT as psychological treatment for children:

II.3. For the evidence-based status of REBT theory and practice see here:

II.4. The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health is the original site for the group REBT/CBT arm (see at http://psychotherapy.psiedu.ubbcluj.ro).

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One Response to “New clinical trial investigating comparatively the efficacy of rational-emotive & cognitive-behavior therapy (REBT/CBT) and medication (sertraline) in youth depression”

  1. Tratamentul Depresiei la Copii/Adolescenţi. Rezultatele Unui Nou Studiu Clinic. | Blogul Prof. Univ. Dr. Daniel DAVID: Pentru o Românie Raţională! on November 15th, 2014 5:03 am

    […] Pentru informaţii preliminare despre acest studiu şi rezultatele acestuia vezi AICI. […]

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