Journal of Depression and Anxiety
Open Access

Abstract

A Qualitative Analysis of the Descriptions of Cognitive Behavioural Therapy(CBT) Tested in Clinical Trials of Depressed Young People

Hetrick SE, Bailey A, Rice SM, Magenta B Simmons, Joanne E McKenzie, Alice E Montague Alexandra G Parker

Objectives: The prevalence of depression in young people is high and the potential negative impacts are significant. Timely evidence-based treatment is critical. Current recommendations are that cognitive behavioural therapy (CBT) is used as a first line intervention, however, the extent to which CBT results in improvements in depression symptoms varies across trials. One possible explanation for this is variation in nature of CBT used across trials. Methods: In the context of a systematic review of evidence based psychotherapy interventions for young people with depression, we extracted the text about the CBT approaches and techniques to investigate how trial authors described their CBT intervention and to examine the nature of CBT delivered in trials. We coded this data on 14 intervention description domains regarding how and by whom CBT was delivered. We used the constant comparative method to categorise the descriptions of CBT interventions. Results: Overall, the reporting of CBT protocols was highly variable across trials, with varying levels of detail provided and inconsistent language used. The categories that we identified from this analysis included: 1. Full CBT; 2. Partial CBT with an emphasis on cognitive techniques; 3. Partial CBT with an emphasis on behavioural techniques. Conclusion: There is need for better standards and guidelines for reporting of trials of psychotherapy interventions to facilitate authors to adequately describe their work for their audience, including details about approaches and techniques included in the intervention, as well as how it was delivered and by whom. Understanding the nature of the CBT protocols being tested in research is important for ensuring effective translation of research findings into clinical practice. Given the variation in approaches to CBT, investigation is needed regarding those that young people find most helpful and effective.