COPING WITH DEPRESSION (CWD-A)

OVERVIEW

A cognitive-behavioral training program was developed to teach moderately to severely depressed early-adolescent middle school students skills and strategies to help them cope with their depression. In an experimental study in which depressed students were randomly assigned to one of four groups, significantly more students who were assigned to group therapy sessions were no longer considered clinically depressed compared with students assigned to the control group. Additionally, students in assigned to receive the cognitive-behavioral treatment reported significantly higher levels of self-esteem than the control students after the treatment was completed. 

DESCRIPTION OF PROGRAM

Target population: moderately to severely depressed early adolescent middle school students

This program, adapted from Clarke and Lewinsohn’s adolescent version of the Coping with Depression (CWD) course, consisted of 12 two-hour sessions held twice weekly.  These lessons were intended to familiarize students with specific skills and strategies to deal with problems related to depression such as constructive thinking, self-reinforcement, and social skills. Additionally, communication, negotiation and problem solving skills are emphasized.

EVALUATION(S) OF PROGRAM

Kahn, J. & Kehle, T. (1990). Comparison of Cognitive-Behavioral, Relaxation, and Self-Modeling Interventions for Depression Among Middle-School Students.  School Psychology Review, 19(2), 196.

Evaluated population: 32 male and 36 female moderately to severely depressed students, aged 10 to 14, from a middle-class suburban middle school served as the subjects for this study.

Approach: A three-stage screening process was administered by the school psychologist and counselor to determine if students in a middle school population were moderately to severely depressed. The 68 qualified students were randomly assigned to one of three treatment groups or to a waitlist control group.  Treatment Group I received the adolescent version of the Coping with Depression program (CWD), a cognitive behavioral group therapy treatment designed to teach social skills, constructive thinking, and problem solving. Students participated in sessions on goal-setting, self-reinforcement, pleasant activities, constructive thinking, communication and social skills, and maintaining and generalizing gains.  Treatment groups II and III received relaxation and self-modeling treatments. Students assigned to the relaxation treatment group were instructed on progressive relaxation and provided with home practice activities. Relaxation group sessions covered topics such as identifying stress-related situations and symptoms; and the acquisition of relaxation skills. As a part of the self-modeling treatment, students in treatment group III were instructed on and videotaped participating in non-depressed behaviors, such as appropriate eye contact, body posture, positive affect-related expression (smiling, laughing) and making positive self statements. Students in the self-modeling treatment then watched the 3-minute tape twice weekly for six to eight weeks. Students assigned to the control group did not receive treatment.

The CWD and relaxation treatment groups and met in groups of two to six students twice a week for 12 2-hour sessions across 6-8 weeks with either the school psychologist or school counselor. All groups were assigned to the school counselor or psychologist randomly.  Subjects in the self-modeling treatment group were assigned randomly to either the school counselor or psychologist and were seen individually for 12 treatment sessions.

All groups were re-assessed following completion of the intervention and again one month later following the same methods used to originally screen the students for moderate to severe depression.

Results: Pre-intervention, there were no significant differences between groups on self-report and clinical measures of depression and self-esteem. Additionally, analyses showed that there were no differences within treatment groups by random assignment to therapy group or therapist.

Post-intervention clinical measures of depression revealed that students in the CWD, relaxation and self-modeling treatment groups were significantly improved compared with students in the control group. Differences in measures of depression between the treatment groups were not significantly different.

Students in the CWD treatment group were found to have significantly greater levels of self-esteem as compared with the students in the control group. Differences in measures of self-esteem between the relaxation and self-modeling treatment groups and the control group were not significant.

SOURCES FOR MORE INFORMATION

Program materials are available free of charge from the Kaiser Permanente Center for Health Research at http://www.kpchr.org/public/acwd/acwd.html.

References:

Kahn, J. & Kehle, T. (1990). Comparison of Cognitive-Behavioral, Relaxation, and Self-Modeling Interventions for Depression Among Middle-School Students.  School Psychology Review, 19(2), 196.

Program categorized in this guide according to the following:

Evaluated participant ages: 10-14

Program age ranges in the guide: Mid-Childhood, Adolescence

Program components: Counseling/Therapy, School-Based

Measured outcomes: Mental Health, Depression

Program information last updated on 3/18/08.