Assessing Outcome in Cognitive Behavior Therapy for Child Depression: An Illustrative Case Series

Abstract

Recent meta-analytic data suggest a need for ongoing evaluation of treatments for youth depression. The present article calls attention to a number of issues relevant to the empirical evaluation of if and how cognitive behavior therapy for child depression works. A case series of 6 children and a primary caregiver received treatment—individual CBT for the child and behavioral parent training involving the caregiver and caregiver–child dyad. The effects were generally promising and illustrate how selection of inclusion criteria, measures, measurement intervals, and informants can alter conclusions. These areas warrant attention in studies of child depression and are important not only in interpreting treatment outcome data but also for conducting sound clinical practice.

KEYWORDS:

• child depression
• cognitive-behavior therapy
• multi-informant
• multi-method

Notes

Note: AA = African-American; EA = Euro-American; NA = Native-American.

Note: The DISC columns only include diagnostic information for depression. For P2, the posttreatment DISC-p also yielded diagnoses of SAD and ODD. For P6, the pretreatment and midtreatment DISC-c interviews yielded diagnoses of SAD and ADHD, while the DISC-p interviews yielded additional diagnoses of ADHD and ODD at pretreatment and midtreatment and ODD at posttreatment.

CDI = Child Depression Inventory.

DISC = Diagnostic Interview Schedule for Children: DISC-c and DISC-p refer to whether the child or parent was the informant.

CBCL-I = Child Behavior Checklist-Internalizing Symptom Scale.

Cutoff = The total number of measures (out of four) or cases (out of six) exceeding clinical cutoffs at that assessment point.

MDE:I = Major Depressive Disorder: Intermediate Impairment.

Note. CTI: 39.50 (11.30) for depressed children, 63.3 (5.1) for control children (grades 4 to 7; Kaslow et al., 1992).

CNCEQ: 70.3 for depressed children, 42.1 for nondepressed children (grades 4, 6, and 8; Leitenberg et al., 1986).

MESSY-c: 65.2 is normative data for girls, 78.3 for boys (Spence & Liddle, 1990).

MESSY-p: 138.6 (25.1) is normative data from parents (Bell-Dolan & Allan, 1998).

CBCL: T score of 64 or greater is considered in the clinical range (Achenbach & Rescorla 2001).

SRMFF: 184 (clinical), 196 (control), based on retrospective report of young adults from disrupted (clinical) and nondisrupted (control) families (Bloom, 1985).