[The treatment of depression in adolescents, a multi-layered challenge]

It is generally accepted that the clinical-psychotherapeutic treatment of severely depressed adolescents is a difficult and complicated undertaking.

To gain insight into the various factors, often present simultaneously, which block or undermine the adolescent development phase of separation-individuation and lead to depression, and to find out how the situation can be remedied.

The multi-layered hypothesis is developed with the help of case-material and takes exogenous as well as endogenous factors into account.

The investigation has demonstrated that in the treatment of depressed adolescents every possible factor needs to be taken into account if a long-lasting result is to be achieved.

This result is not surprising in view of the crucial developmental stage involved which is focused on the formation of identity. This developmental process cannot be consolidated until all the necessary elements have fallen into place.