Future directions in research on psychotherapy for adolescent depression

Research over the past 3 decades has shown that psychotherapy can successfully address adolescent depression. Cognitive behavioral models have been most extensively and rigorously tested, with evidence also supporting interpersonal psychotherapy and attachment-based family therapy. However, the vast majority of studies have focused on short-term treatment of depressive episodes, even as evidence accumulates that depression is frequently a recurring condition extending into adulthood. Moreover, treatment studies indicate that better longer term outcomes are attained by adolescents who respond earlier and more completely to intervention. Given what has been learned to date about adolescent depression treatment, future psychotherapy research should adopt a longer term perspective and focus on the following key challenges: (a) preventing relapse and recurrent episodes, while improving speed and thoroughness of initial treatment response; (b) identifying the necessary treatment components and learning processes that lead to successful and enduring recovery from depression; (c) determining whether-and, if so, how-to address comorbid disorders within depression treatment; (d) addressing the dilemma of simplicity versus complexity in treatment models. Given the relatively small number of evidence-based treatment models, newer approaches warrant investigation. These should be tested against existing models and also compared to medication and combined (psychotherapy plus medication) treatment. Advances in technology now enable investigators to improve dissemination, to conduct experimental psychotherapeutics and to expand application of Internet-based interventions to the goals of relapse and recurrence prevention.