Understanding change - developing a typology of therapy outcomes from the experience of adolescents with depression

Outcome measures mostly focusing on symptom reduction to measure change cannot indicate whether any personally meaningful change has occurred. There is a need to broaden the current understanding of outcomes for adolescent depression and identify whether holistic, interlinked patterns of change may be more clinically meaningful.

To create a typology of therapy outcomes based on the experiences of adolescents with depression.

Interview data from 83 participants from a clinical trial of the psychological treatment of adolescent depression was analysed using ideal type analysis.

Six ideal types were constructed, reflecting different evaluations of the holistic impact of therapy: "I've worked on my relationships", "With the insight from therapy, and feeling validated, I can cope with life challenges better", "My mood still goes up and down", "If I want things to change, I need to help myself", "Therapy might help, but it hasn't been enough", and "I don't feel therapy has helped me".

Assessing change using outcome measures may not reflect the interconnected experience for adolescents or the contextual meaning of symptom change. The typology developed offers a way of considering the impact of therapy, taking into account how symptom change is experienced within a broader perspective.