Response of depressed adolescents to cognitive-behavioral treatment: do differences in initial severity clarify the comparison of treatments?

This study evaluated the impact of pretreatment depression severity and functional impairment on the response of 2 samples of older depressed adolescents to 2 group cognitive-behavioral treatments. Differences between the 2 active treatments and between active treatment and a waiting-list control condition were expected to be greater in the more severely depressed-impaired group. Variables assessing severity and impairment appeared to be best conceptualized as measures of a single factor. Improvement for the 2 active treatments in comparison to the control condition was greater in the more severely depressed group in one of the samples but not the other. The prediction that the relative effectiveness of the 2 treatments would be accentuated in the more severely depressed adolescents received no support in either sample. Implications of these findings for future psychotherapy research are discussed.