Wonder

Log in

Behavior Alignment

Delivered January 25th, 2018. Contributors: Connor D., Shannon R., Catherine M. and

Part
01
of three
Part
01

Behavior therapies-Adolescents

Behavior therapy is mainly used for treating psychological disorders (as opposed to goal setting or behavior alignment for a particular passion) among adolescents. While there is no preexisting information to fully answer your question, we've used the available data to pull together key findings: The behavior therapies cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT), as well as the psychotherapy multidimensional family therapy (MDFT), are proven effective with adolescents afflicted with depression and behavior problems.

Below you'll find an outline of our research methodology to better understand why the information you've requested is publicly unavailable, as well as a deep dive into our findings.

METHODOLOGY

To complete your request, I looked for medical and academic studies around behavior therapies proven successful with adolescents for behavior alignment with a particular goal. I researched academic and medical studies, reports, and resources from industry groups such as the Association for Child and Adolescent Mental Health (ACAMH). However, I found that behavior therapy is primarily used to treat psychological disorders as opposed to goal setting or behavior alignment for a particular passion.

Nevertheless, I found two behavior therapies as well as a psychotherapy with proven track records of success with adolescents, albeit those primarily afflicted with depression. I focused on finding established therapies for this response as strategies for goal setting with adolescents have been covered in a previous response. Please continue below to see the results of my research.

BEHAVIOR THERAPIES FOR ADOLESCENTS

Research shows that the 2 behavior therapies, cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT), have proven efficacy with adolescents dealing with depression.

■ Cognitive-Behavioral Therapy

The 2017 study "Depression and Anxiety Prevention Based on Cognitive Behavioral Therapy for At-Risk Adolescents: A Meta-Analytic Review" analyzed a total of 36 studies to investigate the efficacy of CBT-based programs in preventing depression and anxiety in adolescents. Based on their analysis, the study authors reported that CBT is effective in preventing depression for high-risk adolescents in the short term.

An earlier study 'Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality' (2012) published in the US National Library of Medicine, National Institutes of Health, also reported that CBT is "a well-established treatment for depression in children and adolescents" but not for suicidality.

■ Interpersonal Psychotherapy

The 2017 paper "Efficacy and Acceptability of Interpersonal Psychotherapy for Depression in Adolescents: A Meta-analysis of Randomized Controlled Trials" analyzed 7 studies that investigated a collective 538 patients. Analysis showed that IPT was "significantly more effective than control conditions in reducing depressive symptoms" among adolescents during post-treatment and follow-up.

Also, the earlier study "Interpersonal Psychotherapy for Depressed Adolescents" (2008) reported that IPT has been proven effective in treating unipolar depressions in adolescents without bipolar or psychotic disorders.

These 2 behavior therapies were also recommended by the Child Mind Institute as proven effective for childhood and adolescent depression.

However, Behavioral Activation (BA) therapy lacks sufficient research to establish its efficacy with adolescents afflicted with depression.

■ Behavioral Activation Program

The only recent meta-analysis study I found regarding BA was the 2017 paper "Is Behavioural Activation Effective in the Treatment of Depression in Young People? A Systematic Review and Meta-analysis". The study authors analyzed 10 studies investigating a collective 170 young patients. Therefore, the studies pooled for analysis were not focused primarily on adolescents but on young people 18 years old and younger. The study authors' conclusion following their analysis was that "BA may be an effective treatment of depression in young people," with no further reports of significant results.

An earlier study in 2016, entitled "Brief Behavioral Activation for Adolescent Depression" reported that a brief program of BA was useful in treating adolescent depression. However, the study focused on only one adolescent patient. The full report is locked behind a paywall.

PSYCHOTHERAPY

I also found the book "What Works with Children, Adolescents, and Adults?: A Review of Research on the Effectiveness of Psychotherapy" that investigates different psychotherapies that work with children, adolescents and adults. Though the book is locked behind a paywall, a keyword search yielded the following psychotherapies for adolescents discussed in the book:

• Dialectical behavior therapy - primarily for suicidal adolescents
• Multidimensional treatment foster care - primarily used for adolescent conduct disorder
• Group therapy - used with self-harming, suicidal adolescents
• Multisystemic therapy - used with adolescent conduct disorder

The book is available for purchase here. I did not find sufficient evidence for some therapies' success rate with adolescents in recent years. However, I have gathered the following findings from isolated studies of the MTFC and MDFT therapies:

The Institute for Innovation and Implementation at the University of Maryland School of Social Work for the Children’s Cabinet reported positive outcomes for multidimensional treatment foster care (MTFC). In a 2013 paper (the latest available), the Institute reported that among youths who completed MTFC therapy in 2012, none were involved with further juvenile crimes during the next year. The average age of youths enrolled in the MTFC program was 14.4 years.

The Association for Child and Adolescent Mental Health (ACAMH) reported in 2017 that multidimensional family therapy (MDFT) had a proven track record of success with adolescents showing antisocial behavior and substance abuse. ACAMH reviewed 19 papers that collectively studied nearly 1,500 participants. The Association concluded that "MDFT is effective for adolescents with substance abuse, delinquency, and comorbid behavior problems."

ADDITIONAL RESOURCES

Here are additional materials for further review:

'Psychotherapy for Children and Adolescents' from the American Academy of Child and Adolescent Psychiatry (AACAP) lists 7 therapies including CBT and IPT.

'Goal-Setting Interventions for Students with Behavior Problems' published in SAGE Journals investigates several interventions for K-12 students with behavior problems.

CONCLUSION

To wrap it up, we found that behavior therapy is primarily used in treating psychological disorders (as opposed to goal setting or behavior alignment for a particular passion) among adolescents.

Despite lack of available information around behavior therapies successfully used among adolescents for goal setting, we've used available data to pull together the following key findings: The behavior therapies Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT), as well as the psychotherapy Multidimensional family therapy (MDFT), have proven track records of success with adolescents afflicted with depression and behavior problems.
Part
02
of three
Part
02

Adolescent Behavioral therapies-critiques

OVERVIEW

In the previous request, 'Behavior Therapies- Adolescents,' the identified therapies for adolescents are Cognitive Behavioral Therapy, Interpersonal Psychotherapy, and Behavioral Activation Program. In the public domain, the only true criticism was for CBT, and no other significant criticism was found for any other form of adolescent therapy.

Cognitive Behavioral Therapy (CBT)

One of the main criticisms of CBT revolves around the idea that CBT is mechanical and that there is no therapeutic relationship between the therapist and the patient. The reasoning for this criticism is that CBT tends to be a more structured and methodical way of approaching therapy using homework and formal sessions. For adolescents, this can be reminiscent of school which might make them bored or uninterested in therapy. The therapist in one study used CBT in conjunction with therapeutic techniques to help his patient and stated that the CBT was helpful after establishing rapport with the patient. The therapist would go back and forth between the general therapeutic techniques and CBT depending on how the client was presenting that day. Days when the client was more open and communicative the therapist focused more on CBT, and more uncommunicative days the focus was on other therapeutic techniques. Throughout the study, the therapist struggled with when to use the different methods but thoroughly explains why each was used. This helps to show both the strengths and weakness of CBT in the treatment of depression in adolescents.
Another study was found that evaluated the effectiveness of CBT, except this study focused on CBT delivered through applications on a smartphone. This is interesting to note because it is a very different application of CBT than sitting in front of a therapist. The most significant criticism of these apps is that they don't adhere very closely to the principles of CBT. This could lead to misplaced criticism for CBT due to the lack of adherence to general CBT techniques.

Interpersonal Psychotherapy (IPT)

There was no criticism to be found for interpersonal psychotherapy in the public domain. It is stated that IPT is most effective for the treatment of mild to moderate adolescent depression, and that it was developed only to be used with adolescents.

Behavioral Activation Program (BA)

No direct criticism of BA was located in the public domain. A systemic review of BA was found that documented a few limitations. The limitations mostly revolved around small populations and lack of statistical analyses, but another noted limitation was that the studies did not include information on how the adolescents' school attendance changed throughout the program. Another outlier study in the review was the use of BA in adolescents with depression and anxiety comorbidity. There was no information to determine if BA is helpful on adolescents with anxiety, so the limit for that study was a lack of information on whether BA helps to treat both depression and anxiety or just the depression.
The above study on smartphone apps also includes BA apps on the market. While with CBT there was at least one app that had more than 50% of the criteria, none of the BA apps exhibited more than 50% of the BA criteria. As noted with the CBT apps this could cause patients that use these apps to have a misguided idea of BA.

Other Forms of Psychotherapy

As with IPT, there was no information found in the public domain that criticized any other form of adolescent therapy and most praised the effectiveness of the various forms of therapy.

CONCLUSION

Among adolescent therapy the only type of therapy with criticism was CBT, and the criticism came from the therapist's not preferring the structure that CBT puts forth. The therapists didn't believe they could create a therapeutic relationship with their patients while using CBT. The only other study of note discussed the rising use of smartphone apps and criticism towards the lack of conformity to CBT and BA guidelines in those apps. A systemic review of BA concluded that BA is useful in the treatment of adolescent depression, but that certain metrics were missing from the review. All other forms of therapy lacked criticism in the public domain.
Part
03
of three
Part
03

Most effective behavioral therapy-Adolescents

With an incredible amount of research attention and empirical support for treatment, my research concludes that Cognitive Behavioral Therapy (CBT), is the most effective behavioral therapy for adolescents. In a previous request, Behavior Therapies-Adolescents, some effective behavior therapies that were identified are Cognitive Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT), and Dialectical Behavior Therapy (DBT). My research identified two more therapies that can be effectively used on adolescents in addition to the above three, namely Group Therapy and Psychodynamic Psychotherapy.

Methodology

Since this response was a follow-up to an earlier request, I started by looking for resources that helped to confirm the five therapies earlier identified were most important in regard to adolescents. Through a careful analysis of available resources, the research revealed more resources highlighting CBT—even in reports that discussed other therapies.
The above step was the first step I used to confirm that CBT was the most effective. I then researched and found a resource where a certified medical practitioner highlighted the most effective therapy for adolescent, from where, among the two highlighted, CBT had the preference.
Giving that CBT had many more resources/media coverage with in-depth credible resources, appeared in reports discussing other therapies, and was confirmed by a certified practitioner, I concluded that it was the most effective, given the publicly available resources. I then researched resources to back up my assumption and highlight its benefits, function, and the sessions involved with it.

Most effective behavior therapies for adolescents

 Psychotherapy is a psychiatric treatment involving therapeutic interactions and conversations between a therapist and a child, or an adolescent in this case. In my research, I confirmed that the earlier behavior therapies identified have effectively been used on children and adolescents. These include Cognitive Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT), Dialectical behavior therapy (DBT), Group Therapy, and Psychodynamic Psychotherapy.

I will briefly discuss each therapy and then explain my assumption of why it would be effective for adolescents. The American Academy of Child and Adolescent Psychiatry highlights different behavior therapies used to treat children and adolescents. The five discussed below would be effective in treating adolescents.

1. Behavioral Therapy (CBT)
This therapy improves a child's moods, anxiety and behavior by examining distorted patterns of thinking. Adolescents are at an age where their moods and behavior are easily distorted by the things they watch and listen to, and the people they interact with.

2. Interpersonal Psychotherapy (IPT)
This therapy is used to treat depression and other clinical conditions. Problematic relationships are also addressed. Due to the nature of adolescence and the many changes taking place in an adolescent's body, they are prone to depression and strained relationships.

3. Dialectical Behavior Therapy (DBT)
It is used for treating older adolescents, and emphasizes taking responsibility for one's problems. Adolescents need to be empowered to be able to deal with conflict and negative emotions that they have to deal with as they grow up.

4. Group Therapy
It uses the power of group dynamics and peer interactions to improve social skills. When adolescents are in a group, especially with their peers in the same age group, it is easier for them to open up.

5. Psychodynamic Psychotherapy
It involves understanding the issues that motivate and influence behavior, thoughts and feelings. Sometimes adolescents don't even understand why they act the way they do, and this therapy helps them to understand the motivation behind every action and feeling.

CBT is the most effective therapy

My research concluded that Cognitive Behavioral Therapy (CBT) is the most effective behavioral therapy for adolescents. I will give the reasoning behind this assumption in my discussion below.

Firstly, Dr. Neal Ryan, a certified medical practitioner, who works at the University of Pittsburg Medical Center and who also doubles up as the director for its Center for Integrative Medicine, discussed proven and effective therapeutic interventions for depression in children and adolescents. In his discussion, he narrows down CBT and IPT as the most effective for treating depression in adolescents. He explains that CBT helps adolescents to think positively of themselves without letting the situation leave a toll on them. I make an assumption that CBT is the most effective among the two.

Another study, by Muir Wood, suggests that CBT is the best therapy for teens as it has been found to be effective in treating common teen issues like depression, anxiety, eating disorder, ADHD and substance abuse. The same study states that During CBT sessions, patients are guided toward a better understanding of the complex relationships that exist between thoughts, feelings and actions.

A different study by PMC gives further proof for CBT being the most effective therapy for adolescents after conducting a real-life survey. "Following 12 weeks of acute treatment, 71% of teens across groups no longer met diagnostic criteria, but 50% had residual symptoms. Follow-up results at longer time periods were more positive for CBT: at week 18, the response rates were 85% for combination therapy, 69% for fluoxetine therapy, and 65% for CBT. At week 36, response rates were 86% for combination therapy, 81% for fluoxetine therapy, and 81% for CBT." The study concluded that CBT has emerged as a well-established treatment approach for children and adolescents.

Another study shows how CBT is different from other therapies in treating adolescents by being pragmatic, highly structured, focused on current problems and being collaborative in nature. The study continues to state that CBT can help you make sense of overwhelming problems by breaking them down into smaller parts.

Lastly, a study by SpringerLink summarized the empirical literature regarding the efficacy of CBT for various problems in children and adolescents. It predicts that the importance of CBT in the field of psychotherapy is going to increase.

Conclusion

To wrap it up, Cognitive Behavioral Therapy (CBT), is the most effective behavior therapy for adolescents. It has many more resources and media coverage with in-depth credible resources compared to the other therapies. Real-life surveys have also shown its efficacy in treating adolescents.
Sources
Sources
From Part 01

Behaviour therapy

britannica.com

Psychotherapy for Children and Adolescents: Different Types

aacap.org
j

Goal-Setting Interventions for Students with Behavior Problems: A Systematic Review

journals.sagepub.com
p

What Works with Children, Adolescents, and Adults?: A Review of Research on the Effectiveness of Psychotherapy

play.google.com
t

MULTIDIMENSIONAL TREATMENT FOSTER CARE

theinstitute.umaryland.edu
s

Research Review: The effectiveness of multidimensional family therapy in treating adolescents

stichtingjeugdinterventies.nl
n

Cognitive-behavioral therapy for adolescent depression and suicidality

ncbi.nlm.nih.gov

[Interpersonal psychotherapy for depressed adolescents: an overview of theory, techniques and research]. - PubMed - NCBI

ncbi.nlm.nih.gov
c

What Behavioral Therapies Work on Childhood and Adolescent Depression?

childmind.org

Behavior therapies-Adolescents

askwonder.com

Depression and Anxiety Prevention Based on Cognitive Behavioral Therapy for At-Risk Adolescents: A Meta-Analytic Review

ncbi.nlm.nih.gov

Efficacy and acceptability of interpersonal psychotherapy for depression in adolescents: A meta-analysis of randomized controlled trials. - PubMed - NCBI

ncbi.nlm.nih.gov
o

Is behavioural activation effective in the treatment of depression in young people?

onlinelibrary.wiley.com
j

Brief Behavioral Activation for Adolescent Depression

journals.sagepub.com
From Part 02
e

The Therapeutic Relationship and Cognitive Behavioural Therapy: A Case Study of an Adolescent Girl With Depression | Easterbrook | The European Journal of Counselling Psychology

ejcop.psychopen.eu
c

About Interpersonal Psychotherapy for Adolescents (IPT-A)

childadolescentpsych.cumc.columbia.edu

A Systematic Review of Cognitive Behavioral Therapy and Behavioral Activation Apps for Depression

journals.plos.org

Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta-analysis

onlinelibrary.wiley.com

Behavior therapies-Adolescents

askwonder.com
From Part 03

Psychotherapy for Children and Adolescents: Different Types

aacap.org

Effectiveness of Cognitive Behavioral Therapy & Interpersonal

childmind.org

Cognitive Behavioral Therapy for Adolescents | Muir Wood Teen

muirwoodteen.com
n

Further Proof for CBT being the most Effective therapy

ncbi.nlm.nih.gov

CBT - How it works

nhs.uk

Effectiveness of Cognitive Behavioural Therapy in Adolescents

link.springer.com

Behavior therapies-Adolescents

askwonder.com