Development and Test Effectiveness of a School-Based Cognitive Behavioral Group Therapy for Depression in Adolescents
Main Article Content
Objectives : This study was to develop and test the effectiveness of a school-based cognitive
behavioral group therapy (CBT) for depression in children and adolescents.
Methods : A research and development design was used to study, consisting of two phases.
The first phase was the development stage based on the concept of CBT. Three researchers
who developed this program were trained and experienced in term of CBT in childhood and
adolescence. The CBT program was also evaluated and provided suggestions from an expert
on CBT. The CBT program was divided into six sessions in every session for about 60 minutes,
and it performed in six weeks. The second phase is the evaluation of the CBT program.
Twenty-six participants were children and adolescents experiencing depression and studying
in junior and senior high school of a public school in Ubon Ratchathani province. They were
examined by the revision of 9-questions of an assessment tool for depressive symptoms and
diagnosed by a child and adolescent psychiatrist before recruiting them into the CBT program.
The 9-Q-revision were also used to assess depressive symptoms of the participants after the
end of the program immediately, including follow-up in one and three months. The data were
analyzed using frequency, percentage, and Repeated Measures ANOVA.
Results : The CBT program consists of six sessions, namely, insight into depression, happiness
activities, be aware of own thought, be mindful of own emotion, management own problems,
and set up own goal. The subjects who were willing to participate in all six sessions of the CBT
program were twenty-three persons. The majority of the participants aged 14 years-old (39.1%)
and average aged 14.6 years-old (S.D.=1.335). Most of them were female students approximately
34.8%. Evaluation of the CBT program found that average a score of depressive
symptoms in the participants reduced significantly after finishing the CBT program (p<0.01).
The follow-up period in one and three months also indicated that average a score of depressive
symptoms in participants significantly decreased (p<0.01) when compared with the score
before attending the CBT program. Two participants have still observed the high-risk of suicide.
Conclusion : The school-based cognitive behavioral group therapy (CBT) for depression in
children and adolescents has shown the effectiveness to reduce depressive symptoms.
Therefore, this CBT program should be implemented and applied to childhood and adolescence
experiencing depression in junior and senior high schools.
บทความที่ส่งมาลงตีพิมพ์ในวารสารสมาคมจิตแพทย์ ต้องไม่เคยตีพิมพ์หรือได้รับการตอบรับให้ตีพิมพ์ในวารสารฉบับอื่น และต้องไม่อยู่ระหว่างการส่งไปตีพิมพ์ในวารสารอื่น
Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics 2016; 138: e20161878.
Boonyamalik P, Saosarn P, Chutha W. Prevalence of depression among senior high school and vocational certificate students: a national school and college survey in 2004. Journal of the Psychiatric Association of Thailand 2006; 52: 172-80.
Kaewpornsawan T, Tuntasood B. The Prevalence of Depression in 2nd Year High School Students in Bangkok. Journal of the Psychiatric Association of Thailand 2012; 57: 395-402.
Jiamjaroenkul J, Limsuwan N. Depression among Junior High School Students in Muang District, Chiang Mai Province. Journal of the Psy¬chiatric Association of Thailand 2015; 60: 253-63.
Windfuhr K, While D, Hunt I, Turnbull P, Lowe R, Burns J, et al. Suicide in juveniles and adolescents in the United Kingdom. J Child Psychol Psychiatry 2008;49(11):1155-65.
Hawton K, van Heeringen K. Suicide. Lancet. 2009;373(9672):1372-81.
Fletcher JM. Adolescent depression and educational attainment: results using sibling fixed effects. Health Econ 2010; 19: 855-71.
Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent depression. J Adolesc Health 2007; 41(3): 256-62.
de Jonge-Heesen KWJ, van Ettekoven KM, Rasing SPA, Liempd FHJO-v, Vermulst AA, Engels RCME, et al. Evaluation of a school-based depression prevention program among adolescents with elevated depressive symptoms: study protocol of a randomized controlled trial. BMC Psychiatry. 2016; 16: 402-.
Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet 2012; 379(9820): 1056-67.
Cuijpers P, van Straten A, Smit F, Cathrine Mihalopoulos C Beekman A. Preventing the Onset of Depressive Disorders: A Meta-Analytic Review of Psychological Interventions. Am J Psychiatry 2008; 165: 1272-80.
Gladstone TR, Beardslee WR, O’Connor EE. The prevention of adolescent depression. Psychiatr Clin North Am 2011; 34: 35-52.
Werner-Seidler A, Perry Y, Calear AL, Newby JM, Christensen H. School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clin Psychol Rev 2017; 51: 30-47.
Hetrick SE, Cox GR, Merry SN. Where to go from here? An exploratory meta-analysis of the most promising approaches to depression prevention programs for children and adolescents. Int J Environ Res Public Health 2015; 12: 4758-95.
Idsoe T, Keles S, Olseth AR, Ogden T. Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course. BMC Psychiatry 2019; 19: 155-.
Trangkasombat U, Likanapichitkul D. The Children’s Depression Inventory as a screen for depression in Thai children. J Med Assoc Thai 1997; 80: 491-9.
Trangksombat U, Boonsub W, Pornhavananda P. Utilization of the Center for Epidemiological Studies Depression Scale (CES-D) in screening depression in adolescents. J Med Assoc Thai. 1997; 42: 2-13.
Kongsuk T, Arunpongpaisal S, Janthong S, Prukkanone B, Sukhawaha S, Leejongpermpoon J. Criterion-Related Validity of the 9 Questions Depression Rating Scale revised for Thai Central Dialect. Journal of the Psychiatric Association of Thailand 2018; 63: 321-34.
Tolulope Bella-Awusah, Cornelius Ani, Ademola Ajuwon, Olayinka Omigbodun. Effectiveness of brief school-based, group cognitive behavioural therapy for depressed adolescents in south west Nigeria. Child Adolesc Ment Health 2016; 21: 44-50.
Saw JA, Tam CL, Bonn G. Development and validation of a school-based cognitive-behavioural therapy (CBT) intervention for Malaysian high school students with depressive symptoms. Asia Pac J Counsell Psychother 2019; 10: 171-87.
Vuthiarpa S, Sethabouppha H, Soivong P, Williams R. Effectiveness of a school-based cognitive behavioral therapy program for Thai adolescents with depressive symptoms. Pac Rim Int J Nurs 2012; 16: 206-21.
Nardi B, Massei M, Arimatea E, Moltedo- Perfetti A. Effectiveness of group CBT in treating adolescents with depression symptoms: a critical review. Int J Adolesc Med Health 2016; 29(3). pii: /j/ijamh.2017.29.issue-3/ ijamh-2015-0080/ijamh-2015-0080.xml.
Keles S, Idsoe T. A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression. J Adolesc 2018; 67: 129-39.
Klein JB, Jacobs RH, Reinecke MA. Cognitive-behavioral therapy for adolescent depression: a meta-analytic investigation of changes in effect-size estimates. J Am Acad Child Adolesc Psychiatry 2007; 46: 1403-13.