ebook THE GUILFORD PRESS CBT for Depression in ChilDren anD aDolesCenTs CBT for Depression in Children and Adolescents A Guide to Relapse Prevention Betsy D. Kennard Jennifer l. hughes aleksandra a. foxwell THE GUILFORD PRESS New York London Copyright © 2016 The Guilford Press A Division of Guilford Publications, Inc. 370 Seventh Avenue, Suite 1200, New York, NY 10001 www.guilford.com All rights reserved Except as indicated, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 2 1 LIMITED DUPLICATION LICENSE These materials are intended for use only by qualified mental health professionals. The publisher grants to individual purchasers of this book nonassignable permission to reproduce all materials for which permission is specifically granted in a footnote. This license is limited to you, the individual purchaser, for personal use or use with individual clients. This license does not grant the right to reproduce these materials for resale, redistribution, electronic display, or any other purposes (including but not limited to books, pamphlets, articles, video- or audiotapes, blogs, file-sharing sites, Internet or intranet sites, and handouts or slides for lectures, workshops, webinars, or therapy groups, whether or not a fee is charged). Permission to reproduce these materials for these and any other purposes must be obtained in writing from the Permissions Department of Guilford Publications. The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication. However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences, neither the authors, nor the editors and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information. Readers are encouraged to confirm the information contained in this book with other sources. Library of Congress Cataloging-in-Publication Data Names: Kennard, Betsy D., author. | Hughes, Jennifer L., 1981– , author. | Foxwell, Aleksandra A., author. Title: CBT for depression in children and adolescents : a guide to relapse prevention / by Betsy D. Kennard, Jennifer L. Hughes, and Aleksandra A. Foxwell. Description: New York: The Guilford Press, [2016]. | Includes bibliographical references and index. Identifiers: LCCN 2015041065 | ISBN 9781462525256 (paper : alk. paper) Subjects: | MESH: Child. | Cognitive Therapy—methods. | Adolescent. | Evidence-Based Medicine. | Secondary Prevention—methods. Classification: LCC RJ505.C63 | NLM WS 350.2 | DDC 618.92/891425—dc23 LC record available at http://lccn.loc.gov/2015041065 About the Authors Betsy D. Kennard, PsyD, ABPP, a clinical psychologist, is Professor in Psychiatry and Director of Cognitive-Behavioral Therapy (CBT) in the Pediatric Psychiatry Research Program at the University of Texas Southwestern Medical Center at Dallas (UT Southwestern) and Children’s Health System of Texas. She also serves as Pro- gram Director of the Doctoral Program in Clinical Psychology at UT Southwestern and Clinical Director of the Suicide Prevention and Resilience Program at Children’s Health. Dr. Kennard has been a site co-investigator on three multisite treatment studies of adolescent depression and suicide funded by the National Institute of Mental Health (NIMH) and has coauthored CBT treatment manuals for these stud- ies. She developed this CBT sequential treatment strategy to prevent relapse in youth with depression and is currently Principal Investigator on an NIMH-funded treat- ment development study to treat suicidal adolescents. Jennifer L. Hughes, PhD, is a clinical psychologist at Children’s Health and Assis- tant Professor in Psychiatry at UT Southwestern. She has received funding from the American Foundation for Suicide Prevention to study an intervention designed to prevent future suicide attempts in youth, and she has served as a therapist, treat- ment developer, and co-investigator on several multisite studies of depressed and/or self-harming children and adolescents. Broadly, Dr. Hughes’s research explores the efficacy and effectiveness of psychosocial approaches to the prevention and treat- ment of depression and suicide in youth and the dissemination of evidence-based treatments to the community. v vi About the Authors Aleksandra A. Foxwell, PhD, is a clinical psychologist at the Student Wellness and Counseling Services and Assistant Professor in Psychiatry at UT Southwestern. She has served as a therapist and a co-investigator on several studies of suicidal chil- dren and adolescents with major depressive disorder. Dr. Foxwell’s clinical interests focus on using evidence-based treatments for depression, anxiety, and other mood disorders in children, adolescents, and young adults. She also trains and supervises students and interns in using CBT for the treatment of depression. Acknowledgments First, we would like to thank the children and families who participated in the treatment studies of relapse prevention cognitive-behavioral therapy (RP-CBT). This work would not have been possible without their time, energy, effort, and input. Our work with them inspired many of the examples, as well as the fine-tuning of skills included in this book. In addition, we are grateful to the National Institute of Mental Health (NIMH), who provided the funding for the clinical trials that led to the development of this treatment approach (NIMH R34 MH072737, principal investigator: B. Kennard; NIMH R01 MH39188, principal investigators: G. Emslie and B. Kennard). We would like to acknowledge the original RP-CBT Development Team—Betsy D. Kennard, PsyD, Sunita Stewart, PhD, Jennifer L. Hughes, PhD, Puja Patel, PhD, Avery Hoenig, PhD, and Jessica Jones, MA—who were instrumental in developing the initial intervention. Additionally, we would like to thank Graham J. Emslie, MD, who was the co-principal investigator for the NIMH R01 randomized con- trolled trial to test RP-CBT. Given his experience in testing and developing continu- ation-phase treatments for youth depression, his input was invaluable in developing our approach to the clinical care of these children and their families. We are also grateful to the many therapists, co-investigators, study coordina- tors, and graduate students who contributed to the success of this work: Taryn Mayes, MS, Jeanne Nightingale-Teresi, RN, MS, Carroll Hughes, PhD, RongRong Tao, MD, Kristi Baker, PhD, Mikah Smith, MA, LPC, Charlotte Haley, PhD, Kate Kennard, BA, Jessica King, BA, Alyssa Parker, PhD, Ashley Melson, MSW, Krystle Joyner, MS, Kristin Wolfe, MRC, Jarrette Moore, MA, Hayley Fournier, PhD, vii viii Acknowledgments Heather Lindburg, MS, Jeanne Rintelmann, BA, Lauren Smith, BA, Annie Walley, LCSW, Shauna Barnes, BA, and Tabatha Hines, PhD. Thank you to Kevin Stark, PhD, and his graduate students, Kim Poling, MSW, John Curry, PhD, and Greg Clarke, PhD, for their careful review of the manual and helpful suggestions. In addition, we are grateful to those who served as consultants on the clinical trials of this manual, including David A. Brent, MD, A. John Rush, MD, Greg Clarke, PhD, Michael Frisch, PhD, Robin Jarrett, PhD, and Kevin Stark, PhD. We would also like to acknowledge the influence of several important works that have shaped the development of RP-CBT. These individuals and their work have affected the care of depressed children and have had a major impact on our field. 1. Treating depressed youth: Therapist manual for “ACTION.” (2007b). K. D. Stark, S. Schnoebelen, J. Simpson, J. Hargrave, J. Molnar, and R. Glen. 2. Cognitive behavior therapy manual for TADS (2000). J. Curry, K. Wells, D. Brent, G. Clarke, P. Rohde, A. M. Albano, M. Reinecke, N. Benazon, and J. March, with contributions by G. Ginsburg, A. Simons, B. D. Kennard, R. LaGrone, M. Sweeney, N. Feeny, and J. Kolker. 3. Cognitive behavior therapy manual for TORDIA (2000). D. Brent, M. Bridge, and C. Bonner. 4. Cognitive therapy treatment manual for depressed and suicidal youth (1997). D. Brent and K. Poling. 5. Continuation therapy for major depressive disorder (2001). R. B. Jarrett. 6. Cognitive behavior therapy for suicide prevention (CBT-SP) teen manual, version 3 (2006). D. A. Brent, G. Brown, J. F. Curry, T. Goldstein, J. L. Hughes, B. D. Kennard, K. Poling, M. Scholossberg, B. Stanley, K. C. Wells, and the TASA CBT Team. 7. The SAFETY Program: Ecological cognitive-behavioral intervention for adolescent suicide attempters (2015). J. R. Asarnow, M. Berk, J. L. Hughes, and N. L. Anderson. 8. Stress and your mood: Teen and young adult workbook (1999). J. Asarnow , L. Jaycox, G. Clarke, P. Lewinsohn, H. Hops, and P. Rohde. 9. Stress and your mood: A manual for individuals (2010). J. Asarnow, L. Jaycox, G. Clarke, P. Lewinsohn, H. Hops, P. Rohde, and M. Rea. For additional work related to RP-CBT, readers are referred to Kennard, Emslie, et al. (2008a); Kennard, Stewart, et al. (2008b); and Kennard et al. (2014).
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