Acceptance and Commitment Therapy for adolescent depression: Application with a diverse and predominantly socioeconomically disadvantaged sample

The existing evidence supporting the use of contemporary behavior therapies for adolescent depression is promising but limited. Using a within-series simple phase-change design, 11 adolescents (M age=15.82, SD=1.40, 46% African-American, 36% Multi-Racial, 18% European-American) with major depressive disorder were offered 3 sessions of Motivational Interviewing Assessment (MIA; Phase A) followed by up to 12 sessions (M=6.3) of an Acceptance and Commitment Therapy protocol (ACT; Phase B). Group-level statistically significant effects were found during MIA on 2/5 variables— the Children's Depression Rating Scale – Revised (CDRS-R) and Behavioral Activation for Depression Scale – Short Form (BADS-SF)—while statistically significant changes were found during ACT on 5/5 variables, including the CDRS-R, BADS-SF, Beck Depression Inventory – II (BDI-II), Health-Related Quality of Life (HRQoL), and Avoidance and Fusion Questionnaire for Youth-8 (AFQ-Y8). At the individual level, clinically significant changes on the CDRS–R were observed for 8/11 participants during ACT, while time series analyses controlling for MIA trend demonstrated statistically significant effect sizes on the BADS-SF and AFQ-Y8 for 5/11 and 3/11 participants, respectively. These data suggest the potential utility of ACT for youth from lower income families and from diverse backgrounds; however, given the small sample size and the simple phase-change design, additional research is clearly warranted.

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