Cognitive behavioural therapy is likely to reduce depression in young people, regardless of how it’s delivered
Cognitive behavioural therapy (CBT) can be delivered in various ways, all of which are likely to reduce depression in young people. Self-help with therapist support is the most highly ranked, but the differences between the different types of therapy are small. It is unclear whether therapy delivered remotely (such as online) is effective.
Six to twelve months after treatment, self-help was the highest ranked for reducing depression. However, fewer types of delivery were tested over the long term, and there is no clear evidence of a difference between them.
No types of delivery are more acceptable to young people than any others.
What is this review about?
Depression is a common mental health problem in young people and is often treated with CBT. CBT is a talking therapy that aims to help people by changing negative patterns in the connections between thoughts, feelings and actions.
CBT can be delivered in different ways: face-to-face individually or in a group, via an app or website, using a book, remotely with a therapist online or on the phone or a combination of self-help and therapist support.
It is not clear which of these types of delivery are the most effective for young people.
What is the aim of this review?
This Campbell systematic review aims to collect information from studies of CBT for depression in young people to find out whether some delivery types are more effective than others for reducing depression, and whether any are more acceptable to young people.
What studies are included?
After searching for studies of CBT for depression in young people, 68 studies were included in the review. All studies are randomised controlled trials.
What are the main findings of this review?
Most types of CBT reduce depression in young people. Self-help with support from a therapist is the highest ranked for effectiveness, although the differences are small. We only found one study of CBT delivered remotely.
None of the delivery types are more effective than any others 6-12 months after treatment. Self-help CBT without therapist support is the highest ranking in the long term. No studies examined self-help with support from a therapist or CBT delivered remotely over the long term.
No delivery types are likely to be more acceptable to young people than any others.
What do the findings of this review mean?
All types of CBT are likely to reduce depression in young people, although more research is needed for remote CBT.
Self-help with therapist support is the highest ranked, but it was only tested with young people aged 16–19 years; the results may not apply to younger age groups.
Self-help without support is the highest ranked in the longer term. Further research is needed to learn whether self-help enables young people to maintain improvement and whether therapist support would further improve long-term outcomes.
How up-to-date is this review?
The review authors searched for studies up to November 2020.