Het effect van verschillende CGT-componenten op de therapeutische alliantie en de rol van therapeutische alliantie binnen CGT in de preventie van depressie bij adolescenten.
Summary
Prevention of depression among adolescents is important, given the prevalence of (sub)clinical depression and its negative consequences. Cognitive behavioral therapy (CBT), consisting of various components such as cognitive restructuring (CR), behavioral activation (BA), problem solving (PS) and relaxation (RE), has proven to be an effective treatment form in the prevention of depression among adolescents, with both specific and non-specific factors playing a role. The present study aimed to investigate the effect of specific factors, namely two CBT components cognitive restructuring and behavioral activation, on a non-specific factor, namely therapeutic alliance. In addition, the role of the non-specific factor (therapeutic alliance) as a mediator, in combination with the specific factors (CBT components) within CBT in the prevention of depression in adolescents was examined. The sample consisted of adolescents with elevated depressive symptoms that were randomly assigned to one of four conditions in which the CBT components were differentially sequenced, with each component consisting of three sessions. The current study focused on condition 1: CR-BA-RE-PS (n = 39) and condition 2: BA-CR-RE-PS (n = 29). No significant difference was found in the level of therapeutic alliance after three sessions of CR and three sessions of BA. Also, no significant differences were found in the change of therapeutic alliance when CR was sequenced before or after BA (followed by RE and PS, resp. condition 1 and 2). At last, no mediating effect of therapeutic alliance on the change of depressive symptoms was found. Possible explanations and suggestions for follow-up research are discussed.