Blended Treatment for Depressive Disorders in Youth: a Narrative Review
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Blended Treatment for Depressive Disorders in Youth: a Narrative Review Sanne P. A. Rasing 1,2 Accepted: 16 September 2020/ # The Author(s) 2020
Abstract Depressive disorders are the most prevalent mental health disorder in adolescents with detrimental consequences; effective and available treatment is crucial. Face-to-face and computerized treatments both have advantages but also downsides. Merging these two into one so-called blended treatment seems to be an optimal combination of elements. This current review addresses blended treatment for youth depression and aims to summarize existing knowledge on effectiveness as well as patients’ and therapists’ perspectives. Results showed promising significant decreases in symptoms, but no evidence for differences between blended and face-to-face treatment was found. Patients’ perspectives were mixed; they reported strong preferences for face-to-face treatment, but participants actually receiving blended treatment were mainly positive. Therapists’ attitudes were neutral, but they expressed their worries about the unknown risks on adverse events. Future research is needed and should, beside effectiveness and cost-effectiveness, pay close attention to the risks that are mentioned by therapists. Keywords Blended . Treatment . Youth . Adolescents . Review
Introduction Depressive disorders are the most prevalent mental health disorder in adolescents, and they are the most important cause of illness and disability (World Health Organization 2017). Youth depression has detrimental consequences; it is related to health problems, problems in interpersonal functioning, and decreased academic and professional performance (Kim-Cohen et al. 2003; Portzky and Van Heeringen 2009; Verboom et al. * Sanne P. A. Rasing [email protected]
1
Child and Adolescent Psychiatry, GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
2
Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
International Journal of Cognitive Therapy
2014). Furthermore, depression has a high risk on recurrence and chronicity; it is one of the most important risk factors for youth suicide (Portzky and Van Heeringen 2009), and, therefore, availability of effective treatment is crucial. Regular face-to-face treatment for depression has shown to be effective, with cognitive behavioral therapy (CBT) and interpersonal psychotherapy as first choices of treatment (American Psychological Association and Guideline Development Panel for the Treatment of Depressive Disorders 2019; Weisz et al. 2005). However, average effect sizes are small to moderate, and not all individuals show improvement after receiving treatment (Klein et al. 2007; Watanabe et al. 2007; Zhou et al. 2015). But the most important reasons mentioned by youth for not seeking help are lack of time, high costs, and availability of transport (Gulliver et al. 2010). Hence, computerized treatment is often mentioned as alternative for face-to-face treatment; it ticks the boxes of being flexible, fr
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