Relational factors and cognitive interventions in group cognitive-behavioral therapy : effects on the cognitive triad and depression in preadolescent females

Previous research indicates that cognitive-behavioral therapy (CBT) is helpful in reducing depression in youth. However, little research exists into what specific components within CBT treatment protocols are associated with decreases in depression. Furthermore, little is known about how components within CBT treatment protocols reduce depression. Cognitive theories suggest that interventions targeted at negative cognitions reduce depression. Research has provided initial support for this position, although these studies did not utilize clinically depressed youth. Research has also shown that the therapeutic ingredients of therapist relational behaviors and group cohesion are important general factors in treatment; however, research exploring these variables in youth depression is lacking. Cognitive theories of depression suggest depressogenic thinking mediates the relationship between interventions and depression. However, no research exists exploring depressogenic thinking as a mediator between specific components of CBT treatment protocols and youth depression. The purpose of the current study was to investigate the association between specific components of a CBT treatment protocol and depression. The current study also sought to investigate depressogenic thinking as a mediator between the components of interest and depression. Participants were 42 girls, aged 9 to 14, who completed a manualized CBT group treatment protocol for depression. Participants completed a diagnostic interview for depression and completed self-report measures of depressogenic thinking. Group therapy sessions were coded for cognitive interventions, therapist relational behaviors, and group cohesion. The results of the main hypotheses indicated no significant associations between cognitive interventions, therapist relational behaviors, group cohesion and depression. Furthermore, tests of depressogenic thinking as a mediator could not be conducted based on the aforementioned results. However, post-hoc power analysis revealed extremely low power for the analyses. To further investigate the data, an exploratory analysis was conducted, with steps taken to increase power. Results from the exploratory analysis indicated the therapist relational behaviors measure consisted of two factors, both of which were significantly associated with post-treatment depression. Furthermore, the exploratory analysis revealed a significant association between cognitive interventions and post-treatment depression. Finally, no significant association was found between group cohesion and post-treatment depression. Implications, limitations, and recommendations for further areas of research are presented.