How Therapy Helps: What Really Works for Teen Depression?

This study by Ng et al. (2023) examined how and why therapy works for young people dealing with depression (teen depression). The researchers focused on two types of therapy:

Cognitive Behavioral Therapy (CBT), which helps people change negative thoughts and behaviors.

Interpersonal Psychotherapy (IPT), which focuses on improving relationships and social support.

They wanted to figure out what specific parts of each therapy are actually helping people feel better—these parts are called "change mechanisms" or "mediators". The researchers looked at 34 studies with almost 4,000 young people. They measured things like: Negative thoughts, Being socially involved

Family relationships, Doing fun activities, Problem-solving skills, Avoiding problems, Reframing thoughts (seeing things in a more positive way)

Here’s what they found:

Changing negative thoughts and doing more fun activities helped people improve during CBT. Improving social connections and family relationships helped more during IPT than CBT. Surprisingly, problem-solving and reframing thoughts didn’t seem to have much of an effect, even though CBT theory says they should. In short, some therapy tools really do help with depression, but not always in the ways we expect. And different therapies may work best by targeting different things. However, more studies are needed to confirm these findings, especially for IPT and the less-studied tools.

Ng, M. Y., DiVasto, K. A., Gonzalez, N., Cootner, S., Lipsey, M. W., & Weisz, J. R. (2023). How do cognitive behavioral therapy and interpersonal psychotherapy improve youth depression? Applying meta-analytic structural equation modeling to three decades of randomized trials. Psychological Bulletin, 149(9-10), 507-548. https://doi.org/10.1037/bul0000395

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