Relapse and recurrence prevention in the treatment for adolescents with depression study

Relapse and recurrence in adolescent depression are important problems. Much less is known about relapse prevention compared to the acute treatment of depression in adolescents. Based on previous research, theoretical predictions, and clinical experience, the Treatment for Adolescents With Depression Study (TADS) protocol was designed to determine whether the usual high rates of relapse and recurrence could be decreased by extending acute treatment in the form of booster sessions that included (a) thorough education about the nature of depression, including its longitudinal course; (b) achievement of full symptom remission, (c) graded transfer of skills from therapist to adolescent (i.e., teaching the teen to be his or her own therapist); (d) focus on known risk factors for relapse, such as cognitive factors, family criticism, etc.; and (e) inclusion of the family as a function of need and developmental level. This article reviews the literature on risk factors for relapse and recurrence and then describes how these issues were approached in the cognitive behavioral treatment in TADS.