Cognitive-behavioral prevention of depression in adolescents

• Cognitive-behavioral (CB) prevention has the largest evidence base in teen depression.
• Meta-analyses find small effects in symptom reduction post-intervention and follow-up.
• Selective and indicated prevention achieve stronger effects than universal approaches.
• Consistent evidence suggests that CB prevention reduces disorder onset by 40%.
• Important research is still needed, including why CB prevention works and for whom.

Major depression in adolescents is common but often untreated, underscoring the need for effective prevention. Several prevention programs have been developed, with cognitive-behavioral (CB) interventions having the largest evidence base. Meta-analyses reports find small magnitude effects for depressive symptom reductions at post-intervention and follow-up, with larger effects for selective/indicated than universal programs. More encouraging, long-term studies suggest that depressive disorder rates are approximately 40% lower for CB programs compared to controls. Needed research includes improving the existing programs that work well, developing a more sophisticated understanding of why CB prevention works, identifying subgroups who most benefit from CB, continuing the transition to effectiveness research, developing effective depression prevention programs for college-aged young people, and a broader evaluation of CB-based computerized prevention efforts.