Cognitive Behavioral Therapy has been shown repeatedly to aid in the treatment of Major

Depressive Disorder
Many studies have shown that a combination of medication and CBT are the most effective
method of treatment
Initially and especially with adolescents, it is important to take into account a risk benefit
analysis of medication and therefore therapy is often the primary option in the treatment of
depression for those under 18
CBT is the form of psychotherapy with the most empirical support in the treatment of
depression in children and adolescents
CBT for depression can be divided into cognitive and behavioral components
The cognitive component aims to restructure irrational thought processes into more rational
thought patterns
The term Cognitive Triad is often used to conceptualize depression and refers to negative views
depressed people have about themselves, their worlds, and their futures
The behavioral component seeks to empower the patient to feel control over their own
behaviors
The main assumption of the behavioral component is that changing a persons behaviors will
bring about change in their thoughts and feelings as well
The first step in CBT is the psychological assessment which may utilize a variety of scales
designed to measure the symptoms of depression; Once a diagnosis of Major Depressive
Disorder is reached, the therapist would continue with the implementation of CBT
Although the focus of CBT is generally on the present and immediate future, a background
evaluation may be conducted as well for insight into the clients current cognitive processes
Socratic Questioning is often used to determine what the patients beliefs and thoughts are
This gives the therapist the opportunity to lead to patient to the discovery that many of their
thoughts and beliefs are irrational
The therapist may have the patient monitor their thoughts in a journal so that they may identify
automatic thoughts that are irrational and contributing to their depression and respond to them
in a more rational manner
On the behavioral side, the therapist would seek to find what factors are causing the patient to
feel a lack of control over their life and help them to gain skills to manage their problems by
altering their behaviors
Goal setting is an important component of CBT and every week goals may be set by working
together to find what is causing a problem and change that behavior
For example: if the client is in trouble at work because they are frequently late, the therapist
would act as a catalyst by giving the client behavioral techniques to get to work on time; EX: if
the client has trouble getting out of bed in the morning have them set an alarm and leave it on
the opposite side of the room from the bed so that they must get out of bed to shut the alarm
off
Once these skills are initially taught, the therapist would help the client to continue to monitor
their thoughts and behaviors and apply the learned techniques across a variety of situations
Other techniques such as relaxation and mindfulness training may be implemented in
combination with CBT due to the variety of different implementations