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The experience of cognitive behavioural therapy in depressed adolescents who are fatigued.

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Title: The experience of cognitive behavioural therapy in depressed adolescents who are fatigued.
Authors: Herring, Georgia Tanith, Loades, Maria Elizabeth, Higson‐Sweeney, Nina, Hards, Emily, Reynolds, Shirley, Midgley, Nick
Source: Psychology & Psychotherapy: Theory, Research & Practice. Mar2022, Vol. 95 Issue 1, p234-255. 22p. 1 Diagram, 2 Charts.
Subjects: Safety, Cognitive restructuring therapy, Research methodology, Interviewing, Experience, Qualitative research, Mental depression, Fatigue (Physiology), Thematic analysis, Patient-professional relations, Cognitive therapy for teenagers, Secondary analysis, Trust, Adolescence
Abstract: Objective: Fatigue is a common and debilitating symptom of major depressive disorder (MDD). Cognitive behavioural therapy (CBT) is a recommended psychological treatment for adolescents with moderate to severe depression. This study explored the experience of CBT in fatigued adolescents with MDD. Design: A qualitative study was conducted using existing data from the qualitative arm of a large randomized control trial, the IMPACT study. Methods: Data were obtained from semi‐structured interviews conducted after therapy. Participants were 18 adolescents (aged 13–18 years) who reached the clinical threshold for fatigue on diagnostic assessment before starting treatment. The data were analysed using thematic framework analysis. Results: Three themes and seven sub‐themes were developed. Adolescents appeared to find taking part in initial sessions, engaging in ongoing sessions and completing homework challenging. Perceiving the therapist as genuine seemed to provide a sense of safety which enabled adolescents to open up in sessions. When the therapist was not perceived as genuine, adolescents appeared to find CBT less helpful. The structure of CBT appeared to enable treatment goals to be set, and facilitated an increase in meaningful activity. Ensuring that tasks were perceived as manageable and goals as achievable seemed important for participation. Cognitive restructuring appeared useful, although some adolescents tended to engage in distraction from thoughts as an alternative strategy. Conclusions: This study provides an initial insight into how fatigued adolescents with MDD experience CBT. Further research is required to establish whether the themes are pervasive and relatedly, how best to treat depression in fatigued adolescents receiving CBT. Practitioner points: Fatigued adolescents with depression found engaging in CBT sessions and therapeutic homework demanding.Establishing a collaborative therapeutic relationship, where the therapist was perceived as genuine, appeared helpful for participation.The structured approach to therapy, combined with flexibility, was experienced as helpful. Adolescents who perceived the pace of sessions to be manageable and therapeutic goals as achievable seemed to find CBT helpful overall.These findings provide insight into how fatigued adolescents with depression experience CBT and highlight the importance of being aware of fatigue and adapting therapy accordingly. [ABSTRACT FROM AUTHOR]
Copyright of Psychology & Psychotherapy: Theory, Research & Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The experience of cognitive behavioural therapy in depressed adolescents who are fatigued.
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  Data: <searchLink fieldCode="AR" term="%22Herring%2C+Georgia+Tanith%22">Herring, Georgia Tanith</searchLink><br /><searchLink fieldCode="AR" term="%22Loades%2C+Maria+Elizabeth%22">Loades, Maria Elizabeth</searchLink><br /><searchLink fieldCode="AR" term="%22Higson‐Sweeney%2C+Nina%22">Higson‐Sweeney, Nina</searchLink><br /><searchLink fieldCode="AR" term="%22Hards%2C+Emily%22">Hards, Emily</searchLink><br /><searchLink fieldCode="AR" term="%22Reynolds%2C+Shirley%22">Reynolds, Shirley</searchLink><br /><searchLink fieldCode="AR" term="%22Midgley%2C+Nick%22">Midgley, Nick</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychology+%26+Psychotherapy%3A+Theory%2C+Research+%26+Practice%22">Psychology & Psychotherapy: Theory, Research & Practice</searchLink>. Mar2022, Vol. 95 Issue 1, p234-255. 22p. 1 Diagram, 2 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+restructuring+therapy%22">Cognitive restructuring therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Experience%22">Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Fatigue+%28Physiology%29%22">Fatigue (Physiology)</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Patient-professional+relations%22">Patient-professional relations</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy+for+teenagers%22">Cognitive therapy for teenagers</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Trust%22">Trust</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescence%22">Adolescence</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Fatigue is a common and debilitating symptom of major depressive disorder (MDD). Cognitive behavioural therapy (CBT) is a recommended psychological treatment for adolescents with moderate to severe depression. This study explored the experience of CBT in fatigued adolescents with MDD. Design: A qualitative study was conducted using existing data from the qualitative arm of a large randomized control trial, the IMPACT study. Methods: Data were obtained from semi‐structured interviews conducted after therapy. Participants were 18 adolescents (aged 13–18 years) who reached the clinical threshold for fatigue on diagnostic assessment before starting treatment. The data were analysed using thematic framework analysis. Results: Three themes and seven sub‐themes were developed. Adolescents appeared to find taking part in initial sessions, engaging in ongoing sessions and completing homework challenging. Perceiving the therapist as genuine seemed to provide a sense of safety which enabled adolescents to open up in sessions. When the therapist was not perceived as genuine, adolescents appeared to find CBT less helpful. The structure of CBT appeared to enable treatment goals to be set, and facilitated an increase in meaningful activity. Ensuring that tasks were perceived as manageable and goals as achievable seemed important for participation. Cognitive restructuring appeared useful, although some adolescents tended to engage in distraction from thoughts as an alternative strategy. Conclusions: This study provides an initial insight into how fatigued adolescents with MDD experience CBT. Further research is required to establish whether the themes are pervasive and relatedly, how best to treat depression in fatigued adolescents receiving CBT. Practitioner points: Fatigued adolescents with depression found engaging in CBT sessions and therapeutic homework demanding.Establishing a collaborative therapeutic relationship, where the therapist was perceived as genuine, appeared helpful for participation.The structured approach to therapy, combined with flexibility, was experienced as helpful. Adolescents who perceived the pace of sessions to be manageable and therapeutic goals as achievable seemed to find CBT helpful overall.These findings provide insight into how fatigued adolescents with depression experience CBT and highlight the importance of being aware of fatigue and adapting therapy accordingly. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychology & Psychotherapy: Theory, Research & Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=155147204
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      – Type: doi
        Value: 10.1111/papt.12365
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 22
        StartPage: 234
    Subjects:
      – SubjectFull: Safety
        Type: general
      – SubjectFull: Cognitive restructuring therapy
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Interviewing
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      – SubjectFull: Experience
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      – SubjectFull: Qualitative research
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      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Fatigue (Physiology)
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      – SubjectFull: Thematic analysis
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      – SubjectFull: Patient-professional relations
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      – SubjectFull: Secondary analysis
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      – SubjectFull: Trust
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      – SubjectFull: Adolescence
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      – TitleFull: The experience of cognitive behavioural therapy in depressed adolescents who are fatigued.
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              Text: Mar2022
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