From psychopathology to optimal functioning: contributions to therapy in depressed adolescents

Adolescent depression has alarming prevalence rates, mainly due to consequences of depression on the psychosocial functioning of adolescents (Hankin et al. 2015). Some authors have suggested combining strategies from Cognitive Behavioral Therapy (CBT) and Positive Psychological Interventions (PPI) to increase depression treatment success (Karwoski et al., 2017). This dissertation aimed to develop a manualized individual therapy, entitled “Optimal Functioning Therapy for Adolescent” (OFTA, Teixeira & Freire, 2014) for the treatment of depression. OFTA focus simultaneously on decreasing depressive symptoms and achieving adolescent optimal functioning, by integrating and adapting strategies from CBT and PPI. The second aim was to evaluate the contents and strategies of OFTA and its structure. For this, we first conducted a case study with a female adolescent diagnosed with Major Depressive Disorder. The assessment of OFTA was made using retrospective measures and the Experience Sampling Method (ESM, Csikszentmihalyi & Larson, 1987) from baseline to a 4-month follow-up. Findings showed an improvement in positive trait characteristics and reduction of depressive symptoms; higher levels of momentary positive mood and self-satisfaction and lower levels of momentary negative mood; as well as increased engagement and diversification of life contexts (activities, places, and companies). Then, OFTA was assessed in a pilot study with 22 clinically depressed adolescents recruited in a public hospital. This study also followed a longitudinal design using retrospective measure. Results showed a statistically significant decrease of depressive symptoms and negative affect and an increase of positive affect, self-esteem, and life satisfaction from baseline to follow-up. In this pilot study, only 12 participants answered to ESM questionnaires. Findings from those participants showed a decrease of depressive symptoms and negative affect and an increase in positive affect (measured retrospectively and momentarily). Results ...