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Child Psychiatry & Human Development

, Volume 50, Issue 6, pp 950–959 | Cite as

Ready or Not? Transitions of Depressed Adolescents During Acute Phase of Treatment

  • Natalie Rodriguez-QuintanaEmail author
  • Cara C. Lewis
Original Article

Abstract

Readiness to change has been identified as a predictor, moderator, and mediator of treatment. Individuals may start treatment in one stage and either stay, regress, or progress across stages, but there is little research exploring these transitions within mental health treatment. The present study addressed two aims: characterize the prevalence of stage membership and transitions, and explore predictors of stage membership and transitions. A Treatment for Adolescents with Depression Study sub-sample was used and participants (n = 383) ranged in age from 12 to 17, with a primary diagnosis of Major Depressive Disorder. The 18-item self-report Stages of Change Questionnaire was administered at baseline and week 6 of treatment. A latent transition analysis determined stage membership and transitions. Most adolescents initiated treatment in precontemplation or contemplation, and hopelessness predicted stage membership and stage transitions. This study revealed that readiness to change and hopelessness are related within the first few weeks of treatment, which may have implications for depressed adolescent’s ability to benefit from care.

Keywords

Readiness to change Adolescents Hopelessness Depression Treatment 

Notes

Acknowledgments

The authors thank The Methodology Center at The Pennsylvania State University for answering multiple questions about latent transition analysis and SAS PROC LTA.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
  2. 2.
    SAMHSA (2014) Results from the 2013 National Survey on Drug Use and Health: mental health findings. Substance Abuse and Mental Health Services Administration, RockvilleGoogle Scholar
  3. 3.
    Hawton K, Saunders KE, O’Connor RC (2012) Self-harm and suicide in adolescents. Lancet 379(9834):2373–2382PubMedCrossRefGoogle Scholar
  4. 4.
    Angold A, Messer SC, Stangl D, Farmer E, Costello EJ, Burns BJ (1998) Perceived parental burden and service use for child and adolescent psychiatric disorders. Am J Public Health 88(1):75–80PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Weisz JR, McCarty CA, Valeri SM (2006) Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychol Bull 132(1):132–149PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Kennard BD, Silva SG, Tonev S et al (2009) Remission and recovery in the treatment for adolescents with Depression Study (TADS): acute and long-term outcomes. J Am Acad Child Adolesc Psychiatry 48(2):186–195PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Curry J, Silva S, Rohde P et al (2011) Recovery and recurrence following treatment for adolescent major depression. Arch Gen Psychiatry 68(3):263–269PubMedCrossRefGoogle Scholar
  8. 8.
    Gordon PL (1967) Strategy of ourcome research in psychotherapy. J Consul Psychol 31(2):109–118CrossRefGoogle Scholar
  9. 9.
    Curry J, Rohde P, Simons A et al (2006) Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 45(12):1427–1439PubMedCrossRefGoogle Scholar
  10. 10.
    Lewis CC, Simons AD, Silva SG et al (2009) The role of readiness to change in response to treatment of adolescent depression. J Consult Clin Psychol 77(3):422–428PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Lewis CC, Simons AD, Nguyen LJ et al (2010) Impact of childhood trauma on treatment outcome in the Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 49(2):132–140PubMedGoogle Scholar
  12. 12.
    DiClemente CC, Prochaska JO (1982) Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict Behav 7(2):133–142PubMedCrossRefGoogle Scholar
  13. 13.
    Bellis JM (1994) The transtheoretical model of change applied to psychotherapy: a psychometric assessment of related instruments. Doctoral dissertation, The University of Rhode Island, Kingston, RIGoogle Scholar
  14. 14.
    McConnaughy EA, Prochaska JO, Velicer WF (1983) Stages of change in psychotherapy: measurement and sample profiles. Psychotherapy 20(3):368–375CrossRefGoogle Scholar
  15. 15.
    Fitzpatrick MR, Irannejad S (2008) Adolescent readiness for change and the working alliance in counseling. J Couns Dev 86(4):438–445CrossRefGoogle Scholar
  16. 16.
    Prochaska JO, Norcross JC (2001) Stages of change. Psychotherapy 38(4):443–448CrossRefGoogle Scholar
  17. 17.
    Norman GJ, Velicer WF, Fava JL, Prochaska JO (1998) Dynamic typology clustering within the stages of change for smoking cessation. Addict Behav 23(2):139–153PubMedCrossRefGoogle Scholar
  18. 18.
    Martin RA, Velicer WF, Fava JL (1996) Latent transition analysis to the stages of change for smoking cessation. Addict Behav 21(1):67–80PubMedCrossRefGoogle Scholar
  19. 19.
    Westra HA, Arkowitz H, Dozois DJA (2009) Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: a preliminary randomized controlled trial. J Anxiety Disord 23(8):1106–1117PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Arkowitz H, Westra HA (2004) Integrating motivational interviewing and cognitive behavioral therapy in the treatment of depression and anxiety. J Cognitive Psychother 18(4):337–350CrossRefGoogle Scholar
  21. 21.
    March J, Silva S, Petrycki S et al (2004) Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA 292(7):807–820PubMedCrossRefGoogle Scholar
  22. 22.
    Stalker CA, Horton S, Cait C-A (2012) Single-session therapy in a walk-in counseling clinic: a pilot study. J Syst Ther 31(1):38–52CrossRefGoogle Scholar
  23. 23.
    O’Connor SS, Comtois KA, Wang J et al (2015) The development and implementation of a brief intervention for medically admitted suicide attempt survivors. Gen Hosp Psychiatry 37(5):427–433PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    May DE, Kratochvil CJ, Puumala SE et al (2007) A manual-based intervention to address clinical crises and retain patients in the Treatment of Adolescents With Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 46(5):573–581PubMedCrossRefGoogle Scholar
  25. 25.
    Stevens J, McGeehan J, Kelleher KJ (2010) Readiness to change in adolescents screening positive for substance use in urban primary care clinics. J Child Adolesc Subst Abuse 19(2):99–107PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Pauli D, Aebi M, Metzke CW, Steinhausen H-C (2017) Motivation to change, coping, and self-esteem in adolescent anorexia nervosa: a validation study of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ). J Eat Disord 5(1):11PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Gusella J, Butler G, Nichols L, Bird D (2003) A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy. Eur Eat Disord Rev 11(1):58–71CrossRefGoogle Scholar
  28. 28.
    Brick LAD (2015) Undestanding stage of change transitions across multiple behaviors. Doctoral disseration, The University of Rhose Island, Kingston, RIGoogle Scholar
  29. 29.
    Schumann A, John U, Rumpf H-J, Hapke U, Meyer C (2006) Changes in the “stages of change” as outcome measures of a smoking cessation intervention: a randomized controlled trial. Prev Med 43(2):101–106PubMedCrossRefGoogle Scholar
  30. 30.
    Velicer WF, Martin RA, Collins LM (1996) Latent transition analysis for longitudinal data. Addiction 91(12s1):197–210CrossRefGoogle Scholar
  31. 31.
    Collins LM, Lanza ST (2013) Latent class and latent transition analysis: with applications in the social, behavioral, and health sciences. Wiley, HobokenGoogle Scholar
  32. 32.
    Team TTfAwDST (2005) The treatment for adolescents with depression study (TADS): demographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry 44(1):28–40CrossRefGoogle Scholar
  33. 33.
    TfAWDS Team (2003) Treatment for Adolescents With Depression Study (TADS): rationale, design, and methods. J Am Acad Child Adolesc Psychiatry 42(5):531–542CrossRefGoogle Scholar
  34. 34.
    Ni Y, Tein J-Y, Zhang M, Yang Y, Wu G (2017) Changes in depression among older adults in China: a latent transition analysis. J Affect Disord 209:3–9PubMedCrossRefGoogle Scholar
  35. 35.
    Brent DA, Poling K (1997) Cognitive therapy treatment manual for depressed and suicidal youth. University of Pittsburgh Health System Services for Teens At Risk, PittsburghGoogle Scholar
  36. 36.
    Lewinsohn PM, Clarke GN, Hops H, Andrews J (1990) Cognitive-behavioral treatment for depressed adolescents. Behav Ther 21(4):385–401CrossRefGoogle Scholar
  37. 37.
    Poznanski EO, Mokros HB (1996) Children’s depression rating scale, revised (CDRS-R). Western Psychological Services, Los AngelesGoogle Scholar
  38. 38.
    Beck AT, Steer RA (1993) Beck Hopelessness Scale manual. The Psychological Coorporation, San AntonioGoogle Scholar
  39. 39.
    Kaufman J, Birmaher B, Brent D et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Everitt BS (2006) The Cambridge dictionary of statistics. Cambridge University Press, CambridgeGoogle Scholar
  41. 41.
    Lanza ST, Dziak JJ, Huang L, Wagner A, Collins LM (2015) PROC LCA & PROC LTA users’ guide (Version 1.3.2). University Park, The Methodology Center, Penn StateGoogle Scholar
  42. 42.
    Petrocelli JV (2002) Processes and stages of change: counseling with the transtheoretical model of change. J Couns Dev 80(1):22–30CrossRefGoogle Scholar
  43. 43.
    DiClemente CC, Velasquez MM (2002) Motivational interviewing and the stages of change. In: Miller WR, Rollnick S (eds) Motivational interviewing: Preparing people for change, 2nd edn. The Guildford Press, New York, pp 201–216Google Scholar
  44. 44.
    Miller WR, Rollnick S (2004) Talking oneself into change: motivational interviewing, stages of change, and therapeutic process. J Cognitive Psychother 18(4):299–308CrossRefGoogle Scholar
  45. 45.
    Callaghan RC, Hathaway A, Cunningham JA, Vettese LC, Wyatt S, Taylor L (2005) Does stage-of-change predict dropout in a culturally diverse sample of adolescents admitted to inpatient substance-abuse treatment? A test of the Transtheoretical Model. Addict Behav 30(9):1834–1847PubMedCrossRefGoogle Scholar
  46. 46.
    Zachrisson HD, Rödje K, Mykletun A (2006) Utilization of health services in relation to mental health problems in adolescents: a population based survey. BMC Public Health 6(1):34PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Levesque DA, Van Marter DF, Schneider RJ et al (2011) Randomized trial of a computer-tailored intervention for patients with depression. Am J Health Promot 26(2):77–89PubMedCrossRefGoogle Scholar
  48. 48.
    Jungbluth NJ, Shirk SR (2009) Therapist strategies for building involvement in cognitive–behavioral therapy for adolescent depression. J Consult Clin Psychol 77(6):1179PubMedCrossRefGoogle Scholar
  49. 49.
    Naar-King S (2011) Motivational interviewing in adolescent treatment. Can J Psychiatry 56(11):651–657PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychological and Brain SciencesIndiana UniversityBloomingtonUSA
  2. 2.Kaiser Permanente Washington Health Research InstituteMacColl Center for Health Care InnovationSeattleUSA
  3. 3.Department of Psychiatry & Behavioral SciencesUniversity of WashingtonSeattleUSA

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