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Symposia

Treatment - CBT

Session: How should we talk about depression and mental health? Practical advice to improve Cognitive Behavioral Therapy from clinical and social psychology

2 - (SYM 94) Adolescents' Beliefs About What Causes Depression: Implications for Clinical Psychoeducation

Saturday, November 18, 2023
2:30 PM – 4:00 PM PST
Location: Snohomish (605), Level 6
Client beliefs about the cause of their illness have been linked to treatment preferences, engagement, and clinical outcomes. Research suggests that for clinicians, assessing clients’ causal explanations for their illness (and, ideally, aligning these beliefs between clinician and client) is a useful step in therapy. To date, relatively little research has examined adolescents’ causal explanations for depression, making it hard for clinicians to know what causal beliefs to expect, and how to best assess them. This study explored the causal beliefs about depression held by a diverse sample of U.S. adolescents with elevated depression symptoms (N = 281; 55% White non-Hispanic; 53% cisgender girl; 78% LGBQ*). Qualitative methods were used to identify causal beliefs from open-ended survey responses. Quantitative methods compared the perceived causes of one’s own depression vs others’ depression, compared causal beliefs across groups, and measured the association between causal beliefs and additional clinical constructs. Among these adolescents, the most common causal beliefs for depression were dysfunctional home and family relationships (52%) and stress from school (42%). Several causal beliefs were expressed more in regards to one’s own depression than others’ depression (e.g., adverse childhood events, 11% vs 3%, p = .004) and vice versa (e.g., social media use, 12% vs 2%, p < .001). Additionally, significant relationships emerged between certain causal beliefs and demographic and clinical variables, including a link between hereditary causal beliefs and confidence in medication (r = .23, p = .024). Results provide lessons for clinical work with depressed adolescents, including that many adolescents identify stressful relationships and school responsibilities as primary causes of depression, and that adolescents' causal beliefs are complex and cannot always be reduced to one or two factors. Moreover, when evaluating a client’s beliefs or framing depression for a client, it is necessary to distinguish between adolescents’ beliefs about what causes depression in general (or for other people) and what they believe causes their own depression.