Teenagers with depression who receive cognitive behavioral therapy (CBT) at a primary care clinic are more likely to recover, and to recover faster, than teens who do not receive primary care-based counseling, according to a study published in Pediatrics.

Researchers examined data from 212 teens between 12 and 18 years of age who had been diagnosed with major depression and had recently declined or quickly discontinued treatment via antidepressants. Participants were randomized to receive either standard care or standard care plus CBT, and were followed for 2 years.

Nearly 90% of teenagers in the CBT group had recovered – defined as having no or minimal symptoms of depression for 8 weeks or more – compared with 79% in the standard care group. On average, teens in the CBT group recovered 8 weeks faster than teens in the standard care group – 22.6 weeks versus 30 weeks, respectively. At 6 months, 70% of teens in the CBT group were considered recovered, versus 34% of teens in the standard care group. In addition, more teenagers in the standard care group were hospitalized for psychiatric care during the study period.

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“This study shows that youth who refuse antidepressants can still be successfully treated in primary care using cognitive behavioral therapy,” said Gregory N. Clarke, PhD, lead study author and Senior Investigator and Program Director at the Kaiser Permanente Center for Health Research in Portland, Oregon. “We know from previous studies that when kids aren’t depressed, they do better in school, are less likely to have sleep and substance abuse problems, and ultimately graduate high school more often.”

Study results were consistent with recent meta-analyses of CBT treatment for adolescent depression, the authors concluded, noting that CBT “imparted an important clinical benefit and may reduce the risk of future recurrent depression episodes.”


  1. Clarge G, DeBar LL, Pearson JA, et al. Cognitive behavioral therapy in primary care for youth declining antidepressants: A randomized trial. Pediatrics. 2016; doi: 10.1542/peds.2015-1851