Depression
Depression in Children and Adolescents
Around 11 percent of students already suffer from clinically relevant depression (Sauer et al., 2014). Children and adolescents often experience a lack of positive activities, apathy, and even suicidal thoughts or self-harm unnoticed and untreated.
The information below regarding the treatment of depression also applies to children and adolescents. However, treatment can be supplemented with parent and family therapy.
Medical Treatment
The outpatient day clinic therapy offer of the 8-week program includes:
- On average 6 therapeutic hours per week (group and individual psychotherapy, occupational therapy)
- Physiotherapy and sports therapy individually and in groups, 4 hours per week
- Relaxation training according to Jacobson
- Self-confidence training according to Ullrich (saying no, establishing social contacts) 1 hour per week
- Computer training methods, 1 hour per week
- Cognitive and interpersonal therapy, if necessary, medication options are also discussed
We particularly emphasize
- Observing social behavior in the group
- Learning to deal with depression (relaxation exercises, sports, etc.)
- Exposure exercises (gradually confronting everyday situations)
- Initiating social medical measures (career counseling, assistance with professional, educational, financial, and housing questions, etc.).
If indicated, medication therapies such as Seropram may also be used. This is done in consultation with the doctors before and after treatment.
Individual Therapeutic Offer
Exposures and individual therapy as needed.
MZG patients
As a patient in the partial inpatient or outpatient program, you are entitled to interdisciplinary consultations in your personal area of concern.
You can receive the following information:
- Depression and symptoms
- Possible changes in brain metabolism
- Possible causes
- Additional therapy options (e.g. light therapy)
- Literature for patients and relatives
- Addresses of self-help groups for patients and relatives
If you are interested in such additional consultation, please contact your primary therapist. They will schedule an appointment with one of the specialists for you.
Therapy Goals
- Permanent reduction of depression
- Building a social environment
- Strengthening resources
- Learning relaxation exercises
- Prevention of consequences such as social isolation, medication abuse, suicidality, etc.
To achieve this, we initially work with the patient in the first phase of the process
- on therapy motivation
- on compliance
- on a deeper understanding of the problem and disease contexts
- on access to physical experiential capability through sports and physiotherapy
This first phase of the process can extend over a longer period, often even over the entire duration of the 8 weeks. This means that symptom freedom is not achieved, but awareness for further therapeutic steps has been created.
Depending on the personality structure and cognitive abilities, further work can be done on introspective ability, confrontability, and conflict resolution skills.
Scientifically expected success rate
For depression, the following results can be expected scientifically:
- Cognitive-behavioral therapy has proven especially effective for severely depressed patients (Jacobson & Hollon, 1996). 59% of patients show improvement even 1 year after treatment (Weissman et al., 1981).
- Interpersonal psychotherapy improves 43% of patients 1 year after treatment (Weissman et al., 1981), especially when combined with antidepressants. This is particularly true for patients who are still well integrated socially.
- Behavioral marital therapy can be a good addition to outpatient therapy (Jacobson et al., 1991).
- Psychotherapy leads to better outcomes than purely medication therapy (Hautzinger, 1998). Psychotherapies also increase compliance with medication intake.
Literature on Depression
Forand, N. et al. (2013). Combining medication and psychotherapy in the treatment of major mental disorders. In M. Lambert (Ed.). Handbook of psychotherapy and behavior change (pp. 735-774). New York, NY: Wiley.
Hautzinger, M. (1998). Depression. Göttingen: Hogrefe.
Jacobson, N.S., Dobson, K.S., Fuzetti, A.E., Schmaling, K.B., & Salusky, S. (1991). Marital therapy as a treatment for depression. Journal of Consulting an Clinical Psychology, 59, 547-557.
Jacobson, N.S., & Hollon, S.D. (1996). Cognitive-behavior therapy versus pharmacotherapy: Now that the jury’s returned ist verdict, it’s time to present the rest of the evidence. Journal of Consulting and Clinical Psychology, 64, 74-80.
Sauer K, Barkmann C, Klasen F, Bullinger M, Glaeske G, Ravens-Sieberer U.(2014). How often do German children and adolescents show signs of common mental health problems? Results from different methodological approaches – a cross-sectional study.BMC Public Health. 2014 Mar 5;14(1):229. [Epub ahead of print]
Weissman, M.M., Klerman, G.L, Prusoff, B.A., Sholomskas, D., & Padian, N. (1981). Depressed outpatients: Results 1 year after treatment with drugs and/ or interpersonal psychotherapy. Archives of General Psychiatry, 38, 51-55.
