Characterizing Therapy Experiences in Youth With Depression and Suicide Via the Depression Treatment Experiences Questionnaire

Abstract

Depression and suicidality are prevalent mental health issues among adolescents in the United States. There are multiple evidence-based practices (EBPs) for depression and/or suicidality, including cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) and interpersonal therapy for adolescents (IPT-A), though youth seeking psychotherapeutic treatment in community settings may not consistently receive these EBPs. This study aims to characterize therapy experiences among youth aged 8-20 years with depression and/or suicidal behaviour who were in treatment using the Depression Treatment Experiences Questionnaire (DTEQ), as well as to provide initial construct validity and test-retest reliability of this new measure. Of the first 1000 participants in the Texas Youth Depression and Suicide Research Network (TX-YDSRN), 585 were currently receiving psychotherapy for their depression and/or suicidality. Almost half of the participants engaged in therapy reported receiving some form of CBT (n = 237, 42.4%). The DTEQ showed a two-factor structure, including a 12-item 'Evidence-Based Practice' factor that demonstrated strong internal consistency and test-retest reliability and a two-item 'Parental Involvement' factor that showed acceptable internal consistency and test-retest reliability. Participants receiving psychotherapy generally endorsed being exposed to techniques aligned with EBPs. Additional non-therapeutic elements, such as exercise (n = 276, 47.1%) and changing sleep habits (n = 191, 32.6%), were frequently endorsed as being received by participants in psychotherapy. These results describe the therapy experiences of youth engaged in psychotherapy for depression and/or suicidality and propose a new assessment tool that can be used to characterize these experiences. KEY PRACTITIONER MESSAGES: Youth in psychotherapy for depression or suicidality frequently engage in evidence-based techniques (e.g., problem-solving, cognitive restructuring), yet nearly half are unaware of the type of therapy they are receiving-highlighting a gap in patient-provider communication and psychoeducation. The DTEQ is a promising tool for assessing therapy content and structure and may help practitioners assess that evidence-based components are being implemented and understood by clients. Many adolescents supplement treatment with lifestyle changes like exercise and sleep adjustments-indicating the importance of integrating behavioural health recommendations into therapy for holistic care.

Keywords: adolescent; cognitive‐behavioural therapy; depression; suicide; treatment.