17/11/2016 Taking Action

Taking Action
Kevin Stark and Philip Kendall

* Goalsand objectives (philosophy of treatment, general

description of the treatment)

* Degree to which "Taking Action" addresses the core

features of childhood depression

* Developmental nature of "Taking Action"

* Specific components of "Taking Action" and their rationale

* Pragmatic application issues (completeness of the manual,

ease of use, interest to children, etc.)

* Evaluation of any evidence of effectiveness

 

The successful treatment of depression in youth is a complex problem-solving process that

requires knowledge of effective treatments, including cognitive-behavioral, family, and
systems approaches, and understanding of depression in children and adolescents.

"Taking Action" is a manual-based treatment program for children ages 9 to 13 who have
unipolar depressive disorder, dysthymia, or depressed mood.

Although the treatment model and procedures are appropriate for all ages of youth, the
presentation method used in this program is developmentally appropriate for 9 to 13-year-
olds and would have to be altered to address the developmental needs of younger or older
children.

General Program Description:

    Group (4 to 8 children) or individual format

    Each session designed to last about one hour

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    18 child sessions and 11 family sessions

    Child meetings held twice a  week for first 4 weeks (to provide more rapid symptom
relief), then once a week until         completion

Program Goals:

    Help children learn how to independently apply the skills learned to cope with their
depressive symptoms

    Teach children to take a problem-solving approach to life, accepting that problems and
emotional upsets are inevitable, but they simply reflect problems to be solved

     Produce a deep, seemingly philosophical change, in the way the children perceive
themselves, the world, and the future

    Make the treatment "real" by eliciting and integrating the children's daily concerns into
the treatment program

    Change within-family interactions and communications that may unwittingly support the
children's depressive symptoms and cognitions

    Practice coping skills through homework assignments, which gets the children to think
about the therapy between sessions

Taking Action-Treatment Components

1. Affective Education

Emotion vocabulary

Recognition of internal cues

Link between thinking and feeling

Personal meaning of event and associated emotions

2. Problem-Solving Training

Always do something to feel better

Catch the positive and let the negative go

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Think of it as a problem to be solved

Inspect the situation

Open yourself to the positive

Never get stuck in the negative muck

3. Coping Skills Training

Brainstorm coping strategies for unpleasant emotions

Engage in pleasant activities

4. Cognitive Interventions

Establish a sense of hope

Identify thoughts that are associated with emotions

Identify themes and distortions in thinking

Reconstruct thoughts and images associated with emotions

Observe for pessimism and negative self-evaluations

Develop positive self-statements

Identify and counter thoughts that interfere with coping

Apply “what‛s the evidence” to past problems

Self-monitor positive qualities

Build a positive sense of self-funny stories

Identify personal standards

Apply alternative interpretation

Practice using “what if”

Use change of mood as a cue to tune into negative thoughts

Pragmatic Issues
Overall, this program manual and accompanying child workbook are very user-
friendly and easy to use. The manual has an excellent introduction, providing good

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rationale for the treatment program. Additionally, the manual is very easy to follow
and provides guidance for the therapist leading the sessions. Any advance
preparation or materials needed are clearly indicated. The directions and goals for
each session are outlined for the therapist and scripted for explanation to the
client. Finally, the child's manual provides an excellent, concrete framework in
which the children and therapist are able to work together on the lessons and
skills in each section.
 

Currently, there is not any research that has examined the effectiveness of
“Taking Action” program. However, “Taking Action” is a cognitive-behavioral
program, and there is evidence to suggest the effectiveness of cognitive-
behavioral treatments (CBT) on depression for children and adolescents.

CBT focuses on alleviating symptoms of depression by:

Changing cognitive distortions,

Teaching problem solving skills to enhance children‛s coping with negative life
events, and
Facilitating children‛s engagement in activities that promote positive mood.

The components of “Taking Action” reflect other CBT programs that are focused
on children and youth with depression.
References

Birmaher, Boris, Ryan, Neal D, Williamson, Douglas E, & Brent, David A (1996). Childhood and Adolesecent
Depresssion: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry,
Vol 35(12) (Dec 1996): 1575-1583

Harrington, Richard, Whittaker, Jane, & Shoebridge, Philip (1998). Psychological treatments of depression children
and adolescents: A review of treatment research. British Journal of Psychiatry Vol 173 (Oct 1998): 291-298

 Larrson, Bo (1992). Psychological Issues in the assessment and treatment of depression in children and
adolescents. Scandinavian Journal of Behaviour TherapyVol 21(1), 3-18

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