Sudden gains and large intersession improvements in internet-based psychodynamic treatment (IPDT) for depressed adolescents. (19th May 2021)

• Record Type: Journal Article
• Authors: Mechler, Jakob; Lindqvist, Karin; Falkenström, Fredrik; Carlbring, Per; Andersson, Gerhard; Philips, Björn
• Is Part Of: Psychotherapy research. Volume 31:Number 4(2021)
• Page Start: 455
• Page End: 467
• Publication Date: 2021-05-19
• Subjects: depression -- process research -- psychoanalytic/psychodynamic therapy; Psychotherapy -- Periodicals; Psychotherapy -- Research -- Periodicals; Psychotherapy -- Periodicals; Psychothérapie -- Périodiques; Psychothérapie -- Recherche -- Périodiques; 616.891405
• DOI: 10.1080/10503307.2020.1804084
• Languages: English
• ISSNs: 1050-3307

Abstract

ABSTRACT: Objective: Sudden gains (SGs) have often been found associated with better treatment outcome across different psychiatric disorders. However, no studies have evaluated SGs in internet-based treatment targeting adolescent depression. Method: The sample consisted of 66 adolescents diagnosed with major depressive disorder, attending psychodynamic internet-based treatment. Effects of SGs were evaluated at posttreatment and 6-month follow-up. We also evaluated effects of large intersession improvements (LIIs; sudden and relatively large gains, between sessions, without the stability criterion). Effects of SGs and LIIs early in treatment were also investigated. Results: A total of 17 patients (25.75%) experienced an SG. The effect of having an SG or early SG was non-significant after treatment ( d = 0.48) and at follow-up ( d = 0.66). However, having an LII was related to better outcome after treatment ( d = 0.97) and at follow-up ( d = 0.76). Early LIIs were associated with significantly better results at end of treatment ( d = 0.72). Conclusions: The original criteria of SGs might be overly conservative and thus miss important improvements in depression. Relatively large intersession gains, regardless of stability, seem to be predictive of outcome.