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Mood Brain & Development Unit

Mood Brain and Development Unit - Clinical Work

Cognitive Behavioral Therapy and Pharmacological Treatment

a therapist and patient are seated at a table, talking

Outpatient Talk Therapy

The type of therapy we offer in our outpatient treatment program is called Behavioral Activation. It is talk therapy with good evidence that it is effective in treating depression in adolescents. Our goal is to help you to function better in your life and enjoy your life more. Through your work with us we hope to learn about the way your brain changes while you make changes in your life to feel better. This knowledge will improve our understanding of how therapy works at a brain-level and help us to improve treatments for teenagers with depression.

Depression is something many teenagers face. Depression can lead to feeling down and unmotivated, cranky and tired. When you experience depression, it can be more difficult to focus on school work and you may not want to spend time with your friends and family. It can become a “vicious cycle” whereby you feel depressed and stop doing things that would help you to feel less depressed.

Depression just means that something in your life needs to be changed. Talk therapy can help. Behavioral Activation talk therapy can help you to break the “vicious cycle” of depression through guided activity and steps toward achieving your goals.

In Behavioral Activation therapy, the therapist and parents are the support team to help the adolescent learn new activities that will become new habits that can improve mood. Parents can support their adolescents during therapy by keeping all appointments, collaborating with the therapist to learn new ways to communicate, recognizing how depression affects a teen’s behavior, and supporting your adolescent in trying new strategies and activities.

Dr. DeLonga provides Behavioral Activation therapy to participants enrolled in the Characterization and Treatment study and supervises clinicians in delivering BA treatments to teens and families. Clinical and research participation are supervised by attending physicians, Dr. Stringaris and Dr. Towbin.

To be eligible for participating in our outpatient treatment study means that you fit with what our group is studying and can help us with our research. Eligible teens must have a diagnosis of major depression and a pediatric health care provider in the community. Once we confirm that someone has major depression and is willing to take part in our research, we invite them to enroll in our Characterization study that follows patients over time, which can involve treatment or non-treatment. To be in treatment with us, patients must be enrolled in our longitudinal Characterization study of adolescents with major depression. A component of both the Characterization study and the Outpatient Treatment study is MRI scanning to understand brain function. Because an MRI scan involves a large magnet, participants cannot have braces, metal implants, or permanent piercings. Once you enroll in Characterization and complete an Outpatient Treatment interest form, the clinical team will meet to review eligibility, and you will be contacted by your research assistant.

Inpatient Talk Therapy and Pharmacological Treatment

We offer inpatient treatment at the NIH Clinical Center. This is a 6-bed unit dedicated to treating young people, aged 11-17, who have who have Major Depression. The treatment approach is a multidisciplinary one that relies on individual, group, and family work. Treatment emphasizes psychological treatment but also uses pharmacological interventions when needed. In addition to close nursing care support and regular contact with medical providers, patients also are aided by the NIH School, Clinical Center Recreation Therapy Department, and Speech and Language Pathology Department at the NIH.

Medication treatment for inpatients is tailored to the patient. Most patients who are admitted have already received medication treatments, often a complicated combination of medications, that have not worked as well as they or their treaters would like. The support of inpatient care allows the Treatment Team to review the overall treatment and make gradual, considered medication reductions, even to the point of stopping medicines that have been minimally or completely ineffective, and, if indicated, starting a different medication in a gradual way. The Treatment Team prefers to make decisions about medication changes in partnership with the family, the patient and the patient’s local healthcare provider so that the patient’s care can continue smoothly once they leave NIH and return home.