Date of Award
Summer 8-20-2017
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Psychology
First Advisor
Antonio J. Polo, PhD
Second Advisor
Elizabeth Florez, PhD
Third Advisor
Kathryn Grant, PhD
Abstract
Youth with depression, particularly ethnic minority youth, have low rates of engagement in mental health services, indicating a large need to better understand the role of engagement in effective treatments for depression (Merikangas et al., 2011). Cognitive behavioral therapy (CBT) is one of the leading psychotherapeutic treatments available for youth with depression (Weisz, McCarty, & Valeri, 2006), but several questions still remain regarding why and in what circumstances this therapy is most appropriate. CBT posits that part of the positive treatment effects is accounted by learning certain cognitive and behavioral skills during and outside of session (i.e., through active homework assignments). This study examined: a) the association between engagement (i.e., homework completion and consumer satisfaction) in a school-based group CBT program and changes in depressive symptoms; b) the mediational role of core learning indicators (social functioning and negative cognitions) in the relationship between engagement and change in depressive symptoms; and c) the moderational role of youth English oral language proficiency. The sample of 99 predominantly low-income ethnic minority youth (66.0% female; 85.9% Latino), ages 10 to 14 (M = 12.03, SD = 1.04), participated in the Act & Adapt Program (Polo, Connor, Jensen-Doss, & Weisz, 2009), a manualized group CBT program delivered across nine public schools. Multiple regression analyses revealed that neither engagement variable was directly associated with changes in depressive symptoms. Furthermore, neither change in social functioning nor negative cognitions mediated the engagementtreatment outcome relationship. On the other hand, English oral language 2 proficiency moderated the relationship between homework completion and depressive symptoms (β = -.0002, t = - 2.45, ΔR2 = .05, p < .05), as well as between consumer satisfaction and depressive symptoms (β = .01, t = 2.21; ΔR2 = .04, p <.05). Specifically, those with high levels of English oral language proficiency had an association between increased homework completion and depressive symptoms, while those with low levels of English oral language proficiency did not have a significant association between homework completion and depressive symptoms. Additionally, those with low English oral language proficiency had an association between increased consumer satisfaction and decreased depressive symptoms, while those with high English oral language proficiency did not have a significant association between homework completion and depressive symptoms. There was some evidence of a moderated mediational effect, with oral language proficiency moderating the indirect effect homework completion on treatment outcomes via negative cognitions. However, probing of this moderation revealed no significant indirect effects at the 10th, 25th, 50th, 75th, or 90th percentile. Implications are discussed for researchers and clinicians to take into consideration youths’ oral language proficiency and how language proficiency may interact with engagement in impacting youth treatment outcomes for depression.
Recommended Citation
Wagstaff, Amanda E., "The Role of Therapeutic Engagement, Oral Language Proficiency, and Core Learning Indicators on the Effects of Therapy for Youth with Depression" (2017). College of Science and Health Theses and Dissertations. 222.
https://via.library.depaul.edu/csh_etd/222
SLP Collection
no