How has Cognitive Behaviour Therapy been adapted for adolescents with co-morbid depression and chronic illness? A Scoping Review

Alice Morey, Maria Loades

Research output: Contribution to journalReview articlepeer-review

9 Citations (SciVal)


Background: Depression becomes increasingly common in adolescence. Around 10%–20% of adolescents have a chronic illness, and they are more likely to experience depression. There is emerging evidence for cognitive behaviour therapy (CBT) interventions to treat depression in adolescents with chronic illnesses, yet no review has been undertaken of how these CBT interventions are delivered in practice. Methods: We conducted a scoping review to summarise how CBT has been delivered in adolescents with chronic illness and depression. We included studies that evaluated CBT aimed at treating depression/depressive symptoms in adolescents with chronic illness. Searches were carried out across Embase and PsycNET. Results: Twelve studies met our inclusion criteria. These included diabetes (n = 3), inflammatory bowel disease (n = 3), polycystic ovary syndrome (n = 2), chronic headache (n = 1), chronic pain (n = 1), chronic fatigue syndrome (n = 1) and Fanconi anaemia (n = 1). Adaptations made to the delivery of CBT included cognitive restructuring of illness-related thoughts, behavioural activation balancing illness-related and enjoyable activities, psychoeducation of the comorbidity and link between the chronic illness and depression, relationship building, skill building and parental or familial involvement. CBT was typically delivered by trained professionals with expertise in working with adolescents, who worked under supervision. Conclusions: CBT for depression is commonly adapted for this population, and the nature of cognitions and behaviours targeted in CBT may typically depend on how the chronic illness presents. There is relatively little evidence to date, and a need for more research into the efficacy and effectiveness of treatments for adolescent depression in this vulnerable population specifically.
Original languageEnglish
Pages (from-to)252-264
Number of pages13
JournalChild and Adolescent Mental Health
Issue number3
Early online date20 Sept 2020
Publication statusPublished - 30 Aug 2021

Bibliographical note

Funding Information:
M.E.L. is funded by the National Institute for Health Research (NIHR Doctoral Research Fellowship, DRF‐2016‐09‐021). This report is independent research. The views expressed in this publication are those of the authors(s) and not necessarily those of the NHS, NIHR or the Department of Health and Social Care. A.M. and M.E.L. developed and designed the review. A.M. led on developing the search terms and conducting the searches and identifying papers for inclusion, with oversight from M.E.L. A.M. drafted the manuscript, with editorial input from M.E.L. The authors thank Justin Hodds, Librarian at the University of Bath, for his advice on developing the search strategy. M.E.L. was the author of 2 of the papers included in the review. The remaining author has declared that they have no competing or potential conflicts of interest.

Publisher Copyright:
© 2020 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.


  • CBT
  • chronic illness
  • depression
  • mood
  • paediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health


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