Development and implementation of health and wellness CBT for individuals with depression and HIV

Beth D. Kennard, Larry T. Brown, Linda Hawkins, Andrea Risi, Jerilynn Radcliffe, Graham J. Emslie, Taryn L. Mayes, Jessica D. King, Aleksandra A. Foxwell, Jeylan Buyukdura, James Bethel, Sylvie Naar-King, Jiahong Xu, Sonia S. Lee, Patricia Garvie, Carla London, Mary Tanney, Sarah Thornton

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Rates of depression are reported to be between 22% to 33% in adults with HIV, which is double that of the general population. Depression negatively affects treatment adherence and health outcomes of those with medical illnesses. Further, it has been shown in adults that reducing depression may improve both adherence and health outcomes. To address the issues of depression and nonadherence, Health and Wellness (H&W) cognitive behavioral therapy (CBT) and medication management (MM) treatment strategies have been developed specifically for youth living with both HIV and depression. H&W CBT is based on other studies with uninfected youth and upon research on adults with HIV. H&W CBT uses problem solving, motivational interviewing, and cognitive-behavioral strategies to decrease adherence obstacles and increase wellness. The intervention is delivered in 14 planned sessions over a 6-month period, with three different stages of CBT. This paper summarizes the feasibility and acceptability data from an open depression trial with 8 participants, 16 to 24. years of age, diagnosed with HIV and with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of depression, conducted at two treatment sites in the Adolescent Trials Network (ATN). Both therapists and subjects completed a Session Evaluation Form (SEF) after each session, and results were strongly favorable. Results from The Quick Inventory of Depressive Symptomatology-Clinician (QIDS-C) also showed noteworthy improvement in depression severity. A clinical case vignette illustrates treatment response. Further research will examine the use of H&W CBT in a larger trial of youth diagnosed with both HIV and depression.

Original languageEnglish (US)
Pages (from-to)237-246
Number of pages10
JournalCognitive and Behavioral Practice
Volume21
Issue number2
DOIs
StatePublished - May 2014

Keywords

  • Adherence
  • Cognitive behavioral therapy
  • HIV
  • Health
  • Major depressive disorder

ASJC Scopus subject areas

  • Clinical Psychology

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    Kennard, B. D., Brown, L. T., Hawkins, L., Risi, A., Radcliffe, J., Emslie, G. J., Mayes, T. L., King, J. D., Foxwell, A. A., Buyukdura, J., Bethel, J., Naar-King, S., Xu, J., Lee, S. S., Garvie, P., London, C., Tanney, M., & Thornton, S. (2014). Development and implementation of health and wellness CBT for individuals with depression and HIV. Cognitive and Behavioral Practice, 21(2), 237-246. https://doi.org/10.1016/j.cbpra.2013.07.003