A Hybrid Psychological Intervention for Depression in Adolescents

Efficacy and Sustainability of a Hybrid Psychological Intervention Integrating Resilience Theory and the Satir Model on Depression, Resilience, and Quality of Life in Adolescents: A Multi-center, Randomized Controlled Trial

This multi-center, randomized controlled trial was conducted to evaluate the efficacy and long-term effects of a novel hybrid psychological intervention, which combines Resilience Theory with the Satir Model, for adolescents diagnosed with depression. The study compared this intervention to treatment as usual (TAU) to determine its impact on depressive symptoms, psychological resilience, self-esteem, and overall quality of life.

Adolescent depression is a significant and growing public health concern. Traditional therapies have limitations, highlighting a need for innovative, engaging interventions. This study was designed to address this gap by developing and testing a hybrid model that integrates the strengths-based approach of Resilience Theory with the systemic, humanistic principles of the Satir Model. The study hypothesized that this combined intervention would be more effective than standard care in not only alleviating depressive symptoms but also in building lasting psychosocial resources. A total of 420 adolescents with depression were randomized to either the 12-week hybrid intervention group or a control group receiving treatment as usual. The intervention program was structured in three modules focusing on self-awareness, skill-building, and future-orientation. Outcomes were assessed at baseline, immediately post-intervention (12 weeks), and at a 6-month follow-up to evaluate the sustainability of the effects.

Inclusion Criteria:

• Diagnosis of a major depressive episode according to DSM-5 criteria, confirmed by two independent psychiatrists.
• First episode, with a duration of 4 weeks to 12 months.
• Age between 13 and 18 years.
• HAMD-17 score ≥ 17.
• Capable of normal communication.
• Provision of informed consent by both the adolescent and legal guardians.

Exclusion Criteria:

• Lifetime diagnosis of bipolar disorder, schizophrenia, or other psychotic disorders.
• Depression secondary to a general medical condition or substance use.
• Acute suicidal risk (score ≥ 4 on MADRS item 10) requiring immediate intensive care.
• Currently receiving structured psychotherapy.
• Severe neurological or physical illness that could interfere with participation.