title: Development and Implementation of Health and Wellness CBT for Individuals with Depression and HIV.
abstract: Rates of depression are reported to be between 22-33% 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 non-adherence, 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, 16-24 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.
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: B
authors.initials: B
authors.lastname: Kennard
authors.affiliation: Rhode Island Hospital, Brown University.
authors.forename: L
authors.initials: L
authors.lastname: Brown
authors.affiliation: Children's Hospital of Philadelphia & Perelman School of Medicine, University of Pennsylvania.
authors.forename: L
authors.initials: L
authors.lastname: Hawkins
authors.affiliation: Silver Child Development Center, University of South Florida.
authors.forename: A
authors.initials: A
authors.lastname: Risi
authors.affiliation: Children's Hospital of Philadelphia & Perelman School of Medicine, University of Pennsylvania.
authors.forename: J
authors.initials: J
authors.lastname: Radcliffe
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: G
authors.initials: G
authors.lastname: Emslie
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: T
authors.initials: T
authors.lastname: Mayes
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: J
authors.initials: J
authors.lastname: King
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: A
authors.initials: A
authors.lastname: Foxwell
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: J
authors.initials: J
authors.lastname: Buyukdura
authors.affiliation: Westat, Rockville, MD.
authors.forename: J
authors.initials: J
authors.lastname: Bethel
authors.affiliation: Wayne State University.
authors.forename: S
authors.initials: S
authors.lastname: Naar-King
authors.affiliation: Westat, Rockville, MD.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: National Institute of Child Health and Human Development/Pediatric, Adolescent, and Maternal AIDS Branch.
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.affiliation: St. Jude Children's Research Hospital.
authors.forename: P
authors.initials: P
authors.lastname: Garvie
authors.affiliation: St. Jude Children's Research Hospital.
authors.forename: C
authors.initials: C
authors.lastname: London
authors.affiliation: Children's Hospital of Philadelphia & Perelman School of Medicine, University of Pennsylvania.
authors.forename: M
authors.initials: M
authors.lastname: Tanney
authors.affiliation: Westat, Rockville, MD.
authors.forename: S
authors.initials: S
authors.lastname: Thornton
keywords: Adherence; Cognitive Behavioral Therapy (CBT); Health; Human Immunodeficiency Virus (HIV); Major Depressive Disorder (MDD)