Treatment for Anxiety, Depression, and Family Conflict in Adolescence via Telehealth during the COVID-19 Pandemic

Anxiety and depression are two of the most common mental health disorders diagnosed in adolescents. While either disorder individually creates impairments in psychological, emotional, and social functioning, these disorders often co-occur and reciprocally influence one another which can lead to continual worsening in functioning over time. Specifically with adolescents, anxiety and depression are associated with interpersonal conflicts with family and friends, which can further contribute to disruptions in functioning. This case study explores the effectiveness of using cognitive behavioral therapy (CBT) with a 14-year-old white male with generalized anxiety disorder (GAD) and persistent depressive disorder (PDD) via telehealth during the COVID-19 pandemic. Treatment was divided into two phases, with the first phase occurring over 20 sessions and the second phase occurring over nine sessions for a total of 29 sessions. In the first phase, the Unified Protocol for Adolescents (UP-A) was flexibly implemented to target emotion regulation, behavioral skills, and cognitive restructuring. The second phase focused on family dynamics and targeted effective communication and collaborative problem-solving. Outcome data showed significant reductions in anxiety symptoms and slight reductions in depressive symptoms as well moderate improvements in peer relationships. These results provide support for using the UP-A to target internalizing symptoms in adolescents but also highlight the importance of addressing the family system in treatments. Treatment implications and recommendations for clinicians are discussed.