There is no longer a debate about the existence of major depressive disorder in late childhood and adolescence. Reported prevalence in adolescence ranges from 1% to 6% of the general population, with a recent British study finding that approximately 2% of adolescents had had a recent episode of major depression (Meltzer et al., 2000). Rates in children are much less, probably in the order of one per 1000. There is a great deal of comorbidity with other emotional disorders and also with conduct disorder. Follow-up studies have demonstrated that young people with depression have a greater risk of subsequent episodes than non-depressed psychiatric cases. There is also an increased risk of both attempted and completed suicide.

A variety of treatments are now available for major depression in young people. For example, recent findings suggest that the serotonin-specific reuptake inhibitors (SSRIs) can be effective (Emslie et al., 1997; Keller et al., 2001; Emslie et al., 2002). However, in many cases, psychological treatments are currently the preferred first line of treatment. Several different psychological treatments have been evaluated for depressed children and adolescents. Probably the best evaluated are the cognitive behavioural therapies (CBTs).

This chapter provides a practical account of CBT for depression in late childhood and adolescence. The chapter begins with a brief overview of the theory behind CBT and some general principles of treatment. The core CBT techniques are then described. The chapter concludes with a brief overview of the evidence base for CBT.