Sudden gains and large intersession improvements in internet-based psychodynamic treatment (IPDT) for depressed adolescents. Mechler, J.; Lindqvist, K.; Falkenström, F.; Carlbring, P.; Andersson, G.; and Philips, B. Psychotherapy Research, 0(0):1–13, August, 2020. Publisher: Routledge _eprint: https://www.tandfonline.com/doi/pdf/10.1080/10503307.2020.1804084
Sudden gains and large intersession improvements in internet-based psychodynamic treatment (IPDT) for depressed adolescents [link]Paper  doi  abstract   bibtex   
Objective: Sudden gains (SGs) have often been found associated with better treatment outcome across different psychiatric disorders. However, no studies have evaluated SGs in internet-based treatment targeting adolescent depression. Method: The sample consisted of 66 adolescents diagnosed with major depressive disorder, attending psychodynamic internet-based treatment. Effects of SGs were evaluated at posttreatment and 6-month follow-up. We also evaluated effects of large intersession improvements (LIIs; sudden and relatively large gains, between sessions, without the stability criterion). Effects of SGs and LIIs early in treatment were also investigated. Results: A total of 17 patients (25.75%) experienced an SG. The effect of having an SG or early SG was non-significant after treatment (d = 0.48) and at follow-up (d = 0.66). However, having an LII was related to better outcome after treatment (d = 0.97) and at follow-up (d = 0.76). Early LIIs were associated with significantly better results at end of treatment (d = 0.72). Conclusions: The original criteria of SGs might be overly conservative and thus miss important improvements in depression. Relatively large intersession gains, regardless of stability, seem to be predictive of outcome.
@article{mechler_sudden_2020,
	title = {Sudden gains and large intersession improvements in internet-based psychodynamic treatment ({IPDT}) for depressed adolescents},
	volume = {0},
	issn = {1050-3307},
	url = {https://www.tandfonline.com/doi/abs/10.1080/10503307.2020.1804084},
	doi = {10.1080/10503307.2020.1804084},
	abstract = {Objective: Sudden gains (SGs) have often been found associated with better treatment outcome across different psychiatric disorders. However, no studies have evaluated SGs in internet-based treatment targeting adolescent depression. Method: The sample consisted of 66 adolescents diagnosed with major depressive disorder, attending psychodynamic internet-based treatment. Effects of SGs were evaluated at posttreatment and 6-month follow-up. We also evaluated effects of large intersession improvements (LIIs; sudden and relatively large gains, between sessions, without the stability criterion). Effects of SGs and LIIs early in treatment were also investigated. Results: A total of 17 patients (25.75\%) experienced an SG. The effect of having an SG or early SG was non-significant after treatment (d = 0.48) and at follow-up (d = 0.66). However, having an LII was related to better outcome after treatment (d = 0.97) and at follow-up (d = 0.76). Early LIIs were associated with significantly better results at end of treatment (d = 0.72). Conclusions: The original criteria of SGs might be overly conservative and thus miss important improvements in depression. Relatively large intersession gains, regardless of stability, seem to be predictive of outcome.},
	number = {0},
	urldate = {2020-08-17},
	journal = {Psychotherapy Research},
	author = {Mechler, Jakob and Lindqvist, Karin and Falkenström, Fredrik and Carlbring, Per and Andersson, Gerhard and Philips, Björn},
	month = aug,
	year = {2020},
	pmid = {32799772},
	note = {Publisher: Routledge
\_eprint: https://www.tandfonline.com/doi/pdf/10.1080/10503307.2020.1804084},
	keywords = {depression, process research, psychoanalytic/psychodynamic therapy},
	pages = {1--13},
}
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