Mapping Psychotherapy Experiences of Adolescents: A Mixed-Methods Study to Inform Idiographic Assessment

Introduction: Depression is a debilitating condition that is highly prevalent among adolescents. However, depression is often understood through a nomothetic lens, meaning that there is a tendency to measure general patterns of symptoms. This overgeneralisation largely ignores the individual, lived experiences of depressed youth. To get a better understanding of what adolescents themselves find important in their experiences with depression and psychotherapy, we conducted a mixed-methods study into their perspectives.Methods: Participants were 21 young adults (M = 20.5, SD = 1.3) in university who had attended some form of psychotherapy in the past 2 years. The participants first performed a statement-sorting task and then afterwards an interview was conducted. The descriptive statistics were then followed up by a thematic analysis of the interview content.Results: Descriptives of the statement ratings indicated that there is a high variability in how the statements were rated. Four themes were generated that informed this heterogeneity in prioritisation: 1) the navigation of core problems versus “minor” problems in therapy, 2) the effect of trust in the therapist on the course of therapy, 3) the boundary between one’s identity and one’s mental health concerns, and 4) how individuals choose to accept social support. Conclusion: This study underscores the variety of experiences adolescents can prioritise in psychotherapy. The post-sorting task interviews helped contextualise these experiences. This mixed-methods approach provides an understanding of adolescent depression from the perspectives of adolescents themselves, and can thus inform idiographic assessment of depression.