Editorial: When, Where, and for Whom Does Behavioral Activation Work? Optimizing Treatment for Adolescent Depression.

Depression among adolescents has risen significantly over the past two decades with increases in both diagnoses of major depressive disorders (MDD) and subclinical persistent sadness and hopelessness. Depressive symptoms rose dramatically from 2007 to 2015 within the United States, a trend that intensified during the COVID-19 pandemic, particularly among adolescent girls and youth with histories of adversity.1 Adolescent depression is associated with significant impairment including difficulties with academic performance, interpersonal relationships, substance use, and suicidality.2 Cognitive behavioral (CBT) and interpersonal therapies are well established for adolescent MDD, however, treatment response remains disappointing with non-response rates upwards of 60% among treated youth.3,4 These limitations underscore the need for studies of alternative intervention models, such as the meta-analysis by Huang and colleagues evaluating behavioral activation (BA) for adolescent depression, included in this issue of JAACAP.