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To prepare:Review the Learning Resources related to causes and effects and how this might support your Assignment.Review the “Causes and Effects of Your Capstone Problem Organizational Matrix” found in the Learning Resources and use this template to help you organize your thoughts and ideas for this Assignment.Review your research from your literature review related to your specific problem and consider 3 causes and 3 effects that were described about your problem.Assignment (2–3 pages, not including title page and reference page) Write a clearly defined narrative that incorporates the 3 causes and 3 effects and explain how these causes and effects relate to your problem.Explain your reaction to the findings about the causes and effects of the problem.Explain whether you believe these causes could have been prevented and how.Explain which cause or effect you think was most important in leading to the problem and why.
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PSYC 6393/FPSY 6393/IPSY 6393/DPSY 6393: Capstone
Causes and Effects of Your Capstone Problem
Organizational Matrix
Every problem can have many causes, or reasons, for the problem. When you examine
a cause of a problem, the effects, or what results from that cause, become apparent.
The purpose for this section of the Capstone Project is to identify 3 main causes of your
problem, then to identify 3 effects from those causes.
Use this matrix to organize your information about the causes and effects of your
problem. As with all aspects of a research paper, the information about the causes and
effects of the problem should come from the scholarly literature. Use this information to
complete your written assignment on the Causes and Effects of a Research Problem.
In 2–3 sentences, explain the problem for your Capstone Project:
Cause #1:
Effect #1:
Reference Information for Cause #1:
Reference Information for Effect #1:
Cause #2:
Effect #2:
Reference Information for Cause #2:
Reference Information for Effect #2:
Cause #3:
Effect #3:
Reference Information for Cause #3:
Reference Information for Effect #3:
© Walden University 2019
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Establishing a Working Treatment for managing severe depression among Elementary
Students.
Jose Arias
PSYC – 6393
Dr. Jane Lyons
12/14/2023
Walden University
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Establishing a Working Treatment for managing severe depression among Elementary
Students.
The incidence of major depressive disorder, an often debilitating condition, has increased
at an alarming pace among youth in the United States (NIMH Information Resource Center,
2023). Recent epidemiological analyses reveal deteriorating youth mental health, with the
prevalence of depressive episodes and clinical anxiety reaching unprecedented highs (Goodwin,
20221). Specifically, survey data collected in 2022 found that over 15% of children and
teenagers reported experiencing significant symptoms of major depression within the year,
representing a notable increase in 2021 (Centers for Disease Control and Prevention, 2023).
Concurrently, professionally diagnosed anxiety and depression among individuals under age 18
also hit record levels as of 2020, affecting around one in ten and one in twenty young people,
respectively (Mental Health America, 2023). The escalating burden of depressive disorders,
especially among adolescent and school-aged populations, constitutes an urgent public health
crisis warranting systemic action across institutions. Symptoms range from persistent sadness,
low self-esteem, and changing eating patterns to sleeping problems. The link between depression
levels and student misbehavior has been explored in various studies. For instance, a study
involving 49 students in grades 3-6 in a Midwest elementary school found no significant
difference in the number of detentions received by students with high levels of depression
compared to those with lower levels (Erdem & Koçyiğit, 2019). This suggests that traditional
disciplinary measures may not effectively identify or address depression in students. The
effectiveness of depression treatment is a key area of concern. Family cognitive behavior therapy
(CBT), family therapy, exercise, and spirituality have been identified to minimize depressive
symptoms in adults, while studies indicate that combining psychotherapy and medication is the
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most effective approach to treating children’s depression (American Academy of Pediatrics,
2023). The unique requirements, situations, age, developmental phase, and cultural heritage must
be considered when devising treatment strategies, as they form key variables that influence the
span of treatment, and effectiveness of the outcome, and its permanence in the long run. These
insights underscore the necessity for a holistic, evidence-based strategy to recognize and address
depression in elementary school students efficiently. This approach should encompass training
for healthcare professionals in regular depression screening and implementing tailored treatment
plans. One proposed approach is the application of technologically rooted psychotherapy, like
internet-based cognitive therapy, in managing severe depression among elementary learners.
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References
American Academy of Pediatrics. (2023). Supporting Students with Depression in School.
https://www.aap.org/en/patient-care/school-health/mental-health-in-schools/supportingstudents-with-depression-in-school/
Erdem, C., & Koçyiğit, M. (2019). Student Misbehaviors Confronted by Academics and Their
Coping Experiences. Educational Policy Analysis and Strategic Research, 14(1), 98–
115. https://doi.org/10.29329/epasr.2019.186.6
Goodwin, R. D., Dierker, L. C., Wu, M., Galea, S., Hoven, C. W., & Weinberger, A. H. (2022).
Trends in US depression prevalence from 2015 to 2020: the widening treatment
gap. American Journal of Preventive Medicine, 63(5), 726-733.
NIMH Information Resource Center. (2023, July). Major depression. National Institute of
Mental Health. https://www.nimh.nih.gov/health/statistics/major-depression
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Literature Review: Internet-based Cognitive Therapy in managing severe depression
among Elementary Students.
Jose Arias
PSYC – 6393
Dr. Jane Lyons
1/07/2023
Walden University
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Literature Review: Internet-based Cognitive Therapy in managing severe depression
among Elementary Students.
Depression is a mental condition characterized by a persistent and prolonged feeling of
sadness, low mood, and anhedonia. Given the rapid psychological development among young
people and the uncontrolled exposure to social pressure both in school and at home, the rate of
manifestation of depressive symptoms is profoundly high. Depression among elementary school
students is linked to adverse outcomes that might extend into adulthood, including cases of
substance use, suicidal ideation, poor academic performance, and impaired social functioning.
Thus, given the nature and outcome of depression among elementary school students, the
application of internet-based cognitive therapy has demonstrated effectiveness in its management
and treatment. For the purpose of this literature review, different scholars will be reviewed to
gather empirical evidence on how internet-based cognitive therapy is an effective psychotherapy
for managing severe depression among elementary school students.
Internet-based cognitive therapy is a combination of information technology and
psychotherapy, facilitated through digital platforms such as computers, mobile phones, or tablets
to deliver treatment as opposed to face-to-face cognitive behavioral therapy. A study by
Kheirkhah et al. (2023), experimented to observe the efficacy of ICBT through a peaceful mind
eight-session guided program. Kheirkhah et al. (2023) revealed the application of ICBT can be
blended, self-directed, or therapist-directed. The finding from Kheirkhah et al. (2023), revealed
that in the application of Peaceful Mind ICBT, patients with depression and anxiety reported
change in mental state after completing the 8-session program. The study further expands that
therapist-directed or guided care involves the support of a therapist walking the patient through
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the treatment process, which can be done through asynchronous email communication,
scheduled calls, live chats or streams, and automated notifications technology.
A systematic review of randomized clinical trials by Karyotaki et al. (2021) observed the
long-term and short-term effectiveness of guided and unguided ICBT among depressed patients.
The study noted that the application of therapist-guided internet-based cognitive behavioral
therapy provides a more suitable approach to mental health treatment as it focuses on patient
interaction through internet-enabled devices like phones, tablets, or computers. The study
reviewed the application of both guided and unguided ICBT among patients with depression to
assess its long-term and short-term effectiveness. The result of the study noted that in
posttreatment patients scored PHQ-9 and above for guided treatment compared to unguided
treatment (Karyotaki et al. (2022). The baseline symptoms of depression were noted to reduce
within the short term for guided treatment, and long-term positive effects were noted as well.
The study also noted some benefits of the therapist-directed approach, including time savings,
providing patients with more privacy, and creating more independence throughout the whole
treatment journey. Karyotaki et al. (2022) noted that unguided or self-directed ICBT involves
patients self-managing their treatment process through programs like MoodHackers or e-Ouch.
Herein, students can manage their depression through self-based intervention facilitated through
internet-based platforms integrated with CBT. Therefore, as noted by Karyotaki et al. (2021),
students can benefit more from therapist-directed ICBT as it allows them to maintain adherence
to the treatment and find the process more engaging and interesting compared to traditional faceto-face CBT.
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In a randomized trial study by Karyotaki et al. (2022) exploring the effectiveness of
digital health interventions in addressing depression and anxiety, it was noted that the use of
guided ICBT to provide consistency in treatment increased patient satisfaction. This study
recruited 100 college students aged 18 years and above with depression and subjected to ICBT to
measure the effectiveness of TAU (treatment as usual) and guided ICBT. Findings from the
study showed that students exposed to ICBT show positive recovery (p>0.5) in outcome
(symptoms of depression and anxiety, quality of life, education achievement, and school
dropout), as compared to TAU (Karyotaki et al., 2022). The finding also noted that the use of
guided ICBT among young patients with depression provided a sense of routine, which was
difficult to attain in TAU. Besides, students are often highly destructive when it comes to
treatment. Besides, due to depression, they tend to avoid treatment, especially visiting the
psychiatric hospital, as this can have a negative impact on their social relationships with their
peers.
A descriptive review by Shirotsuki et al. (2022) observation on COVID-19’s impact on
the mental health of children noted that many young students are reluctant to seek help from
counselors or therapists due to the stigma associated with mental illness. The study observed the
effectiveness of ICBT follow-up in managing depression among young children, through the
application of guided therapy. Shirotsuki et al. (2022) noted that young children fear being
labeled and seen as mentally unstable, which limits their ability to open up when they experience
mental health problems or seek treatment. Thus, the application of internet-based cognitive
therapy provides easy access to psychotherapy treatment for elementary students. ICBT has
helped remove barriers to psychotherapy, especially among young people who have a high
dependency on technology. It has helped preference for self-management care in the treatment of
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psychological problems and removed barriers to lack of time and unnecessary perceptions of
mental health treatment.
A recent study by Niles et al. (2021), through their behavioral research, observed the
effectiveness of using ICBT and the patient empowerment associated with this form of
psychotherapy. The findings from their study showed that ICBT provided an individual-tailored
treatment, making it more applicable to patient-specific needs. The study took part in a 10-week
ICBT for depression where patients with depression (n=114) and those with social anxiety
disorder (n=150) were involved in therapist-guided ICBT. Niles et al. (2021) noted that internetbased CBT tackled the core processes that contributed to mental health issues, which were
specific to patient diagnosis. Thus, the use of ICBT among patients with depression allows them
to have an intervention that is tailored specifically to their needs and covers the major issues that
affect them. For instance, elementary students are more exposed to bullying and social exclusion,
which greatly pushes them toward depression. This cohort finds solace in their social media,
electronic gadgets, or any internet-based gadget.
Stjerneklar et al. (2019) conducted a study on the application of a guided ICBT program
called Chilled Out Online to measure the accessibility of ICBT and the cost of treatment among
patients with anxiety and depression. In this study, the authors involved 70 adolescents aged 13
to 17 through the guided ICBT program, where the post-treatment result showed that 40% of
adolescents were free of primary diagnosis compared to 16% who were not on the program
(Stjerneklar et al. 2019). The study purports that to reach this cohort, psychiatrists and counselors
must integrate CBT into information technology, something that resonates more with the target
patient. Therefore, internet-based CBT provides students with a more accessible means of
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treatment and configures the therapy to their clinical needs. Stjerneklar et al. (2019) claim that
the use of ICBT with more advanced technology like artificial intelligence and emotional
intelligence has made the process more streamlined in managing depression for guided and
unguided approaches.
Notably, a systematic review by Christ et al. (2020)) noted that the realm of digital health
has been influenced by the current development of artificial intelligence and machine learning.
These technologies have helped internet-based CBT become more efficient and effective in
managing mental health cases. For example, Christ et al. (2020) noted that artificial intelligence
has been integrated into computerized systems or programs used in CBT to help observe changes
in patient mood and psychology, making it easy to tailor specific treatments or interventions.
This has also been effective in the management of depression among young people, with
symptoms of low moods and anxiety. Nonetheless, the application of internet-based CBT among
elementary students has been facilitated by the ease with which students use these technologies,
which makes mental health treatment more accessible to this cohort.
A study by Sander et al. (2023) observed the short-term and long-term efficacy of using
both guided and unguided internet-based CBT treatment for depression. The research findings
showed that younger patients benefit from both guided and unguided ICBT, but when it comes to
the longevity of treatment, guided or therapist assisted ICBT is more effective. A similar study
noted that young people needed constant observation and follow-up on mental health treatment,
which was not available in unguided ICBT. However, when using guided or therapist assisted
ICBT, therapists and counselors managed to maintain up-to-date clinical check-ups and followup with patients. Sander et al. (2023) noted that adolescents placed on guided ICBT responded
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faster to treatment than those placed under unguided ICBT, due to the constant involvement of
the therapist in the intervention process. The fallout of elementary students undertaking
treatment when not supervised is high because of a lack of keenness and understanding of the
intensity of mental health repercussions on their health and lives. Thus, the use of guided
internet-based CBT is considered more effective and efficient for elementary school students
with depression.
In summary, some gaps were noted in the literature review, including the lack of
identification of ICBT in the management of potential comorbidities associated with depression.
Most of the studies focused on how ICBT tackles symptoms of depression without addressing
some underlying factors that contribute to the development of major depression among
elementary school students. Also, the majority of the scholars focused on the application of
ICBT from a holistic point of view without providing a clinically specific approach to depression
interventions related to elementary students. Nonetheless, the issue of depression among
elementary school students has adverse outcomes that, when not properly controlled through the
required interventional mechanisms, may extend into adulthood, and cause mental health
disorders like substance use and suicidal ideation. It can also affect their social and school
performance, leading to poor academic performance and impaired social functioning. Thus, the
application of internet-based cognitive behavior therapy is essential among elementary students.
This treatment approach is effective and efficient, as it provides them with a more interactive and
engaging approach to self-managing depression.
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References
Christ, C., Schouten, M. J., Blankers, M., van Schaik, D. J., Beekman, A. T., Wisman, M. A., …
& Dekker, J. J. (2020). Internet and computer-based cognitive behavioral therapy for
anxiety and depression in adolescents and young adults: systematic review and metaanalysis. Journal of Medical Internet Research, 22(9), e17831.
Käll, A., Jägholm, S., Hesser, H., Andersson, F., Mathaldi, A., Norkvist, B. T., … & Andersson,
G. (2020). Internet-based cognitive behavior therapy for loneliness: a pilot randomized
controlled trial. Behavior therapy, 51(1), 54-68.
Karyotaki, E., Efthimiou, O., Miguel, C., genannt Bermpohl, F. M., Furukawa, T. A., Cuijpers,
P., … & Forsell, Y. (2021). Internet-based cognitive behavioral therapy for depression: a
systematic review and individual patient data network meta-analysis. JAMA psychiatry,
78(4), 361-371.
Karyotaki, E., Klein, A. M., Ciharova, M., Bolinski, F., Krijnen, L., de Koning, L., … &
Cuijpers, P. (2022). Guided internet-based transdiagnostic individually tailored Cognitive
Behavioral Therapy for symptoms of depression and/or anxiety in college students: A
randomized controlled trial. Behavior Research and Therapy, 150, 104028.
Kheirkhah, F., Faramarzi, M., Shafierizi, S., Chehrazi, M., & Basirat, Z. (2023). Preliminary
examination of acceptability, feasibility, and effectiveness of internet-based cognitive
behavioral therapy for treatment of depression and anxiety in infertile women. Heliyon,
9(5).
Lindegaard, T., Wasteson, E., Demetry, Y., Andersson, G., Richards, D., & Shahnavaz, S.
(2022). Investigating the potential of a novel internet-based cognitive behavioral
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intervention for Dari and Farsi speaking refugee youth: A feasibility study. Internet
Interventions, 28, 100533.
Niles, A. N., Axelsson, E., Andersson, E., Hedman-Lagerlöf, E., Carlbring, P., Andersson, G., …
& Ljotsson, B. (2021). Internet-based cognitive behavior therapy for depression, social
anxiety disorder, and panic disorder: Effectiveness and predictors of response in a
teaching clinic. Behavior Research and Therapy, 136, 103767.
Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., … & Mehlsen,
M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for Anxiety and
depression in cancer survivors: Predictors of treatment response. Internet interventions,
23, 100365.
Rahmadiana, M., Karyotaki, E., Schulte, M., Ebert, D. D., Passchier, J., Cuijpers, P., … & Riper,
H. (2021). Transdiagnostic internet intervention for Indonesian university students with
depression and anxiety: evaluation of feasibility and acceptability. JMIR mental health,
8(3), e20036.
Sander, L., Beisemann, M., Doebler, P., Micklitz, H. M., Kerkhof, A., Cuijpers, P., Batterham, P.
J., Calear, A. L., Christensen, H., De Jaegere, E., Domhardt, M., Erlangsen, A. M.,
Bergeijk, O. E. V., Hill, R., Mühlmann, C., Österle, M., Pettit, J. W., Portzky, G., Steubl,
L., . . . Büscher, R. (2023, January 1). The Effects of Internet-based Cognitive Behavioral
Therapy for Suicidal Ideation Or Behaviors on Depression, Anxiety, and Hopelessness in
Individuals with Suicidal Ideation: Systematic Review and Meta-analysis of Individual
Participant Data. http://books.google.ie/books?id=mkMi0AEACAAJ&dq=Internetbased+Cognitive+Therapy+in+managing+severe+depression&hl=&cd=10&source=gbs_
api
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Shirotsuki, K., Sugaya, N., & Nakao, M. (2022). Descriptive review of internet-based cognitive
behavior therapy on anxiety-related problems in children under the circumstances of
COVID-19. BioPsychoSocial Medicine, 16(1), 1-6.
Stjerneklar, S., Hougaard, E., McLellan, L. F., & Thastum, M. (2019). A randomized controlled
trial examining the efficacy of an internet-based cognitive behavioral therapy program for
adolescents with anxiety disorders. PloS one, 14(9), e0222485
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