Blueprints Program Rating: Model
A six-week group intervention focused on reducing negative cognitions and increasing engagement in pleasant activities in an effort to prevent the onset and persistence of depression in at-risk high school youth with depressive symptoms.
- Illicit Drug Use
- Cognitive-Behavioral Training
- Counseling and Social Work
Continuum of Intervention
- Selective Prevention (Elevated Risk)
- Indicated Prevention (Early Symptoms of Problem)
- Late Adolescence (15-18) - High School
- Male and Female
- All Race/Ethnicity
- : Model
Program Information Contact
Paul Rohde, Ph.D.
Oregon Research Center
1776 Millrace Drive
Eugene, OR 97403
- Paul Rohde
- Oregon Research Institute
Brief Description of the Program
The Blues Program (Cognitive Behavioral Group Depression Prevention) is intended to actively engage high school students with depressive symptoms or at risk of onset of major depression, includes six weekly one-hour group sessions and home practice assignments. Weekly sessions focus on building group rapport and increasing participant involvement in pleasant activities (all sessions), learning and practicing cognitive restructuring techniques (sessions 2-4), and developing response plans to future life stressors (sessions 5-6). In-session exercises require participants to apply skills taught in the program. Home practice assignments are intended to reinforce the skills taught in the sessions and help participants learn how to apply these skills to their daily life.
See: Full Description
Compared to participants in one or more comparison groups, participants completing the cognitive behavioral depression prevention program had:
- greater reductions in interviewer-rated depressive symptoms at posttest (Rohde et al., 2014a; Stice et al., 2008), six-month follow-up (Stice et al., 2008), and one- and two-year follow-ups (Stice et al., 2010a);
- greater reductions in self-rated depressive symptoms at posttest (Stice et al., 2006; Stice et al., 2008), one-month follow-up (Stice et al., 2006), six-month follow-up (Stice et al. 2008), and two-year follow-up (Stice et al., 2010a);
- lower rates of major depression onset at six-month follow-up (Rohde et al., 2014a; Stice et al., 2008) and two-year follow-up (Rohde et al., 2015; Stice et al., 2010a);
- greater reductions in self-reported substance use at posttest and six-month follow-up (Stice et al., 2008).
Effects on risk and protective factors:
- Participants in the intervention group had significantly higher scores on a measure of cognitive behavioral knowledge than control group participants at posttest (Rohde et al., 2014b), greater improvements in social adjustment at six-month follow-up (Stice et al., 2008), and reduced negative cognitions and increased reports of pleasant activities (Stice et al., 2010b).
All samples were primarily female including between 56% (Study 2) and 70% (Study 3) girls. Study 1 included primarily White participants (72%), Study 2 included primarily White (46%) and Hispanic (33%) participants, and participants in Study 3 were 55% White, 17% Asian, 15% Hispanic, 6% Black, and 7% identified as other or mixed racial/ethnic category.
One study included a subgroup analysis by race/ethnicity (Marchand et al., 2010). In reanalyzing data from Studies 2 and 3, it found no differences in program effects across race and ethnic groups.
Risk and Protective Factors
- Individual: Stress
- Individual: Coping Skills
See also: Blues Program Logic Model (PDF)
Training and Technical Assistance
Skype or onsite 4- to 6- hour training programs for groups of therapists (typically about $1,000/day plus travel expenses) conducted by either Paul Rohde, Ph.D., or his colleagues, Eric Stice, Ph.D., or Heather Shaw, Ph.D., can be organized by contacting Dr. Rohde. Individual therapists or small groups of therapists can also be trained by coming to Oregon Research Institute, Eugene, OR, and meeting with Dr. Rohde and/or Drs. Stice and Shaw for 1-day trainings. Training consists of reading key outcome papers and the prevention intervention manual, discussion of intervention rationale, modeling and role play of all key intervention components, discussion of process issues, and review of crisis response plans.
Brief Evaluation Methodology
All studies included students with depressive symptoms (but not a major depression diagnosis) when screened prior to conducting the study. Each study involved the random assignment of participants to groups (ranging from three groups in Rohde et al., 2014a and Rohde et al., 2014b, to six in Stice et al., 2006) participating in various interventions for depression, with only one study (Stice et al., 2006) including a non-intervention control group. All studies included measures of depressive symptoms and major depression onset.
Rohde et al. (2014a, 2015) included 378 students from five high schools who completed self-report surveys and diagnostic interviews at pretest, posttest (upon program completion), and 6-, 12-, 18- and 24-month follow-ups.
Stice et al. (2008, 2010a) included 341 students from six high schools in the greater Austin, Texas area who completed self-report surveys and diagnostic interviews at pretest, posttest (upon program completion), and six-month, one-year, and two-year follow-ups.
Stice et al. (2006) included 225 students from two high schools and one college who completed self-report surveys at pretest, posttest (upon program completion), and one-month and six-month follow-ups.
Rohde et al. (2014b) included 82 students from one large state university who completed self-report surveys and diagnostic interviews at pretest, posttest (upon program completion), and 6-month and 12-month follow-ups.
Peer Implementation Sites
Vice president for evidence-based practices
Marchand, E., Ng, J., Rohde, P., & Stice, E. (2010). Effects of an indicated cognitive-behavioral depression prevention program are similar for Asian American, Latino, and European American adolescents. Behaviour Research and Therapy, 48, 821-825.
Rohde, P., Stice, E., Shaw, H., & Briere, F. N. (2014a). Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: Acute effects of an effectiveness trial with adolescents. Journal of Consulting and Clinical Psychology, 82(1), 65-74.
Rohde, P., Stice, E., Shaw, H., & Gau, J. M. (2014b). Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: Nonsignificant effects in pilot effectiveness trial with college students. Behaviour Research and Therapy, 55, 48-53.
Rohde, P., Stice, E., Shaw, H., & Gau, J. M. (2015). Effectiveness trial of an indicated cognitive-behavioral group adolescent depression prevention program versus bibliotherapy and brochure control at 1- and 2-year follow-up. Journal of Consulting and Clinical Psychology, 83(4), 736-747.
Stice, E., Burton, E., Bearman, S. K., & Rohde, P. (2006). Randomized trial of a brief depression prevention program: An elusive search for a psychosocial placebo control condition. Behaviour Research and Therapy, 45, 863-876.
Stice, E., Rohde, P., Gau, J. M., & Wade, E. (2010a). Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: Effects at 1- and 2-year follow-up. Journal of Consulting and Clinical Psychology, 78(6), 856-867.
Stice, E., Rohde, P., Seeley, J. R., & Gau, J. M. (2008). Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial. Journal of Consulting and Clinical Psychology, 76(4), 595-606.
Stice, E., Rohde, P., Seeley, J. R., & Gau, J. M. (2010b). Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs. Journal of Consulting and Clinical Psychology, 78(2), 273-280.