Depression Clinical Pathway — Outpatient Behavioral Health and Primary Care

Initial Treatment Considerations

Providers should decide which type of treatment to initiate first based on patient clinical presentation, risk factors, and clinical judgment.

Initial Treatment Based on Depressive Disorder	Children (ages 6-11)	Adolescents (ages 12-18)
Mild Depression	/clinical-pathway/risk-diagnosis-depression-definitions Active Monitoring Supportive Psychotherapy Family Therapy or Cognitive Behavioral Therapy	Active Monitoring Supportive Psychotherapy Family Therapy or Cognitive Behavioral Therapy or Interpersonal Psychotherapy for Depressed Adolescents
Moderate Depression	Cognitive Behavioral Therapy and/or Medication Management plus Family Therapy if indicated and Consider Consultation with Mental Health Specialist if needed	Cognitive Behavioral Therapy Interpersonal Psychotherapy for Depressed Adolescents and/or Medication Management plus Adjunctive Family Therapy if indicated and Consider Consultation with Mental Health Specialist if needed
Severe Depression	Begin with Medication Management and add Cognitive Behavioral Therapy as soon as possible plus Adjunctive Family Therapy if indicated and Consult with or Refer to Mental Health Specialist or Refer to Intensive Outpatient Program or Partial Hospitalization Program if indicated	Begin with Medication Management and add Cognitive Behavioral Therapy or Interpersonal Psychotherapy for Depressed Adolescents as soon as possible plus Adjunctive Family Therapy if indicated and Consult with or Refer to Mental Health Specialist or Refer to Intensive Outpatient Program or Partial Hospitalization Program if indicated

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Depression Clinical Pathway — Outpatient Behavioral Health and Primary Care

Initial Treatment Considerations

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Depression — Initial Treatment Considerations — Clinical Pathway: Outpatient Behavioral Health and Primary Care

Depression Clinical Pathway — Outpatient Behavioral Health and Primary Care

Initial Treatment Considerations