About This Program

Target Population: 9 to 14-year olds who are depressed.

For children/adolescents ages: 9 – 14

Program Overview

ACTION is a developmentally sensitive group treatment program for depressed youth that follows a structured therapist's manual and workbook. Each of the 20 group and 2 individual meetings lasts approximately 60 minutes. The child treatment is designed to be fun and engaging while teaching the youngsters a variety of skills and therapeutic concepts that are applied to their depressive symptoms, interpersonal difficulties, and other stressors. Skills are taught to the children through didactic presentations and experiential activities. The skills are rehearsed during in-session activities and are applied through therapeutic homework. Skills application is monitored and recorded through completion of workbook activities, and completion of the therapeutic homework is encouraged through an in-session reward system. In general, the first nine sessions focus primarily on affective education and teaching coping and problem-solving skills. Sessions 10–19 focus primarily on learning and applying cognitive restructuring as well as continued use of previously learned strategies. Beginning with the 11th meeting and continuing through the 20th meeting, children work to improve their sense of self.

Program Goals

The goals of ACTION are:

  • Learn five core coping skills and be able to independently apply the skills to improve their moods and maintain a pleasant mood
  • Learn a five-step problem solving strategy and apply it to stressors in their everyday life
  • Be able to identify their own depressive thoughts
  • Learn three cognitive restructuring strategies and be able to independently apply the strategies to their depressive thinking
  • Build a positive core belief that will replace existing depressive core beliefs
  • Understand and apply the principles that:
    • When you feel bad and you can change the situation, use problem solving.
    • When you feel bad and you can't change the situation, use coping skills.
    • When you feel bad and it is due to negative thoughts, change your thinking.

Logic Model

The program representative did not provide information about a Logic Model for ACTION.

Essential Components

The essential components of ACTION include:

  • Psycho-education
  • Goal setting
  • Behavioral activation
  • Coping skills and emotion regulation skills training
  • Problem solving skills
  • Cognitive restructuring
  • Improvement in self-schema
  • Self-monitoring
  • Self-evaluation
  • Self-reinforcement
  • Social reinforcement
  • Interpersonal skills

Program Delivery

Child/Adolescent Services

ACTION directly provides services to children/adolescents and addresses the following:

  • Depression.
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents can help the children apply the techniques they learn in group at home.

Recommended Intensity:

The ideal is 2 one-hour sessions a week, but one session will work if time/transportation is an issue.

Recommended Duration:

20 group meetings and 2 individual meetings completed in 11 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Outpatient Clinic
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)


ACTION includes a homework component:

Structured workbook that facilitates application of the therapeutic skills to daily life.


ACTION has materials available in languages other than English:

Dutch, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Therapist
  • Manuals
  • Workbooks
  • Meeting space
  • Space to get up, and complete therapeutic activities

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Completion of training workshop is required. Additional supervision while implementing the program for 6 months is ideal. No minimum educational requirement is necessary.

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

On-site or regional

Number of days/hours:

Two days

Implementation Information

Pre-Implementation Materials

The program representative did not provide information about pre-implementation materials.

Formal Support for Implementation

The program representative did not provide information about formal support for implementation of ACTION.

Fidelity Measures

The program representative did not provide information about fidelity measures of ACTION.

Implementation Guides or Manuals

The program representative did not provide information about implementation guides or manuals for ACTION.

Research on How to Implement the Program

Research has been conducted on how to implement ACTION as listed below:

Stark, K. D., Arora, P., & Funk, C. L. (2011). Training school psychologists to conduct evidence-based treatments for depression. Psychology in the Schools, 48(3), 272–282.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Stark, K. D., Reynolds, W. M., & Kaslow, N. J. (1987). A comparison of the relative efficacy of Self-Control Therapy and a behavioral problem-solving therapy for depression in children. Journal of Abnormal Child Psychology, 15(1), 91–113.

Type of Study: Randomized controlled trial
Number of Participants: 29


  • Age — 9–12 years
  • Race/Ethnicity — Not specified
  • Gender — 57% Male
  • Status — Participants were children in the fourth, fifth, and sixth grades of a semirural elementary school.

Location/Institution: Semirural elementary school

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of two intervention programs for children who were identified as moderately to severely depressed. Participants were randomly assigned to either a self-control condition [now called ACTION], behavioral problem-solving condition, or waiting list condition. Measures utilized include the Children’s Depression Inventory (CDI), the Child Depression Scale, the Child Behavior Checklist (CBCL), the Coopersmith Self-Esteem Inventory, and the Revised Children's Manifest Anxiety Scale. Results indicate that at posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 8 weeks.

Additional References

Stark, K. D., Herren, J., & Fisher, M. (2009). Treatment of childhood depression. In M. J. Mayer, R. Van Acker, J. Lochman & F. M. Gresham (Eds.), Cognitive behavioral interventions for students with emotional/behavioral disorders (pp. 266–294). New York: Guilford Press.

Stark, K. D., Streusand, W., Arora, P., & Patel, P. (2011). Childhood depression: The ACTION treatment program. In P. C. Kendall (Ed.), Child and adolescent therapy (4th ed., pp. 190-233). New York: Guilford Press.

Stark, K. D., Streusand, W., Krumholz, L. S., & Patel, P. (2010). Cognitive-behavioral therapy for depression: The ACTION treatment program for girls. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 93–109). New York: Guilford Press.

Contact Information

Kevin D. Stark, PhD
Agency/Affiliation: University of Texas, Dell Children's Medical Center
Phone: (512) 471-4407

Date Research Evidence Last Reviewed by CEBC: September 2022

Date Program Content Last Reviewed by Program Staff: June 2015

Date Program Originally Loaded onto CEBC: September 2010