Family-focused Treatment for Childhood-onset Depressive Disorders: Results of an Open Trial

Abstract

Study objectives were to develop a treatment manual for a family-focused intervention for depressed school-aged children, evaluate its feasibility and acceptability, and complete an initial open trial to examine treatment effects. Nine young people meeting criteria for depression (major depressive disorder, dysthymic disorder, or depression not otherwise specified), completed a 12-week family intervention, and were assessed immediately and at 9 months following treatment completion. The intervention presented an interpersonal model of how depressive symptoms are maintained, and emphasized developing family strategies for altering interpersonal processes, supporting recovery and enhancing resilience. At posttreatment 66% of the young people had recovered from their depressive episodes; by 9 months posttreatment 77% had recovered. Significant improvements in global functioning were noted. There were no relapses in the follow-up period and no instances of suicidal behavior during the intervention or follow-up. Mothers' and fathers' Child Behavior Checklist reports and children's self reports indicated significant symptom reductions. Exploratory analyses suggest particular benefit for young people with parents high in criticism. The family-focused intervention for childhood-onset depression demonstrated gains similar to those seen with empirically supported treatments for depressed adolescents and superior to those seen in naturalistic studies of depression outcomes. This favorable risk/benefit profile supports the value of a randomized controlled trial.

Extending Parent–Child Interaction Therapy for Early Childhood Internalizing Problems: New Advances for an Overlooked Population

“…Well-articulated psychosocial treatments for depression in elementary school-aged children, let alone preschool populations, are only just beginning to be understood, more often in the context of family-based approaches (Tompson et al 2007) and CBT (Eckshtain and Gaynor 2012; Weisz et al 1997). In fact, the simple phenomenology of depression in very young children is a relatively unexamined domain (Luby and Belden 2012), and therefore, effective interventions for very young children are unsurprisingly lagging.…”

Family-Based Interpersonal Psychotherapy for Depressed Preadolescents: Examining Efficacy and Potential Treatment Mechanisms

“…Multi-family psychoeducation therapy (MF-PEP) has been found to be an effective augmentation strategy to treatment as usual in children between the ages of 8 and 12 with a diagnosed depressive or bipolar disorder as compared to treatment as usual alone 22 . In addition, small, uncontrolled treatment development trials involving a family-focused CBT intervention (N = 9) 23 and a contextual emotion regulation therapy for conjoint parent-child delivery (N = 20) 24 have demonstrated promise in reducing depressive symptoms but have not examined parent-child conflict and social impairment, pathways that may sustain poor interpersonal functioning in preadolescents with depression.…”

Enhancing the Developmental Appropriateness of Treatment for Depression in Youth: Integrating the Family in Treatment

“…One study included only eight prepubertal subjects, 21 and the other included six 12-year-old participants and 13 participants younger than the age of 12 years (Vostanis P, personal communication, February 2007). There have been some treatment development studies with diagnosed school-aged youth, including our own, 22–26 but RCTs are needed to evaluate treatment efficacy. In most of these treatments, parents are included in parallel sessions 27,28 or in groups.…”

“…In this article, we describe two intervention approaches as examples of how a family-centered approach can be used to support youth recovery: Family-Focused Treatment for Childhood Depression (FFT-CD) is a developmentally informed treatment specifically designed for preadolescent youth with depression and their families. 26 SAFETY is an intensive 12-week intervention designed to decrease suicide and suicide attempt risk among with a recent history of suicidal behavior.…”