What Do Chinese Families With Depressed Adolescents Find Helpful in Family Therapy? A Qualitative Study

Abstract

Despite research supporting the efficacy of family therapy for adolescent depression, little research has been done to clarify the therapeutic variables that Chinese families with depressed adolescents consider helpful in family therapy. This study explored depressed Chinese adolescents' and their parents' perceptions of the factors promoting improvement in family therapy. Twelve Chinese families with one adolescent child fulfilling the criteria for major depressive disorder were recruited. A total of 134 family therapy sessions were conducted by four therapists. After therapy, semi-structured interviews about the clients' perceptions of the helpful and effective aspects of therapy were conducted. Thematic analysis was used to analyze the transcribed dialogues. Five overarching themes emerged: factors supporting therapeutic alliance formation, the therapist's systemic attitude, systemic therapy direction, effective systemic therapy techniques, and strategies for dealing with current issues. A trustworthy therapy alliance with a competent and supportive therapist helped depressed adolescents improve by facilitating the expression of their emotions; exploring family interactions, beliefs, and emotion flows related to their symptoms; promoting their self-development; and activating their resources. The families valued the respectfulness of the therapists and their collaborative and non-authoritative approach. Adolescents' academic difficulties and crises received special attention. The possible clinical implementations of our findings in the design of family therapy strategies for depressed Chinese adolescents are discussed.

Development of a measure quantifying helpful psychotherapy interventions: The Helpful Therapeutic Attitudes and Interventions Scale

“…Using techniques to solve practical issues focused on the process by which therapists conducted deliberated techniques to facilitate clients' solutions to actual stress and challenges. This finding coincides with prior research suggesting the necessity of incorporating targeted therapeutic strategies for the solution of daily issues and crises in psychotherapy (7,16). More importantly, the three factors developed this study match the three-stage helping skills model (exploration, insight or understanding, and action) used for therapists training 10.3389/fpsyt.2022.1023346 (41).…”

“…Another interesting finding of our study was that participants were more impressed by "warm, easy-tounderstand, visible, and practical" therapeutic strategies (e.g., showing empathy and respect, drawing, discussing how to solve family conflicts) than by certain "profound and professional" theoretical approaches, such as the promotion of self-differentiation (7) and psychodynamic interpretation (21). For example, two items related to psychodynamic interpretation ("the therapist analyzed the reasons for my/our problems" and "the therapist provided professional explanations and knowledge for my/our confusion") and another selfdifferentiation item ("the therapist encouraged my family to support each other's self-development") were included in the initial version of our scale.…”

“…For example, if therapists use a convenient instrument to assess the accomplished sessions and find that some helpful interventions have not been delivered, they may make synchronous and immediate adjustments to their following therapeutic strategies, such as applying more helpful therapeutic techniques and strategies. This may increase the efficiency of clients’ positive changes and the following therapy sessions, as well as reduce the time, energy, and economic costs for both therapists and clients ( 7 ).…”

School-Aged Students’ Sustainable Online Learning Engagement during COVID-19: Community of Inquiry in a Chinese Secondary Education Context

“…Adolescence is considered a challenging stage, involving bio-psycho-social changes and exploring various identities [14]. Adolescents' mental health during the school closures of the COVID-19 pandemic has been investigated in the latest research.…”

What Contributes to the Development and Maintenance of School Refusal in Chinese Adolescents: A Qualitative Study

“…Meanwhile, our analysis implied that this phenomenon might be related to Chinese culture. Chinese tradition emphasizes filial piety and children's obedience to the family ( 40 ). In most families in our study, the adolescents might have experienced more excessive control from their families than their Western counterparts would experience ( 24 ).…”