Martha C Tompson1, David A Langer2, Joan R Asarnow3. 1. Department of Psychological & Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA 02215, United States. Electronic address: mtompson@bu.edu. 2. Department of Psychology, Suffolk University, Boston, MA, United States. 3. UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, United States.
Abstract
BACKGROUND:Depression in childhood frequently involves significant impairment, comorbidity, stress, and mental health problems within the family. Family-Focused Treatment for Childhood Depression (FFT-CD) is a 15-session developmentally-informed, evidence-based intervention targeting family interactions to enhance resiliency within the family system to improve and manage childhood depression. METHODS: We present the conceptual framework underlying FFT-CD, the treatment development process, the intervention strategies, a case illustration, and efficacy data from a recent 2-site randomized clinical trial (N = 134) of 7-14 year old children randomly assigned to FFT-CD or individual supportive psychotherapy (IP) conditions. RESULTS: Compared to children randomized to IP, those randomized to FFT-CD showed higher rates of depression response (≥50% Children's Depression Rating Scale-Revised reduction) across the course of acute treatment (77.7% vs. 59.9%, t = 1.97, p = .0498). The rate of improvement overall leveled off following treatment with a high rate of recovery from index depressive episodes in both groups (estimated 76% FFT-CD, 77% IP), and there was an attenuation of observed group differences. By final follow-up (9 months post-treatment), one FFT-CD child and six IP children had suffered depressive recurrences, and four IP children attempted suicide. LIMITATIONS: Without a no treatment control group it is not possible to disentangle the impact of the interventions from time alone. CONCLUSIONS: While seldom evaluated, family interventions may be particularly appropriate for childhood depression. FFT-CD has demonstrated efficacy compared to individual supportive therapy. However, findings underscore the need for an extended/chronic disease model to enhance outcomes and reduce risk over time.
RCT Entities:
BACKGROUND:Depression in childhood frequently involves significant impairment, comorbidity, stress, and mental health problems within the family. Family-Focused Treatment for Childhood Depression (FFT-CD) is a 15-session developmentally-informed, evidence-based intervention targeting family interactions to enhance resiliency within the family system to improve and manage childhood depression. METHODS: We present the conceptual framework underlying FFT-CD, the treatment development process, the intervention strategies, a case illustration, and efficacy data from a recent 2-site randomized clinical trial (N = 134) of 7-14 year old children randomly assigned to FFT-CD or individual supportive psychotherapy (IP) conditions. RESULTS: Compared to children randomized to IP, those randomized to FFT-CD showed higher rates of depression response (≥50% Children's Depression Rating Scale-Revised reduction) across the course of acute treatment (77.7% vs. 59.9%, t = 1.97, p = .0498). The rate of improvement overall leveled off following treatment with a high rate of recovery from index depressive episodes in both groups (estimated 76% FFT-CD, 77% IP), and there was an attenuation of observed group differences. By final follow-up (9 months post-treatment), one FFT-CDchild and six IP children had suffered depressive recurrences, and four IP children attempted suicide. LIMITATIONS: Without a no treatment control group it is not possible to disentangle the impact of the interventions from time alone. CONCLUSIONS: While seldom evaluated, family interventions may be particularly appropriate for childhood depression. FFT-CD has demonstrated efficacy compared to individual supportive therapy. However, findings underscore the need for an extended/chronic disease model to enhance outcomes and reduce risk over time.
Authors: Laura J Dietz; Rebecca J Weinberg; David A Brent; Laura Mufson Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-12-30 Impact factor: 8.829
Authors: M M Weissman; S Wolk; R B Goldstein; D Moreau; P Adams; S Greenwald; C M Klier; N D Ryan; R E Dahl; P Wickramaratne Journal: JAMA Date: 1999-05-12 Impact factor: 56.272
Authors: Martha C Tompson; Claudette B Pierre; Fawn McNeil Haber; Jason M Fogler; April R Groff; Joan R Asarnow Journal: Clin Child Psychol Psychiatry Date: 2007-07 Impact factor: 2.544