Depression therapy – it can be a family affair

Depression can get into the marrow of family life. Having a depressed parent puts a child at considerable risk for becoming depressed too. Indeed, by the time they are 25, 60 percent of children with depressed parents will have experienced a bout of depression themselves.

It’s not clear how much of the risk is the result of children inheriting genes that make them prone to depression and how much because their depressed parents lack parenting skills.

However, there is evidence that depressed children tend to benefit from family therapy, and a group of Boston-area researchers, headed by William R. Beardslee of the Judge Baker Children’s Center, Harvard [1] used that simple insight as a basis for designing a family-based intervention, (noting also that, in the main, existing treatments did not involve families at all).

Beardslee and his team set out to develop two brief, easily administered interventions. One involved about seven sessions with a therapist (a psychologist, social worker, or other type of trained therapist). Some of the sessions included both parents and children, others each in isolation. The alternative approach was even briefer: families attended two lectures and had the option of consulting therapists afterwards.

Both approaches concentrated on combating likely problems such as family conflict and lack of parental focus. They sought to increase children’s involvement with outside activities and to improve their relationships with other members of their families – while in the process boosting the whole family’s understanding of depression.

The team assessed the impact of the two approaches by following the progress of 105 families, some of whom participated in the therapy sessions and some of whom attended the lectures. All of the families included at least one parent who suffered from a mood disorder and at least one child, between the age of eight and 15, who was not depressed.

They found that both interventions helped most families, even four-and-a-half years after they had enrolled. More children in the therapy group than in the lecture group reported that their parents developed better parenting skills. The therapy group kids also showed better understanding of their parents’ depression.

More important perhaps, young people in both groups generally became less depressed over the course of the study, even though one would expect an increase in depression given their children’s ages and backgrounds.

The authors conclude that involving the whole family can help make even a brief intervention effective.

• Summary of “Long-Term Effects From a Randomized Trial of Two Public Health Preventive Interventions for Parental Depression” by William R. Beardslee, Ellen J. Wright, Tracy R. G. Gladstone, and Peter Forbes in Journal of Family Psychology, December 2007, Vol. 21, No. 4, pp703–713.