Development and efficacy of a family-focused treatment for depression in childhood
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Date
2020-11-01
Version
Accepted manuscript
OA Version
Citation
M.C. Tompson, D.A. Langer, J.R. Asarnow. 2020. "Development and efficacy of a family-focused treatment for depression in childhood." Journal of Affective Disorders, Volume 276, pp.686-695. https://doi.org/10.1016/j.jad.2020.06.057
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.