Systems of Support Study for Childhood Depression
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      This study is designed to compare two treatments for depression in pre-adolescent (7-13 year
      old) children. A family-focused treatment will be compared to an individual child-focused
      treatment in this 14-week intervention.
    

Detailed description: 
      Childhood-onset depression is an impairing and often recurrent and persistent disorder that
      impacts current and later development resulting in high personal, social, and economic costs.
      Despite the costs of early-onset depression, the emphasis in current practice parameters on
      an initial course of psychosocial treatment, and extensive research on adolescent depression,
      we currently lack randomized controlled trials evaluating psychosocial treatments for
      children with depressive disorders.

      The present proposal aims to address this gap in knowledge regarding optimal psychosocial
      treatment strategies for children suffering from depressive disorders. We propose a 2-site
      randomized controlled trial to evaluate the efficacy of Family Focused Treatment (FFT), as
      compared to an individual client-centered psychotherapy (IP) modeled after "usual" community
      care. FFT adopts an interpersonal model for understanding how depressive symptoms are
      maintained, emphasizes developing family skills/strategies for altering interpersonal
      processes, and works on building a family environment that supports recovery and enhances
      stress resistance and resilience. This approach may be particularly appropriate to the
      developmental needs of depressed children, given their dependence on parents, the potential
      of FFT to address the needs of multiple family members, and our data supporting benefits on
      depression, functioning, and other co-occurring symptoms.

      The proposed project will enroll 140 children (ages 8-12) with depressive disorders. Children
      will be randomly assigned to receive a 14-week trial of either FFT or IP. At study entry,
      immediately post-treatment, and at a 9-month post-treatment follow-up all participants will
      undergo intensive evaluation of clinical state and psychosocial and family functioning.
    

Intervention name(s): Family Focused Treatment (FFT); Individual Treatment (IP)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): FFT is designed to specifically address the developmental needs of school-aged children and their parents through an emphasis on fostering positive and supportive parent-child interactions that scaffold the development of a positive self, to help parents provide the child additional positive feedback on his/her developmentally appropriate achievements, and to enhance family and child coping. This treatment is conducted with the child and his/her parent(s) and includes education about depression, communication training, relationship enhancement, and problem-solving.; The goals of the treatment are to foster the therapeutic relationship, to provide a supportive and empathic setting where the child can come to better understand his/her emotions/feelings and address issues underlying current symptoms. Therapeutic goals will be addressed through reflection and clarification of feelings/emotions and understanding the child's perception of the context of depressed feelings.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Depression, children, adolescent, family