Designing and Testing a Family Therapy for Adolescent Depression
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional
Phase: Phase 1

Summary: 
      This study will design and test a cognitive behavioral therapy for depressed adolescents that
      uses family interactions to help with treatment.
    

Detailed description: 
      Adolescent depression causes persistent feelings of sadness, loss of self-worth,
      discouragement, and loss of interest in usual activities. Treatments for adolescent
      depression have mixed success, with 25% to 40% of depressed adolescents still experiencing
      depressive symptoms at the end of the most effective treatments and gains made in treatment
      sometimes fading over time. Research suggests that family processes are associated with the
      effectiveness of treatments for adolescent depression and with reducing symptoms over time.
      Evidence also shows that treatments developed and tested in a research setting are not easily
      applied to community settings. This study will first design a cognitive behavioral therapy
      for adolescent depression that will involve the families of the depressed adolescents and
      then test the therapy in several settings, including clinics.

      Development of this therapy will involve five different groups of participants. Each group
      will include both depressed adolescents and a parent or guardian. The first group of
      participants will partake in a focus group, in which they will break into two discussion
      groups, one of parents and guardians and one of adolescents, that will discuss what kind of
      help and information would be useful to them and why they would consider seeing a therapist.

      The second group will participate in alpha testing, which will involve receiving the first
      version of the therapy. The therapy is anticipated to include 8 to 12 weekly treatment
      sessions, with homework assignments to practice their learned skills in everyday life.
      Participants in alpha testing will also complete interviews and questionnaires at Week 7 and
      at the end of treatment to assess satisfaction with treatment, treatment clarity, and
      usefulness of the information and strategies they learned. After alpha testing, the therapy
      will be revised based on the feedback received. The third group will participate in beta
      testing, which will involve receiving the second version of the therapy and completing the
      same assessments as those done by the alpha group.

      The fourth group of participants will receive pilot testing of the finalized therapy. This
      finalized version will involve 11 to 15 weekly sessions. The fifth group will receive
      treatment as usual from a mental health clinic and serve as a control group to compare to the
      pilot testing group. Before and after treatment, both of these groups will complete
      questionnaires and interviews assessing the effectiveness of their treatment and
      questionnaires and observations of family functioning. All sessions throughout the study
      involving the newly designed family therapy will be videotaped.
    

Intervention name(s): Behavioral Family Treatment; Community-based treatment as usual
Intervention type(s): Behavioral; Other
Intervention description(s): 11 to 15 sessions of a cognitive behavioral family therapy that will be developed during the course of this study and will address the following:
parent-adolescent conflict
adolescent development
support and closeness
behavioral activation
response to adolescent negative affect
relapse prevention
suicide prevention, if necessary; Treatment as usual, which will most likely consist of 8 to 10 sessions of community-based depression treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment