title: Parents and Adolescent Depression: Evaluation of a Model and an Intervention Program for Parents
Creators: name: Ham, David R
Publisher: name: Griffith University
Year: 2006
Subjects: subject: Adolescent depression
subject: RAP-P (Resourceful Adolescent Parent Program)
subject: parents and adolescents

description: Adolescent depression affects up to 24% of adolescents before adulthood and is linked with serious outcomes. However as only 25% of affected adolescents in Australia receive appropriate assistance the prevention of adolescent depression has a high priority. Risk and protective factors exist in the individual, family, school and society, but the connection between these factors is often uncertain. Prevention at the individual level has been found to be successful but despite the importance of family factors there is little research into prevention at the family level. Because of the difficulty in engaging parents in preventive interventions it has been suggested that convenient, flexible delivery interventions may achieve better penetration. This study evaluates in two stages the Resourceful Adolescent Parent Program (RAP-P), a positively-focused family-based intervention for parents which has been developed to fill the need for a universal preventive intervention for adolescent depression. Firstly the study evaluates the theoretical basis for RAP-P by developing and testing models linking the family-based psychosocial risk and protective factors for teenage depression that are addressed by RAP-P, and the family systems factors underpinning these. No previous models linking these variables could be found in the literature. The study then evaluates two formats of RAP-P, one of three facilitated workshops attended by parents; the other a videotaped flexible delivery format for use at home, developed to overcome parents' poor involvement in preventive programs. Participants were 242 adolescents in Year 8 and 361 of their parents, recruited from eleven schools in Brisbane, Australia. Schools were randomly allocated to one of three conditions: workshop intervention, video intervention and control. Adolescents and parents completed measures at pre-test, post-test and 15 month follow-up. Based on the current adolescent depression literature and Bowen Theory, four models were developed, tested using structural equation modeling and confirmed after minor revisions. The first model examined links between adolescents' depression and the family based risk factors of parent-adolescent conflict and adolescents' negative perceptions of their parents' interactions with them, and the protective factor of parental attachment. Other models, based on Bowen Theory, examined the trans-generational transmission of differentiation of self from the adolescents' grandparents (generation 1) to the adolescents' parents (generation 2) and the effects of parents' differentiation and anxiety on the third generation adolescents' perceptions of their mothers, attachment and depression. The second part of the study examined the implementation and efficacy of the two formats of RAP-P. Predictions that the convenience of the flexible delivery format of RAP-P would result in better recruitment and lower attrition than for the workshop format were not supported, with the flexible delivery format encountering poorer recruitment and higher attrition. Predictions that parents' evaluations of both formats would be equally positive were not supported; the flexible delivery format was consistently evaluated less positively than the workshop format. However parents perceived both formats to be of similar benefit to them. Parents in the intervention conditions were predicted to exhibit better differentiation and lower anxiety than those in the control condition, resulting in their adolescents experiencing less intense conflict over fewer issues and appraising their parents more positively, and consequently exhibiting better parental attachment and lower levels of depression. The level of improvement was predicted to be related to the level of parental engagement in the interventions. However parents and adolescents in the intervention conditions did not show any positive effects of the interventions at post-test or follow-up. Parents who were engaged in the interventions and their adolescents similarly did not show any measurable benefits from the intervention. Thus this study has found support through modeling for the theoretical basis for RAP-P. Parents' feedback strongly supported the overall thrust and ethos of RAP-P and particularly of the workshop format, indicating that the intervention targeted the right factors in the right way. However the interventions did not achieve measurable improvements for parents or adolescents within the time frame of the study. With models supporting the appropriateness of the measured variables it appears that the potency of the intervention was insufficient. Finally the study found that the use of a flexible delivery videotape intervention did not achieve its goal of increased participation and was still very costly of resources.