The primary goal of this application is to design a developmentally-appropriate Behavioral Family Therapy Intervention (BFT) for the treatment of Adolescent Depression that is suitable for use in applied clinical settings. Despite the success that has been obtained in the treatment of adolescent depression, only 60-75% of depressed adolescents can be expected to recover by post-treatment with the most effective interventions available, leaving many youth experiencing ongoing symptomatology (Asarnow et al., 2001;TADS;2004). Moreover, research on the maintenance of treatment gains has been disappointing (Weisz, McCarty, &Valeri, 2006). The last decade has witnessed a substantial expansion in the evidentiary base regarding family processes associated with depression in youth. However, very limited work has been directed at using this research base to tailor family-focused interventions for this population of vulnerable youth. Evidence that family processes are associated with the development and maintenance of symptoms over time, and moderate the effectiveness of treatment interventions, suggests the potential benefit of doing so. Finally, there has been very limited progress toward the adoption of empirically-supported treatments by applied community settings and substantial questions remain as to whether empirically supported treatments (ESTs) are appropriate for or likely to be effective within community settings (Weisz, Jensen, &McLeod, 2005;Sheeber et al., 2002). Hence, using the combined expertise provided by our research-community collaboration, we plan to design an intervention that targets the difficulties experienced by families of depressed youth, is tailored to the unique developmental challenges and tasks of adolescence, and is well-suited to the demands, constraints, and goals of community-based clinical settings. The development process will be informed by: 1) the empirical literature and our own programmatic research on family processes associated with adolescent depression;(2) the clinical expertise of our clinical co-investigators;(3) an esteemed team of consultants including scientists, experienced doctoral-level clinicians, and senior administrators in community mental health settings;and (4) input from depressed adolescents and their families. As part of our program of formative development and evaluation, we will examine, in an iterative fashion, the feasibility, acceptability, and sustainability of the intervention. All phases of intervention testing will be conducted in the field, first by a clinical member of the investigative team, then by doctoral level practitioners in the field, and then in by masters level therapists in a community mental health center. Using a quasi-experimental design, we will garner preliminary estimates of effect sizes for the proposed intervention with regard to changes in depressive symptomatology as well as family relationships and interactional processes. Data from this development grant will position us to conduct a subsequent controlled-trial of the intervention. Adolescent depression is a significant public health problem. In this study, we are developing a behavioral-family therapy to treat depressive symptoms and improve family relationships. The treatment will be based on the latest research on adolescent development and depression. Our team of clinicians and researchers seek to develop a treatment that will be appropriate for use in community treatment settings.
Adolescent depression is a significant public health problem. In this study, we are developing a behavioral-family therapy to treat depressive symptoms and improve family relationships. The treatment will be based on the latest research on adolescent development and depression. Our team of clinicians and researchers seek to develop a treatment that will be appropriate for use in community treatment settings.