When mothers suffer from depression, the effects of their illness are borne not only by mothers but also by their dependent offspring. The converse may also be true: that is, effective treatments for mothers with depression may also improve outcomes for their children. The purpose of this proposed Mentored Patient-Oriented Research Career Development (K23) Award is to promote the Candidate's long-term goal of conducting clinical trials of psychosocial interventions for mothers with depression in community settings and to study the impact of these treatments on mothers and their dependent children. The activities described in this application will enable the Candidate to assess the reciprocal relationship between maternal depression and child illness, successfully engage and retain mothers in multi-session psychosocial treatments, and collaborate with health services researchers in order to enhance the public health value of the intervention. Interpersonal psychotherapy (IPT), an efficacious treatment for depression, addresses both depressive symptoms and problematic interpersonal relationships. For mothers whose struggles caring for ill children contribute to her psychiatric illness, IPT provides the opportunity to resolve both the depression itself and depression-engendering conflicts with a child or partner. The first phase of the research plan consists of modifying an 8-session form of IPT (IPT-B) for depressed mothers with ill children by incorporating an engagement strategy and minimizing practical barriers to care. The second phase of the research plan consists of a small, preliminary, randomized trial comparing enhanced IPT-B to a referral for usual care in a sample of depressed mothers who bring their school-age children for treatment in a community mental health clinic. Mothers and children will be assessed at baseline, post-treatment, and 6-month follow-up. The skills, training, and pilot data obtained from this award will subsequently support the Candidate's development of an R01 application in Years 03-05 of the award period.
