We have designed and validated a school-based """"""""Coping Skills Program"""""""" which teaches cognitive skills and social problem-solving to groups of schoolchildren at-risk for depression. Pilot data with at-risk children (n = 142) and 6, 12, 18, and 24 month follow-up data show both relief and marked prevention of depression in 11-13 year old children. Moreover, the preventive effect has grown over time: after 2 years, the children in the prevention groups have two to three times less depression than the untreated children. Now we propose to test the effectiveness and generalizability of this program among children at-risk for depression in a 3 group design, using teachers as the intervention providers. Risk is defined as current, low to moderate depressive symptoms and by familial turmoil. Children will be randomly assigned to one of three groups. In one group (n = 216), the children will participate in the Coping Skills program. The second group (n = 216) is the Social and Personal Awareness group. This is a nonspecifics intervention, which controls for group cohesion, adult attention, expectations of benefit, and depression relevant focus which are non-specific to the cognitive intervention but may contribute to the program's effectiveness. The third group (n = 216) will be a no- intervention control group. We will follow the children for three years, targeting depressive disorder and depressive symptoms, as well as behavior problems as reported by children, parents, and teachers. Teachers will be recruited from the two school districts serving as sites for this study and will be trained as intervention providers. This program is reproducible and its pilot effects are large; if teachers are successful in implementing this program, it opens up the possibility that depression might be preventable on a sweeping scale by programs carried out by teachers in the public schools.
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