Depression is a highly prevalent disorder in adolescence that significantly impairs daily functioning and often continues into adulthood. Providing treatment in school-based clinics may be an effective way of reaching large numbers of depressed adolescents. The overall aim of this grant is to test whether group interpersonal psychotherapy (IPT-AG) improves the clinical effectiveness of the treatment of adolescent depression currently provided within school-based health clinics in impoverished urban areas. A group therapy treatment is proposed because of the centrality of peer interactions in the lives of adolescents. Groups also provide opportunities for adolescents to learn that they have similar difficulties and to collaboratively work on their problems. Group therapy is resource efficient as it enables clinicians to treat more adolescents at one time. School-based mental health professionals will be trained to conduct group interpersonal psychotherapy for depressed adolescents (IPT-AG). It is an adaptation of individual interpersonal psychotherapy for depressed adolescents (IPT-A), which has established efficacy in 2 randomized controlled university hospital-based trials and 1 effectiveness trial in school-based health clinics. All students seeking health services in the school-based health clinic will be screened for depression using the CES-D with a cut score of CES-D >24. Students who meet criteria for major depression, dysthymic disorder, depression disorder not otherwise specified or adjustment disorder with depressed mood (N=125) will be randomly assigned to receive IPT-AG or treatment as usual. One-half of the clinical staff at each clinic will be randomly assigned and trained to administer IPT-AG. Students will be administered structured diagnostic instruments and self-report questionnaires over a 4 month treatment period and for one year after completing the acute treatment phase. The study groups will be compared regarding clinical effectiveness (treatment adherence, symptomatic outcomes, and social and school functioning). We also will examine therapist adherence and competence in delivering the treatment intervention as well as patient satisfaction with care and utilization of other health services. The development of an effective, efficient, and accepted school-based intervention will help to reduce the extensive morbidity associated with adolescent depression in these impoverished communities. ? ?
| Mufson, Laura; Sills, Rebecca (2006) Interpersonal Psychotherapy for depressed adolescents (IPT-A): an overview. Nord J Psychiatry 60:431-7 |
