CLINICIAN-BASED COGNITIVE PSYCHOEDUCATIONAL INTERVENTION FOR FAMILIES

 

OVERVIEW

 

The Clinician-Based Cognitive Psychoeducational Intervention for Families is a home or community-based program aimed at influencing children’s understanding of and attitudes towards parental depression. These changes in attitudes and understanding also are expected to increase children’s self-understanding and decrease depressive symptoms among the children. In a random assignment study of 105 families reporting at least one depressed parent, families either were assigned to receive one of two intervention approaches: the clinician-facilitated intervention or a lecture approach. Results indicated that the clinician-facilitated intervention was more beneficial than the lecture program, and that the amount of change in parents’ intervention and depression-related attitudes and behaviors towards children (e.g., talking to children about their depression) increased over time. Children who participated in either intervention program reported decreased internalizing symptoms over time.

 

DESCRIPTION OF PROGRAM

 

Target population: children between the ages of 8 and 15 with at least one parent who has recently experienced or is currently experiencing depression.

 

The Clinician-Based Cognitive Psychoeducational Intervention for Families is a home or community-based program aimed at influencing children’s understanding of, and attitudes towards, parental depression. In turn, these changes in attitudes and understanding are expected to increase self-understanding and decrease depressive symptoms in children. 

 

The clinician-facilitated intervention consists of 6 to 11 sessions that include separate meetings with parents and children, family meetings, and telephone follow-ups or refresher meetings at six- and nine-month intervals. Sessions are conducted by trained psychologists, social workers, or nurses. The core elements of the program include the following:  1) Conducting assessments on all family members, 2) teaching information about depression as well as risks and resilience in children, 3) linking information to the family’s experiences, 4) decreasing feelings of guilt and blame in children, and 5) helping children to develop relationships within and outside the family to encourage their independent functioning in school and in activities outside the home.

 

The lecture intervention consists of two group meetings with parents only. Material presented is the same as that of the clinician-based intervention, but without relating it to anyone’s specific situation.

 

Start-up training costs for the deliverer include the master trainer fee, at a standard rate of $1,000 per day. The deliverers must engage in several one-day or half-day training sessions.       

 

EVALUATION(S) OF PROGRAM

 

Beardslee, W.R., Gladstone, T.R., Wright, E.J., & Cooper, A.B. (2003).  A Family-Based Approach to the Prevention of Depressive Symptoms in Children at Risk:  Evidence of Parental and Child Change.  Pediatrics, 112, 119-131.

 

Evaluated population: 105 families reporting at least one parent with depression and at least one child between the ages of 8 and 15 served as the sample for this evaluation. The sample was 93.6% white, and 77% of the families reported an annual family income greater than $40,000.

 

Approach: Researchers collected data on the parent and child psychopathology, functioning, and perceptions of the impact of depression and the intervention. The data were collected pre-intervention, during the intervention, and at one and two years following the intervention.    

 

Results: While parents in both intervention conditions were found to benefit significantly, at one and two years following the intervention, parents in the clinician-based intervention reported more change in intervention and depression-related attitudes and behaviors towards children (e.g., talking to children about their depression) than parents in the lecture group. Additionally, parents reported more change on these indicators two years after the intervention than one year after the intervention. 

 

Children in the clinician-facilitated group reported significantly greater understanding of parental illness than children in the lecture group. Change in child understanding of the parental illness was associated with parental report of change in the children’s behaviors and attitudes associated with the illness. Sub-group analyses indicate that younger males reported less change in understanding of depression than older males, younger females, and older females. Both younger and older females’ change in understanding decreased two years after the intervention, relative to one year after the intervention. Additionally, children from families defined as upper class reported increased change in understanding relative to children in lower classes. Length of time since the intervention and couples’ worst global assessment of functioning were not related to changes in child understanding. Changes in child understanding one year after the intervention were highly related to changes two years after the intervention.

 

Internalizing symptoms for all children decreased with increased time (up to two years later) since the intervention. There was no significant impact of intervention type on change in internalizing symptoms.    

 

SOURCES FOR MORE INFORMATION

 

Program manuals and materials may be obtained from:

 

William R. Beardslee, M.D.

Academic Chair, Department of Psychiatry, Children’s Hospital Boston

Gardner Monks Professor of Child Psychiatry, Harvard Medical School

One Autumn St., Suite 435

Boston, MA 02215

Phone:  (617) 355-6087; Fax:  (617) 730-0271

E-mail:  William.beardslee@childrens.harvard.edu

 

References:

 

Beardslee, W.R., Gladstone, T.R., Wright, E.J., & Cooper, A.B. (2003).  A Family-Based Approach to the Prevention of Depressive Symptoms in Children at Risk:  Evidence of Parental and Child Change.  Pediatrics, 112, 119-131.

 

Program categorized in this guide according to the following:

 

Evaluated participant ages:  8 to 15 years

Program age ranges in the guide:  Middle Childhood, Adolescence, and Youth

Program components:  Counseling/Therapy, Clinic/Provider-Based, Home Visiting, Parent or Family Component

Measured outcomes:  Education and Cognitive, Social and Emotional Health, Mental Health

 

KEYWORDS: Children (3-11), Adolescents (12-17), Co-ed, White/Caucasian, home-based, community-based, home visitation, counseling/therapy, depression/mood disorders, parent-child relationship, cost, manual

 

Program information last updated on 9/8/08.

 

 

		© Child Trends 2003