Program

Sep 08, 2008

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.

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.

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