Depressed youth: treatment outcome and changes in family functioning in individual and family therapy

This study explores the role of family functioning in therapeutic change in focused individual psychodynamic psychotherapy (FIPP) and time‐limited systems integrative family therapy (SIFT) for depressed children and adolescents. After a screening process, 72 participants aged 8 to 15 were randomized to either FIPP or time‐limited SIFT. Assessments took place prior to, at the end of, and 6 months after treatment. Families in both SIFT and FIPP showed a small but significant and sustained improvement in family functioning by the end of treatment in both mothers' self‐reports and family therapists' assessments. Better family functioning at baseline in mothers' self‐reports and improved family functioning during SIFT, as assessed by family therapists, predicted a sustained decrease in self‐reported depressive symptoms. Results indicated that time‐limited SIFT may be more effective with younger children and in patients without a diagnosis of double depression than adolescents.     

Trauma‐focused CBT with maltreated children: A clinic‐based evaluation of a new treatment manual

The effectiveness of a locally developed trauma‐focused cognitive behavioural therapy (TF‐CBT) program for maltreated children with post‐traumatic stress disorder (PTSD) was examined across different therapists in a child protection clinic setting. An earlier phase of the research piloting the program had provided promising results. This second phase involved two studies evaluating the completed TF‐CBT manual delivered by (a) the developer and (b) other therapists. A single‐case multiple‐baseline design was used to demonstrate the controlling effects of the treatment on PTSD symptoms and child coping. Eight 9–13‐year‐old abused children with PTSD were treated. Positive outcomes support the effectiveness of the TF‐CBT program delivered by both the developer and other therapists. The study design and methodology were robust enough to confirm empirically the clinically beneficial effects and potential for this new program. It was also apparent, however, from study limitations, including missing data for some patients, that there are a number of challenges in carrying out such research in a busy child protection service setting with multiply‐abused patients. This paper considers implications and ways forward for engaging in empirically supported practice as well as future development and research.     

A qualitative evaluation of a mental health literacy intervention for parents delivered through community sport clubs

Intervention studies have rarely targeted parent mental health literacy despite its importance for adolescent mental health. This qualitative study evaluated the experiences of parents (n = 352) who participated in the Ahead of the Game mental health literacy workshop delivered through community sport clubs. Moreover, the study aimed to investigate the relevance, retention and use of intervention content by parents, assess the acceptability and feasibility of delivering mental health education through community sport clubs, and identify strategies for increased engagement. In total, 17 parents (13 mothers, four fathers) participated in semi-structured interviews up to one month after the workshop. Reflexive thematic analysis revealed that parents perceived mental health education as important and valuable, and believed the community sport club was an appropriate setting to discuss adolescent mental health. Parents reported increased awareness and knowledge of mental health disorders and help-seeking options, and increased confidence and preparedness to communicate and assist someone experiencing a mental health issue. The workshop stimulated conversation about mental health between parents and their children, and between parents within and outside the sport club community. Parents used information and resources provided in the workshop to help those in their networks and reflected back on the workshop when noticing changes in their adolescent’s behavior. Potential additions to the workshop (as suggested by parents) included increased discussion among parents as well as opportunities for further information sessions or tailored online material. Future research might look to engage more fathers, actively encourage parents to aid in the recruitment of others, and investigate long-term adolescent mental health outcomes.     

‘Someone to talk to who'll listen’: addressing the psychosocial needs of children and families

The paper presents the Lewisham Community Child and Family Service (LCCFS), a community‐based intervention providing psychosocial help for children, young people, parents and families. The service is focused on early intervention, prevention and promotion in the improvement of local health. It works under a service framework based on inter‐agency collaboration, and a counselling model based on community and interpersonal partnerships, grounded in personal construct theory (Kelly, 1955). The policy demands and local need for accessible and acceptable mental health are discussed, and quantitative and qualitative findings of the needs assessment preceding the establishment of the LCCFS are presented, supporting the need for community mental health provision. The feasibility for the LCCFS to reconcile and meet the policy demands and the needs of parents with respect to child psychosocial help and services are discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

Psychoeducation: A promising intervention strategy for families of children and adolescents with mood disorders

Mood disorders and suicide in youth represent major health concerns requiring effective intervention strategies. This paper briefly summarizes the literature on childhood mood disorders and discusses expressed emotion (EE) and the link between lowering EE and improved outcome for mood disordered individuals. Family psychoeducation is discussed as a means of reducing EE and similarities and differences between psychoeducation and other therapeutic interventions explored. The authors' adaptations that made psychoeducation developmentally appropriate for families of children and adolescents are reviewed. Psychoeducation for families of mood disordered youth is suggested as worthy of further clinical and empirical effort.     

Associations between symptoms of maternal postpartum depression,gestational age and infant social withdrawal: A longitudinal study in a community cohort

Infant social withdrawal is a risk factor for non-optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2–3, 4–7 and 8–12 months postpartum. Linear regressions showed that prematurity predicted higher infant social withdrawal at all time points, and maternal symptoms of PPD were positively associated with withdrawal at 2–3 months. Logistic regressions showed that odds for elevated social withdrawal were increased with elevated levels of maternal symptoms of PPD at 2–3 and 8–12 months. Partner's symptoms of PPD were not associated with withdrawal. Future studies should investigate how PPD symptoms and prematurity may impact the individual development of social withdrawal.     

A Longitudinal Analysis of Family Empowerment and Client Outcomes

We examined the relationship between family empowerment, parent satisfaction, and mental health outcome across time. Based on the Vanderbilt Family Empowerment Project Model, increased empowerment should lead to positive changes in client outcomes. Data consisted of the Family Empowerment Scale (FES), which was used to assess the caregiver's perception of empowerment, Child and Adolescent Functional Assessment Scale (CAFAS), which measures the degree of disruption in the youth's current functioning, Client Satisfaction Questionnaire (CSQ), and demographic information gathered from families receiving services from a county mental health service system at intake and discharge. The results showed that the CAFAS and CSQ were related to empowerment at intake and discharge. Results also indicated significant increases in the knowledge subscale of the FES and the CAFAS and moderate increases in the advocacy subscale of the FES and the CSQ. We discuss the implications of these findings for systems of care, such as stronger parent-professional relationships.     

Adolescent motherhood: a Q‐methodological re‐evaluation of psychological and social outcomes

Traditionally, adolescent motherhood has been associated with numerous negative social, psychological and societal outcomes. However, in recent years there has been a gradual acceptance that there are many positive features to adolescent motherhood, but methodological issues have been identified within the field. This study aimed to examine adolescent motherhood from the mothers' own perspectives, exploring their attitudes towards the issues that they described as being important in their lives, by using Q‐methodology in an attempt to counter some of these methodological limitations. The mothers within the study appeared to be coping positively in their role in that levels of symptomatology, as determined from questionnaire assessment, appeared to be relatively low and they indicated through Q‐sort analysis that motherhood had been beneficial to their lives. Three independent factors (clusters of attitudes) were identified within the sample (N = 23) which differed over the dimensions of: employment, social support, coping, partner co‐habitation, financial support, maternal role satisfaction, aspirations for the future, as well as the nature of the relationship with their child(ren)'s father and their satisfaction with the fathers' role. The significance of these findings with regard to educational and social services is discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Emotional and behavioral problems in children of depressed mothers: a school-based study in Southern Brazil

The present study aimed to verify the association between maternal depression and emotional and behavioral problems in school children in Pelotas, Southern Brazil, considering that maternal depression increases children’s vulnerability for developing psychiatric disorders. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016 and it is part of a major project entitled ‘Healthy Childhood in Context: A Multidisciplinary Investigation’. Schoolchildren aged between 7 and 8 years and one of their respective parents or a primary caregiver were included in the study. Maternal depression was assessed using the Mini International Neuropsychiatric Interview (MINI). The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ) – parents version. Children of depressed mothers exhibited higher mean scores in all SDQ domains and in the total score when compared to children of non-depressed mothers. Lower socio-economic status was also associated with higher SDQ scores. Our results showed the effects of both maternal depression and poverty on children emotional and behavioral problems, which evidence the need for child mental health preventive care, and free quality assistance for both mothers and their children.     

Building a research base for community services for children and families: What we know and what we need to learn

We examine the knowledge base for community-based mental health services for youth and their families. A brief historical perspective on the development of community services is presented, and the fundamental components of a comprehensive child mental health service system are described. Outcome studies for service components as well as the service system as a whole are summarized. Research related to the context of treatment, i.e., service setting, cost, is presented. The authors conclude that a research base for child and family services is emerging, but there is still a paucity of well designed studies that address the complexities of a community-based system as well as the critical outcome questions that need to be addressed. Finally, promising service system developments are described and recommendations for future research are presented.     

Pluralistic approaches to the study of process and outcome in psychoanalysis. The LAC depression study: a case in point

Approaching process and outcome in psychoanalysis is a topic that touches on ambitious and complex epistemological and methodological issues. As discussed in the first part of the paper, in keeping with challenging epistemic considerations, it would seem appropriate to describe the specificity of psychoanalysis as a specific scientific discipline of the unconscious (spezifische Wissenschaft des Unbewussten, see LIT). Psychoanalysis, over its more than 100-year history, evolved a range of highly advanced research methods for investigating the specific object of its research, namely unconscious conflicts and fantasies. Hence, like many other scientific disciplines, contemporary psychoanalysis comprises a plurality of theories, methods of clinical treatments as well as a plurality of research topics. This position is discussed with reference to a model illustrating different forms of clinical and extra-clinical research in psychoanalysis. A major, ongoing comparative study of outcomes of psychoanalytical and cognitive behavioural, long-term treatments of chronically depressed patients, the so-called LAC-study, serves to illustrate the richness of contemporary research in psychoanalysis.     

Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.