Systems of Support Study for Childhood Depression

Childhood-onset depression is an impairing and often recurrent and persistent disorder that
impacts current and later development resulting in high personal, social, and economic costs.
Despite the costs of early-onset depression, the emphasis in current practice parameters on
an initial course of psychosocial treatment, and extensive research on adolescent depression,
we currently lack randomized controlled trials evaluating psychosocial treatments for
children with depressive disorders.

The present proposal aims to address this gap in knowledge regarding optimal psychosocial
treatment strategies for children suffering from depressive disorders. We propose a 2-site
randomized controlled trial to evaluate the efficacy of Family Focused Treatment (FFT), as
compared to an individual client-centered psychotherapy (IP) modeled after "usual" community
care. FFT adopts an interpersonal model for understanding how depressive symptoms are
maintained, emphasizes developing family skills/strategies for altering interpersonal
processes, and works on building a family environment that supports recovery and enhances
stress resistance and resilience. This approach may be particularly appropriate to the
developmental needs of depressed children, given their dependence on parents, the potential
of FFT to address the needs of multiple family members, and our data supporting benefits on
depression, functioning, and other co-occurring symptoms.

The proposed project will enroll 140 children (ages 8-12) with depressive disorders. Children
will be randomly assigned to receive a 14-week trial of either FFT or IP. At study entry,
immediately post-treatment, and at a 9-month post-treatment follow-up all participants will
undergo intensive evaluation of clinical state and psychosocial and family functioning.

Inclusion Criteria:

- current Depressive Disorder

- ages 7-13 years

- living with at least one biological parent willing to participate

Exclusion Criteria:

- thought disturbance

- severe conduct disorders

- unstable on antidepressant medications

- continuation in current non-study treatment

- non-English speaking