FAMILY-BASED TREATMENT FOR DEPRESSED ADOLESCENTS

描述（改编自申请人摘要）：心理健康 社区需要经验验证的治疗抑郁症的儿童， 青少年，特别是市中心的少数民族青年。 数个单独 为成人制定的重点治疗模式正在儿童身上进行测试。 然而，这些治疗方法未能使用有效的背景， 家庭关系是评估和干预的主要重点。 在 在过去十年中，以家庭为基础的干预措施越来越多地证明， 成功地针对与儿童有关的具体家庭因素， 青春期紊乱 因此，一些著名的研究人员 建议家庭治疗方法可以有效地减少 儿童和青少年抑郁症。 这项治疗开发研究将最终确定技术， 结构族经验评估所需的工具 治疗（SFT）治疗青少年抑郁症。 三 将进行具体但高度相关的研究。 在研究#1中，我们 将完成治疗抑郁青年的治疗手册，重点是 市中心的少数民族 我们正在调整这种方法， 家庭因素与青少年抑郁症的发生和维持 抑郁症：脱离，批评和敌意，父母 精神病理学和无效的父母教育 干预的目的是 增强家庭凝聚力，减少敌意，改善沟通， 增加家庭和社会支持，教授权威性育儿。 本手册的大部分内容已经完成。 在研究#2中，我们 验证将用于确保 确保治疗准确有效 在研究#3中，我们 将收集30例随机分配至SFT或 最小联系人等待列表控制组。 本研究的数据将 用于估计治疗效应量。 这将使我们能够传导能量 分析和计划未来的比较研究。 一般来说，这项研究 将试验新的仪器，培训治疗师，建立实施 程序，并测试处理的可行性和可接受性。 这些 任务已被确定为NIMH资助的重要基础， 心理治疗的随机临床试验 我们将进行 在费城儿童指导中心学习并招募患者 住院病人、门诊病人和危机处理项目。 这些项目几乎 每年有1000名青少年，其中90%是市中心的青少年， 都是非裔美国人 目前，约有15%的人获得了 抑郁症的诊断 这笔赠款将为一个 方案调查，比较和结合家庭为基础的 治疗与其他发达的治疗在大学 宾夕法尼亚州精神病学系（例如精神药理学和 认知疗法）。

DESCRIPTION (Adapted from applicant's abstract): The mental health community needs empirically validated treatments for depressed children and adolescents, particularly inner city, minority youth. Several individually focused therapy models developed for adults are being tested with children. However, these treatment approaches fail to use the potent context for family relationships as a primary focus of assessment and intervention. In the last decade, family-based interventions have increasingly proven successful in targeting specific family factors associated with child and adolescent disorders. Consequently, several prominent researchers have proposed that family treatment approaches could be efficacious in reducing child and adolescent depression. This treatment development study will finalize the techniques and instruments necessary for the empirical evaluation of Structural Family Therapy (SFT) for treating adolescents with major depression. Three specific, yet highly related studies will be conducted. In study #1, we will complete a treatment manual for treating depressed youth, focusing on inner-city minorities. We are tailoring this approach to target several family factors associated with the onset and maintenance of adolescent depression: disengagement, criticism and hostility, parental psychopathology, and ineffective parenting. Interventions are aimed at increasing family cohesion, reducing hostility, improving communication, increasing family and social supports, and teaching authoritative parenting. Large portions of this manual have been completed. In study #2, we will validate an adherence and competence measure that will be used to ensure that the treatment is accurately and effectively delivered. In study #3, we will collect pre and post-treatment data on 30 cases randomized to SFT or to a minimal contact wait list control group. Data from this study will be used to estimate treatment effect size. This will allow us to conduct power analyses and plan for future comparative study. More generally, this study will pilot new instruments, train therapists, establish implementation procedures, and test feasibility and acceptability of the treatment. These tasks have been identified as the essential foundation for a NIMH funded, randomized, clinical trial for psychosocial treatments. We will conduct the study at the Philadelphia Child Guidance Center and recruit patients form the inpatient, outpatient and crisis programs. These programs treat nearly 1000 adolescents a year, 90% of whom are inner city youth and 75% of whom are African American. About 15% of this population currently receive a diagnosis of depression. This grant will set the foundation for a programmatic investigation that compares and combines the family-based treatment with other well developed treatments at the University of Pennsylvania, Department of Psychiatry (e.g. psychopharmacology and cognitive therapy).