Family Check-Up for Depression Prevention

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DESCRIPTION (provided by applicant): There is a great need for new research and development of depression prevention programs. Over the past few years, we have begun to develop the Family Check-Up (FCU), a brief family intervention that targets family functioning and may be effective in preventing depression. The FCU is modeled on the Drinker's Check-up, as described by Miller, Sovereign, & Krege, (1988). Like the Drinker's Check-Up, the FCU consists of assessment, feedback, and goal-setting, and is conducted using a motivational interviewing style. The FCU is designed for use with adults and older adolescents. Because poor family functioning is a significant risk factor for depression, we believe that the FCU will prevent depression by improving family functioning. In the current application, we propose to continue the process of treatment development. Preliminary evidence from an open trial of the FCU (n = 32 families) suggests that it is acceptable to families and that it is associated with improvements in depression symptoms and family functioning. At this point, further development and pilot testing are needed, hi Phase 1 of this project, we propose to conduct an open trial of the FCU specifically with African-American and Latino families. This will allow us to ensure that perspectives of different cultural and racial groups are included in treatment development. We will also create adherence and competency measures, and a clinician-training program, hi Phase 2 of the proposed project, we will conduct a pilot randomized controlled trial of the FCU as a selective prevention program for depression in a multi-ethnic and multi-racial sample of families (n = 60). The FCU will be compared to a minimal treatment control group. Families who report poor family functioning and have at least one family member with a recent history of depression (but no current major depression or dysthymia) will be eligible to participate. Family members will be followed for 6-months after being randomized, and the primary outcome variable will be number of weeks with at least a subsyndromal level of depression between baseline and 6- month follow-up. Secondary outcome variables include incidence of major depressive episodes and change in family functioning. The purpose of Phase 2 is to gain an estimate of effect size for a larger randomized controlled trial.