Parent Intervention in CBT for Depressed Latino Youth

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DESCRIPTION (provided by applicant): Despite progress in treating mental disorders in youth, little is known about these interventions with Latinos who are now the largest minority group in the United States. This study examines the impact of enhancing effective interventions through the involvement of parents in an 8 session of a psycho education intervention (PPI). This PPI will be incorporated into the 12-session CBT, a Cognitive Behavioral treatment method that has already been shown effective for the treatment of adolescent depression. This study will randomize 140 Latino adolescents with Major Depression to CBT with or without a PPI delivered in groups. Intake diagnoses will be obtained via structured diagnostic interviews (Diagnostic Interview Schedule for Children-DISC for adolescents and Composite International Diagnostic Interview-CIDI for parents). The study will focus on Puerto Rican adolescents and their parents. The primary aims address both the efficacy and effectiveness of the intervention and treatments. Efficacy questions focus on the comparison of the active treatment with and without the PPI for reducing depressive symptoms and diagnosis (DISC) after 12 weeks of treatment and for preventing relapse over the course of one year post-treatment (DISC). Effectiveness questions focus on the impact of the treatment with or without the PPI on broader functional outcomes. Patient functional outcomes include general functioning status, family functioning, school attendance, and attrition rates. The relative value of CBT with and without the adjunctive parent intervention for improved parent functioning regarding psychiatric distress and symptoms, burden of patient illness, and work attendance will be examined. We hypothesize that the active treatment with PPI will be superior to no PPI in reducing depression at post treatment. Because the PPI is designed to involve parents and thus impact other aspects of the family system, this treatment is expected to produce better outcomes in several of the functional domains. To test the theoretical assumptions of the intervention, we also aim to examine the contribution of hypothesized treatment-specific change mechanisms to mediate the short-term outcome and predict long-term relapse over one year. This study responds to NIH and NIMH initiatives on decreasing disparities in health and mental health care between minorities and White populations and will contribute to our knowledge base.