FAMILY-BASED TREATMENT FOR DEPRESSED ADOLESCENTS

描述(改编自申请者摘要)：心理健康 社区需要经验性验证的抑郁症儿童治疗方案 青少年，特别是市中心的少数民族青年。几个单独的 为成人开发的重点治疗模型正在儿童身上进行测试。 然而，这些治疗方法未能利用有效的上下文 将家庭关系作为评估和干预的主要重点。在……里面 在过去的十年里，以家庭为基础的干预越来越多地被证明 成功地针对与儿童和儿童有关的特定家庭因素 青春期精神障碍。因此，几位著名的研究人员 提出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和 结构族经验评估所需的工具 治疗青少年重度抑郁症(SFT)。三 将进行具体的、但高度相关的研究。在研究1中，我们 将完成治疗青少年抑郁症的治疗手册，重点是 市中心的少数民族。我们正在针对以下几个目标定制此方法 影响青少年发病和维持的家庭因素 抑郁：脱离、批评和敌意、父母 精神变态和无效的教养方式。干预措施的目的是 增加家庭凝聚力，减少敌意，改善沟通， 增加家庭和社会支持，教授权威的育儿方式。 这本手册的大部分内容已经完成。在研究2中，我们将 验证遵从性和能力衡量标准，以确保 治疗是准确和有效的。在研究3中，我们 将收集随机分配到SFT或TFT的30例患者的治疗前后数据 最小联系等待列表控制组。这项研究的数据将是 用于估计治疗效果大小。这将使我们能够行使权力 对未来的比较研究进行分析和规划。更广泛地说，这项研究 将试验新的仪器，培训治疗师，建立实施 程序，并测试治疗的可行性和可接受性。这些 任务已被确定为NIMH资助的基本基础， 心理社会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病人表格 住院病人、门诊病人和危机处理方案。这些计划治疗了几乎 每年1000名青少年，其中90%是市中心的年轻人，75% 都是非裔美国人。目前，约有15%的这类人口获得了 抑郁症的诊断。这笔赠款将为 比较和结合以家庭为基础的计划调查 在芝加哥大学用其他成熟的治疗方法进行治疗 宾夕法尼亚州精神病学系(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).