Combined cognitive behavioral treatment plus caregiver sessions for childhood depression

Childhood depression is intimately related to the family context and caregiver-child relations, but only a limited number of treatment outcome studies for depressed youth have formally included members of the family in the intervention. To address this discrepancy the present study evaluated the efficacy of adding caregiver sessions to individual cognitive behavioral therapy (CBT) for the treatment of depressed youth. The treatment included 16 individual sessions and 7 caregiver sessions administered in the child's school to promote accessibility. Fifteen children (10 females and 5 males ranging in age from 8-13), who met inclusion criteria based on self-report and interview measures of depression were enrolled. Pre-, mid-, post-treatment, and one-month follow-up assessments showed significant decreases in depressive symptoms. Self-, caregiver-, and teacher-report of child psychosocial functioning, depressotypic cognitions, coping skills, (caregiver reported) caregiver-child relationships, and parenting stress also showed significant improvements. The exception was child-reported caregiver-child relations, which did not change. Caregivers reported uniformly high satisfaction with the treatment. Benchmarking the depression results against those from the literature suggested that the treatment equaled or outperformed CBT in other studies and appeared markedly superior to control conditions. Benchmarking the results against relevant pharmacotherapy studies revealed that the treatment compared favorably to pharmacotherapy and appeared to outperform a pill placebo. Examination of moderators and predictors of change suggested that age and negative thoughts moderate change of depressive symptoms, and that change in negative thoughts predict change in depressive symptoms. These results provide support for using a combination of individual CBT plus caregiver sessions in decreasing depressive symptoms and caregiver stress and improving psychosocial functioning and caregiver-child relations (according to caregivers).