Child and adolescent depression

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This is a fraught process in the best of times with all of the confounding variables. Practitioner skill, for instance, could significantly alter outcomes regardless of theoretical model, as could development of patient’s coping skills, their outside influences (culture, age, alcohol or drug usage etcetera). These incredibly complex set of confounding variables is made doubly so in youth and children, when brain development is a continuing process that can significantly change treatment strategies and outcomes (Luby, Lenze, and Tillman 2012), and parental and family systems could theoretically have a significant impact on the treatment outcomes (Parra et al. 2011). In at 2012 study published in Couple and Family Psychology: Research and Practice, Stark, Banneyer, Wang Arora attempted to evaluate the relative value of family-based or family-involved cognitive behavioral therapy for depressed youth to cognitive behavioral therapy for the youth alone. In this meta-analysis, they hypothesized that family involvement would have little impact, except in maintenance of treatment effects. There is a strong theoretical backing for the idea that cognitive behavioral therapy for a family would benefit treatment outcomes for depressed youth. … 178). Furthermore, the findings of attachment theory demonstrate that the family environment, especially at early ages, can have significant impact on brain structure in more fundamental ways, meaning that altering family outcomes could actually have significant impact on the underlying causes of depression and other forms of mental illness in youths. In short, there is a great deal of theoretical evidence that would seem to indicate that there should be measurably improved treatment outcomes for incidences where the family is heavily involved with cognitive behavioral therapy in addition to the depressed youth. In their study, however, Star et. al. (2011) found that there was actually no measurable difference in treatment outcomes for interventions that involved family cognitive behavioral therapy compared to individual cognitive behavioral therapy for the depressed youth. They found that there was, however, a positive correlation between treatment maintenance and family-based therapy, which makes sense: many incidences of youth depression obviously stem from family situations, and thus treatment for the depression itself will not stay as effective as treatment that also helps deal with some of the related family dynamics. Depressive episodes are thus more likely to relapse. On a related note, family members can help keep up treatment practices if also involved with treatment, and can probably develop a better understanding of how to support the depressed youth, adding an element of skill development to the mix. Based on the findings of the study, the authors question the validity of continued family therapy in cases of depressed youth, as it pulls resources from others who might need it more. The issue with the study, however, is that it was