Family Therapy for Children with Depression

Depressed patients tend to be aversive to others and also feel victimized by them. They frequently engage in escalating negative exchanges. One of Treatment of depression in children is family therapy, in addition there are other psychotherapies such as cognitive behavior therapy, music therapy and other that may contribute to treating depression.

Depressed patients and their family members tend to verbalize negative, subjective feelings more frequently than non depressed couples, whose communications are more task oriented. The marriages of depressed women (or men) are characterized by friction, poor communication, a lack of affection, withdrawal, and a tendency for the nondepressed spouse to view his or her spouse as accusatory.

Children of depressed parents are at risk for many diagnosable psychological problems, a rate as high as 40%-50%. The risk to children is increased if 1) the depressed person's spouse becomes depressed or is an available to the child, 2) there are marital problems or divorce, and 3) there is no supportive relationship with another adult.

Family-based interventions with depressed patients are based on an integration of family systems theory psychoeducational model, psychodynamic theory and attachment theory within a developmental model. The role of nondepressed parent in enhancing the coping capacity of the family is crucial.

Brent et al have reported that Cognitive behavior Therapy is more effective than structural family therapy with depressed adolescents at the end of treatment but equally effective in 2-year follow-up. When methodological issues are put aside, structural family therapy as practiced by the group may not have addressed crucial family issues for depressed adolescents such as poor attachment and low affective involvement between the parents and children. Beardslee's comprehensive preventive model to reduce the likelihood of transmission of depression from the parents to the children remains dominant in the field.

Family therapy with children who depressed or other symptom of mood disorders describes the clinical process and office arrangements that are most welcoming toward the children. The office should be equipped with toys that are conductive to imaginative play; paper and crayons provide unlimited possibilities for drawing and expression of fantasies. A special attempt should be made to include the children in the depression treatment process by using age-appropriate methods of communication for the child. Long and complex discussions discourage children from participating and should be avoided. The observational data on families with young children are especially significant. Techniques for family therapy with children have been described by Zilbach and Chasen and White. Sholevar has described in detail the process of initial and diagnostic family interview.

Often, family therapy with children who depressed can disclose physical or emotional child neglect. When family support is potentially available, family intervention can mobilize and rehabilitate family resources to provide the necessary nurturance to resume the child's developmental progress. When such resources are not present, enabling the family to search for an alternative living situation with the help of social agencies may be necessary