Tuesday, June 02, 2009

Schools can prevent depression in students

After yesterday's 9th Circuit opinion absolving a school bully (an adult) of the suicide of a student, the following article seemed particularly important. Of course, my guess is that there was no group therapy option at Ontario-Mountclair School District. So Gene Bennett did what he thought vice principals are supposed to do: make sure that kids who broke rules thoroughly understood how worthless they were.

Group Therapy Prevents Depression in Teens, Study Finds

New York Times
June 2, 2009

Depression often strikes during adolescence, and teenagers whose parents have a history of depression are at particularly high risk. Now, a large clinical trial has found that a group cognitive behavioral program that teaches coping and problem-solving skills to these high-risk teens can reduce their risk of developing the mood disorder.

But the success rate of the prevention program varied greatly depending on the mental health status of the teenagers’ parents at the time they began intervention, the study also found. The program was much more effective than standard care if the teens’ parents were also without depression when the intervention began.

The study was published in this week’s Journal of the American Medical Association.

“Were we surprised? No,” said Judy Garber, a professor of psychology and human development at Vanderbilt University in Nashville. “There is evidence in the literature that kids don’t respond as well to treatment if the parent is depressed.”

John Weisz, a professor of psychology at Harvard University who was not involved in the trial, said the results may help identify the best candidates for the prevention program.

He said there were several reasons why treatment may be less effective when an adolescent’s parent is depressed. “It may be the biological risk for depression is greater in these adolescents — that if the parents were once depressed but aren’t depressed any longer, the biological risk isn’t as great," he said.

Another possibility is that living with a depressed parent is difficult and stressful for a child, he added, while a third possibility is that teenagers model their parents’ behavior.

The new study is a randomized controlled clinical trial conducted in four cities: Nashville, Boston, Pittsburgh and Portland, Ore. The trial included 316 adolescents between the ages of 13 and 17, all of whom had parents who were depressed or had been depressed at some earlier point in the child’s life.

The teenagers were randomly assigned to either the prevention program, which consisted of eight weekly 90-minute group sessions followed by six monthly sessions, or to receive only the usual care.

While almost one-third of the teens who got the usual care developed depression during the eight months of the study, only 21 percent of teens who participated in the prevention program became depressed.

But among teens whose parents were free of depression when the intervention started, the impact of the prevention program was more dramatic. Only 11.7 percent of those teens became depressed, compared to 40.5 percent of teens with healthy parents who received the usual care.

Among teenagers whose parents were depressed, the cognitive behavioral program was only slightly more effective. Some 31.2 percent of these adolescents went on to become depressed themselves, compared with 24.3 percent among those who received the usual care. The researchers said that difference was not statistically significant.

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