Rural American Indian (AI) middle school students with depressive symptoms who participated in a culturally modified version of the Adolescent Coping with Depression (CWD-A) course (n = 8) reported significant improvement in depressive symptoms at post-intervention and at 3-month follow-up. There was also a nonsignificant but clinically relevant decrease in participants' anxiety symptoms. Students reported satisfaction with the intervention, and it was potentially more cost-effective and less stigmatizing than the individualized treatment-as-usual interventions to which it was compared. These results suggest the CWD-A is a promising approach for reducing depressive and anxiety symptoms in rural AI students and should be further evaluated with a larger sample of students.

Although parent-report measures continue to demonstrate higher levels of symptoms for siblings of children diagnosed with ADHD compared with control siblings, there are no indications that self-reported internalizing symptoms are different.

Parent behavior management and child social skills training programs have demonstrated efficacy in clinical research settings and are highly efficient treatment modalities. Few studies have examined their effectiveness and efficiency within the typical clinical setting. The current paper examines the use of a concurrent parent behavior management and child social skills training program, evaluating the current sample, which consists of 22 children (ages 5-10) and their guardians, as well as two previous typical clinical samples. The Eyberg Checklist was utilized to assess pre and post treatment intensity scores for childhood externalizing symptoms, with an average treatment effectiveness of 0.89 standard deviations. This is consistent with previous findings (Tynan, et al., 1999; Tynan, et al., 2004) and further demonstrates the effectiveness of the concurrent parent and child training approach as utilized within the typical clinical setting.