Effect of a bereavement support group on female adolescents' psychological health: a randomised controlled trial in South Africa

Thurman, Tonya R.; Luckett, Brian; Nice, Johanna; Spyrelis, Alexandra; Taylor, Tory M.

doi:10.1016/s2214-109x(17)30146-8

Cited by 37 publications

(45 citation statements)

References 50 publications

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“…However, recent evidence has found no significant differences in overall effects between selective programs such as this one targeted to orphans and other vulnerable children, and indicative or universal depression prevention programs (Merry et al., ). Further, offering the intervention without baseline mental health criteria is consistent with other time‐limited structured peer‐support group interventions for orphans in sub‐Saharan Africa that have shown positive effects on depression (Kumakech et al., ; Thurman et al., ). Screening using depression inventories or other detailed diagnostic criteria requires a significant investment of time and resources which may impede implementation and scale‐up for organizations working in under‐resourced contexts.…”

Section: Discussionsupporting

confidence: 63%

“…Further, prior research highlights the value of preliminary work to adapt depression scales based on cultural considerations (Bolton, Wilk, & Ndogoni, ), a process not used in this study due to limited time to intervention roll‐out. While the CES‐DC has a successful history of use with South African youth (Martin et al., ; Thurman et al., ), additional research including local validation with representative community samples is needed to establish appropriate CES‐DC cutoff points among adolescents in this context. A prior study of IPTG in the United States suggests that alternative depression inventories may be even more sensitive to change, and advocates for the use of multiple instruments (Horowitz et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…The outcome of interest was depression symptomology measured using the 20‐item Center for Epidemiologic Studies Depression Scale for Children (CES‐DC; Faulstich, Carey, Ruggiero, Enyart, & Gresham, ; Weissman, Orvaschel, & Padian, ). The CES‐DC has been validated among youth in Rwanda (Betancourt, Scorza et al., ) and previously applied in South Africa (Martin, Viljoen, Kidd, & Seedat, ; Thurman et al., ). Questions assess the frequency of specific wellness or problem symptoms in the prior week including feelings of happiness, appetite, self‐esteem, energy levels, and difficulty sleeping (Cronbach's α = 0.82 at baseline).…”

Section: Methodsmentioning

confidence: 99%

“…A 2009 Cochrane review found no randomized controlled trials (RCTs) investigating psychological support interventions for children affected by HIV and AIDS in sub‐Saharan Africa (King, De Silva, Stein, & Patel, ). Since that time, two RCTs of structured peer‐support group interventions have found positive psychological effects, including reductions in depression symptomology (Kumakech, Cantor‐Graae, Maling, & Bajunirwe, ; Thurman, Luckett, Nice, Spyrelis, & Taylor, ). Evidence for the treatment of major depressive disorders among adolescents in low‐ and middle‐income countries, however, remains scarce (Klasen & Crombag, ).…”

Section: Introductionmentioning

confidence: 99%

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Mitigating depression among orphaned and vulnerable adolescents: a randomized controlled trial of interpersonal psychotherapy for groups in South Africa

Thurman

Nice

Taylor

et al. 2017

Child Adoles Ment Health

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Background: Children and adolescents affected by HIV are at elevated risk of depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa. Method: A cluster randomized controlled trial wherein adolescents ages 14-17 enrolled in community-based programming for HIV-affected and vulnerable families were randomly assigned by geographic cluster to participate in a 16-session IPTG intervention or the standard of care (n = 489). Baseline and postintervention surveys conducted with enrollees included standardized depression screening. Utilizing an intent-to-treat design, mixed effects models were performed to examine treatment effects for all participants and potential moderators including gender and baseline depression level (Clinical Trials registration: ClinicalTrials.gov NCT02386878). Results: While 23% of adolescents in the intervention group did not attend any IPTG sessions, average attendance was 12 out of 16 possible sessions among participants. The intervention was not associated with changes in depression symptomology. Conclusions: Results underscore the importance of mitigating participation barriers prior to intervention roll-out and the need for increased evidence for psychological health interventions to mitigate depression among orphaned and vulnerable adolescents. This intervention and the study selectively targeted at-risk adolescents versus using diagnostic mental health criteria for enrollment; more research is needed to identify the potential benefits and disadvantages of these approaches. Key Practitioner Message• Children and adolescents who have been orphaned due to AIDS or who are living with a chronically ill parent are at increased risk for depression; the need for effective interventions is high in generalized HIV epidemic settings like South Africa.• Interpersonal psychotherapy for groups (IPTG) delivered by lay practitioners has been evaluated in other populations in sub-Saharan Africa and found to be an effective method for treating depression.• Results from this cluster randomized controlled trial did not find IPTG delivered by community workers to be measurably associated with changes in depression symptomology among orphaned and vulnerable adolescents, regardless of gender or preexisting depressive symptomology.• The study took place within the context of rapid program expansion with a cadre of relatively inexperienced facilitators, which may have affected the results; nevertheless, such implementation challenges are common when scaling up interventions in resource-constrained environments. Intervention adjustments, quality control mechanisms, more specific enrollment criteria and efforts to promote participation may deliver better results.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mitigating depression among orphaned and vulnerable adolescents: a randomized controlled trial of interpersonal psychotherapy for groups in South Africa

Thurman

Nice

Taylor

et al. 2017

Child Adoles Ment Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, the psychological condition of bereavement is often ignored or misdiagnosed; indeed, few evidence-based bereavement support services are currently available. 9 During recovery from a pandemic and the reconstruction period, evidence-based psychological interventions for the bereaved are needed. The current lack of mental health care for the bereaved may due to a lack of mental health awareness, stigma and discrimination, or the lack of mental healthcare resources.…”

mentioning

confidence: 99%