Family-Based Interpersonal Psychotherapy for Depressed Preadolescents: Examining Efficacy and Potential Treatment Mechanisms

Abstract

Objective To conduct a randomized controlled trial to evaluate the preliminary efficacy of family-based interpersonal psychotherapy (FB-IPT) for treating depression in preadolescents (ages 7–12) as compared to child-centered therapy (CCT), a supportive and nondirective treatment that closely approximates the standard of care for pediatric depression in community mental health. Method Preadolescents with depression (N=42) were randomly assigned FB-IPT or CCT. Pre- and posttreatment assessments included clinician-administered measures of depression, parent- and child-reported depression and anxiety symptoms, and parent-child conflict and interpersonal impairment with peers. Results Preadolescents receiving FB-IPT had higher rates of remission (66.0% vs. 31%), a greater decrease in depressive symptoms from pre- to posttreatment, and lower depressive symptoms at posttreatment (R2=0.35, Δ R2 = 0.22; B= -8.15, SE= 2.61, t(37)= -3.13, p=0.002, F2=0.28) than did preadolescents with depression receiving CCT. Furthermore, preadolescents in the FB-IPT condition reported significant reductions in anxiety and interpersonal impairment than did preadolescents in the CCT condition. Changes in social and peer impairment from pre- to posttreatment were associated with preadolescents’ posttreatment depressive symptoms. There was a significant indirect effect for decreased social impairment accounting for the association between the FB-IPT and preadolescents’ posttreatment depressive symptoms. Conclusion Findings indicate FB-IPT is an effective treatment for preadolescent depression and support further investigation of interpersonal mechanisms by which FB-IPT may reduce preadolescent depression. Clinical trial registration information Phase II Study of Family Based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents; http://clinicaltrials.gov/show/NCT02054312; NCT02054312.

Interpersonal Psychotherapy for Adolescents With Mood and Behavior Dysregulation: Evidence-Based Case Study

“…IPT-A has been included in the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-Based Programs and Practices, American Psychological Association evidence-based treatments, and the Academy of Child and Adolescent Psychiatry’s practice parameters. Preliminary evidence also suggests benefits of IPT for preadolescent depression (Family-Based Interpersonal Psychotherapy for Depressed Preadolescents; Dietz, Weinberg, Brent, & Mufson, 2015) and bipolar disorder in adolescents (Interpersonal and Social Rhythm Therapy for Adolescents with Bipolar Disorder [IPSRT-A]; Hlastala, Kotler, McClellan, & McCauley, 2010). …”

Recent developments in the treatment of major depressive disorder in children and adolescents

“…IPT was adapted so there was much greater parental involvement—family based interpersonal therapy (FB-IPT). FB-IPT was more effective than more individually based client-centred therapy for 38 children aged  7–12 years with a depressive disorder (remission rates 66% vs 31%, p=0.04) 21. A recent moderate-sized (n=154) study showed FT to be more effective than individual therapy for children aged 7–14 years with depression 22.…”

Pilot effectiveness evaluation of community-based multi-family psychoeducational psychotherapy for childhood mood disorders.

“…While CBT is the only well-established theoretical orientation for school-aged children with depression, a recent RCT reported promising findings for Family-Based IPT with this younger age group (Dietz, Weinberg, Brent, & Mufson, 2015). CBT teaches symptom management strategies, including scheduling and engaging in pleasant activities, identifying and challenging negative thoughts, relaxing the body, and effectively solving problems.…”