Keeping company with hope and despair: family therapists' reflections and experience of working with childhood depression

Abstract

The BIOMED international outcome study on childhood depression offered a unique opportunity for the systematic treatment of children and families with major depression using systemic psychotherapy. This paper describes the experiences of clinicians working with the families referred and the theoretical and clinical models that evolved during the treatment process. The concept of 'keeping company with hope and despair' emerged as an overarching framework for thinking about the quality of the therapeutic relationship in this developing area of clinical practice. We illustrate our systemically informed interventions with case examples and discuss the role played by therapists' 'use of self ' in engaging and fostering change in families gripped by depression. IntroductionOur recent contribution to the development of research and clinical practice in the area of childhood depression (Campbell et al., 2005) led to conversations between us about the importance of a therapist's experience when working in this clinical area. This article is about what is demanded of systemic psychotherapists embarking on family work where a child has been diagnosed with depression. It speaks to the emotions we experienced both during and after family sessions and what sense we have made of these in order to work effectively. A systematic approach to clinical discussion among clinicians proved to be the key to theory building and the interventions described. This paper demonstrates what happens when clinicians talk and think together about what they do. Its conclusions about working with childhood depression have emerged from reflecting on the emotive experience of the therapist during the therapeutic encounter. We do r The Association for Family Therapy 2007. Published by Blackwell Publishing,

Depressed youth: treatment outcome and changes in family functioning in individual and family therapy

“…The trial was implemented in three clinical settings in Europe: the Tavistock Clinic, London, the Aghia Sophia Children's Hospital, Athens and the Hospital for Children and Adolescents, Helsinki. Previously reported results that both FIPP and SIFT resulted in a marked and sustained improvement in children's depression (see Trowell et al, 2007 for a more detailed description of the project and outcome and Pentecost and McNab, 2007 for experiences of clinicians working with the families and the theoretical and clinical models that evolved during the treatment process). In the present study we explored the significance of family functioning, as assessed by mothers and family therapists, as an element of therapeutic change in youth depression in individual and family therapy.…”

Thematic review of family therapy journals in 2007

“…Pruitt (2007) gave an overview of structural, interpersonal and attachment-based family therapy for depression in adolescent boys and concluded that there was some evidence for the effectiveness of each of these approaches to treatment. Pentecost and McNab (2007) described how the concept of 'keeping company with hope and despair' emerged as an overarching framework for thinking about the quality of the therapeutic relationship when working with depressed young people and their families within the context of a controlled trial (which is mentioned below in the section on research (Trowell et al, 2007)). On a similar theme, Flaskas (2007) explored the dynamics of hope and hopelessness within intimate relationships, and their embeddedness in wider social and historical processes.…”

Διερεύνηση Των Ψυχικών Παραμέτρων Και Των Κοινωνικών Δεξιοτήτων Στην Προσαρμογή Των Παιδιών Με Μαθησιακές Δυσκολίες Στην Α/Θμια Εκπαίδευση

“…Παρόλα αυτά επισημαίνεται ότι η κατάθλιψη στα παιδιά, πολλές φορές παραμένει αδιάγνωστη (Son & Kirchner, 2000). Σ' αυτό συμβάλλει η ανάγκη του ενήλικα να πιστεύει στην ελπίδα και την υπόσχεση της παιδικής ηλικίας, που τον εμποδίζει να αποδεχθεί τα συμπτώματα απελπισίας και κατάθλιψης σ' ένα παιδί (Pentecost & Mc Nab, 2007). Ως εκ τούτου καθίσταται σημαντική η πρόωρη διάγνωση και αντιμετώπιση της διαταραχής, γιατί δίνουν τη δυνατότητα για σχεδιασμό αποτελεσματικότερων παρεμβάσεων πρόληψης στην παιδική ηλικία, αποφεύγοντας έτσι την εμφάνιση χρόνιας ψυχοπαθολογίας στην ενήλικη ζωή (Maughan, Collishaw & Stringaris, 2013).…”