Improving care. Changing lives.

Preventive Intervention

 

The Preventive Intervention Project was originally designed to examine the efficacy of two forms of cognitive, psychoeducational, preventive intervention: clinician-facilitated and lecture discussion group interventions. The project targeted families in which one or both parents had experienced serious affective disorder, and in which there were children in the 9 to 14 year age range who were not acutely ill. Overall, both interventions were found to have long-term positive effects, but the clinician-facilitated intervention was associated with more positive change in parents and in children.  

Recently, the original clinician-facilitated intervention program has been adapted for new settings and populations locally, nationally and internationally.  Current efforts are underway to adapt the revised clinician-facilitated intervention (i.e., Family Talk) for use on the Internet.

The overarching purpose of this project is to explore the effectiveness of two forms of cognitive, psychoeducational, preventive intervention: clinician-facilitated and lecture discussion group interventions. The project targeted families in which one or both parents had experienced serious affective disorder, and in which there were children in the 9 to 14 year age range who were not acutely ill. Families were recruited from a variety of sources, including Harvard Pilgrim Health Care.

Families were then randomly assigned to either the clinician-based or lecture-based interventions. Equal numbers of families received the clinician-based intervention and the lecture. The clinician-based intervention contained six sessions and led to a family conversation about depression and how to overcome it.  Both forms of the intervention were designed to be public health interventions to be widely used.  Both were expected to provide significant help to families with the clinician-based intervention providing greater help.  All family members were assessed before and after the intervention and re-interviewed at six to nine months intervals over at least five years to evaluate the effectiveness of the two forms of intervention.  

Both the clinician-facilitated and lecture discussion groups were found to be safe and effective.  Both groups reported satisfaction and benefit and furthermore, both forms of intervention were associated with a reduction in the kinds of symptoms associated with developing depression in the future.  There were important differences in the groups as well. Children in the clinician facilitated group reported greater understanding of parental illness. Parents in the clinician facilitated group reported more changes in how they relate to their children. Our most important finding was that the benefits of participating in either form of intervention were sustained over many years.

We are now completing the eighteenth year of the Preventive Intervention Project.  Our current work involves implementing what we have learned from this study into treatment programs both in the U.S., Canada, and Scandinavia. This work has received high ratings from the National Registry of Effective Programs (NREPP). We have developed adaptations for inner city and Latino families.  Manuals for the intervention are available from Dr. Beardslee who has also written a book for families on how they can overcome depression. 

References:

  1. Beardslee, W.R. When a parent is depressed:  How to protect your children from the effects of depression in the family.  Originally published in hardcover under the title, Out of the darkened room:  When a parent is depressed:  Protecting the children and strengthening the family, by Little, Brown and Company, June 2002.  First paperback edition, December 2003. 
  2. Beardslee, W.R., Gladstone, T.R.G., Wright, E.J., & Cooper, A.B.  A family-based approach to the prevention of depressive symptoms in children at risk: Evidence of parental and child change.  Pediatrics, August 2003, 112(2), e119-e131.
  3. Beardslee WR, Wright EJ, Gladstone TRG, & Forbes P.  Long-term effects from a randomized trial of two public health preventive interventions for parental depression.  J Family Psychol (In Press). 
  4. Podorefsky, D.L., McDonald-Dowdell, M., & Beardslee, W.R.  Adaptation of preventive interventions for a low-income, culturally diverse community.  Journal of the American Academy of Child and Adolescent Psychiatry, August 2001, 40:8: 879-886.