Engaging Parents in CBT for Depressed Youth: An Evaluation of the Effects of the Modular Act and Adapt Program (MAAP) Parent Module

Introduction:

Mood disorders, including depression, are among the most pervasive mental health problems in adolescence. Recent epidemiological data reveal that ethnic minority youth are less likely to receive mental health services, compared to youth from other racial and ethnic groups (Merikangas et al., 2010). Although evidence supports cognitive behavioral therapy (CBT) as an efficacious treatment modality across a large number of youth and adult disorders (Butler et al., 2006), only a handful of studies have evaluated its efficacy among minority youth (e.g., Rosselló et al., 2008). Additionally, despite the established link between a range of parent indicators and child mental health outcomes (e.g., Mellick et al., 2015), less is known about parental involvement in CBT interventions.

Methods:

This study describes the successful implementation of a parent module to complement a 10 session, group-based CBT intervention for depression delivered at schools with low income, urban minority youth. The parent module consisted of 2-3 meetings aimed to 1) build stronger relationships with parents, 2) increase engagement through transparency and psychoeducation, 3) monitor treatment progress and tailor services, and 4) praise youth participation and accomplishments. Additionally, this study explores the collateral effects of treatment in parental outcomes. Some outcomes include expressed emotion (EE), a construct defined by high criticism, hostility and emotional over-involvement; attachment; and parenting behaviors. EE, for instance, has been consistently linked with mental and physical health problems in youth, particularly among those with mood disorders (Peris & Miklowitz, 2015). Data were collected as part of a randomized control trial in six Chicago public schools. Participants include 55 youth (M_age = 11.2; 55% female) and their mothers. EE was assessed using the Brief Dyadic Scale of Expressed Emotion (Medina-Pradas, et al., 2011). Attachment was assessed using the Inventory on Parent and Peer Attachment (Armsden & Greenberg, 1987). Parenting behaviors were assessed using the Children’s Report of Parent Behavior Inventory (Schaefer, 1965).

Results:

Preliminary results show a significant effect of the intervention in youth depression scores, F(1,52)=5.97, p<.05. Further analyses will explore the effects of the intervention on parental factors such as EE, parenting behaviors, and attachment. Moderation of parental factors on youth outcomes will also be assessed. Finally, parental participation and satisfaction with the parental module will be evaluated.

Conclusions:

These results make an important contribution to the literature by providing a successful model of parental inclusion in an intervention for youth, and an indication of its potential stratified effects on parents.