Preventing Youth Depression: A Multimedia Internet-Based Parent Program

DESCRIPTION (provided by applicant): Depression is one of the most prevalent mental disorders to afflict adolescents. It seriously impacts role functioning and typically takes a recurrent or chronic course. There is also mounting evidence for familial transmission of depression. Because most depressed youth never receive treatment, there is a critical need to develop easily accessed prevention programs. This project will develop and test an interactive multimedia intervention aimed at preventing youth depression by teaching parents skills for intervening with their children. The program integrates two empirically validated approaches for intervening with youth using interactive multimedia technology: cognitive-behavioral skills training and parenting skills training techniques. An empirically tested framework will be adapted for self- administration via the Internet or CD-ROM. The intervention will consist of six knowledge- and skills-based intervention sessions: education about youth depression, mood and activity monitoring, positive thinking, pleasant activity engagement, linking mood and activities, and planning for the future. Additional browser (i.e., unrestricted access) modules will include: self-screening for depression, enhancing personal relationships, learning to relax, improving communication and problem-solving, depression resources, and parenting resources. The competency-based instructional design will be structured for multiple sessions using self-paced video-based tutorials, family member and peer testimonials, and behavior modeling vignettes. The program will be targeted to three user groups: single mothers, single fathers, and couples. The basic structure of the program will be the same for each target population, but specific content will be customized to each group. The Phase I prototype, targeted to single mothers of 11 to 14-year-olds reporting elevated depressive symptoms, provided training on understanding depression, monitoring mood, and engaging in pleasant activities. A within-subjects pre-post design tested the feasibility of the program in which participants were followed over a 1-week period. The results indicated significant pre-post change in parent knowledge and self- efficacy to use the skills taught as well as youth depressive symptomatology, mood, and pleasant activity engagement. Subjects found the program easy to use and gave it high user satisfaction ratings. The Phase II product will be evaluated in a large randomized trial (N = 320 parent-child dyads); participants will be followed over a three-month period. Results are expected to show increased parent knowledge of and self-efficacy for using the cognitive-behavioral skills taught as well as improvement in parenting skills; these changes in parent outcomes are expected to mediate the association between intervention condition and decreases in youth depressive symptomatology. The potential commercial applications of the Phase II product are to employee assistance programs, health plans, and disease management organizations. PUBLIC HEALTH RELEVANCE: Depression is one of the most prevalent mental disorders among adolescents, however most go untreated. Parents play a significant role in their child's mental health yet lack access to support services and training programs. Given the evidence that cognitive-behavioral therapy and parenting skills training are both effective intervention strategies to help prevent youth depression, there is a critical need to develop a training program for parents incorporating these approaches that can be easily implemented and widely disseminated.