Child and adolescent psychiatric clinics of North America
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There is solid evidence that active and goal-oriented cognitive-behavioral or relationship-focused therapies are generally superior to more generic therapies or to no treatment for clinically diagnosed and for undiagnosed but symptomatic youths. Between 50% to 87% of diagnosed youths who received a targeted treatment had recovered from their depressive episodes, in comparison to 21% to 75% of those who received some other generic therapy and 5% to 48% of wait-listed youths. The cognitive behavioral and relationship-oriented interventions that were tested tended to be even more successful in reducing depressive symptoms in school-based samples, possibly because the participants in the school-based studies may have been less disturbed than the clinically diagnosed cases. ⋯ It also appears that group interventions may be used as profitably as the more traditional individual therapy formats. And although parental participation in empiric treatment trials of pediatric depression has been limited to either separate parent groups as an adjunct [20,21 or family therapy [7], it can be argued that for various practical and clinical reasons [30] direct involvement of parents may be a wise choice. Parents may be critical to the success of interventions with depressed children and should be regarded as potential important agents of change.
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Child Adolesc Psychiatr Clin N Am · Jul 2002
Depression among youth in primary care models for delivering mental health services.
This article emphasizes the promise of efforts to improve care for depression within the primary care setting. These efforts, however face a number of potential obstacles. We have reviewed the literature on the detection and treatment of depression among youth in primary care settings and argue that primary care offers underutilized potential for reaching out to youth and improving access to high-quality care for depression. ⋯ These models build on the strengths of primary care settings and relationships and suport primary care providers with resources that enables them to expand with diagnostic and treatment targets to include depression and other mental health problems. The recent and ongoing studies reviewed in this articles provide some examples of these models. Future research is needed to clarify the effectiveness, costs,and benefits of this approach.