Clinicians can enhance resiliency in children whose parents suffer from depression through short-term interventions. A recent study shows that when clinicians meet with immediate family members of a depressed parent and educates them about the disease in relation to their concerns and experiences, the results are significantly better than simply educating them in a lecture format.

Parents who participated in the clinician-led sessions reported a better understanding of their illness and increased communication with their children. They also understood more fully how their disorder affected their children and developed new ways of helping them become more resilient such as encouraging their involvement in activities, according to William Beardslee, M.D., psychiatrist in chief at Children’s Hospital in Boston.

The lecture and clinician-led interventions focused on education about depression, the risks to children, and promoting resiliencies or protective factors in children. However, the duration and the format of the sessions differed.

In the lecture format, parents were given two one-hour lectures by Beardslee and encouraged to talk to their children. In the other format, clinicians met with individual families for an average of seven sessions and related the educational material to the family’s experiences and concerns about the disorder. The clinician also advised the parents on how to explain the disorder to their children and emphasized that the mental illness was a biological disease and the affected parent was not to blame.

The children in the clinician-led sessions reported increased understanding of the parent’s mood disorder, less guilt and self-blame, and improved functioning, noted Beardslee, who presented his research on children of parents with affective disorders at the October meeting of the American Academy of Child and Adolescent Psychiatry in Chicago.

"Depression is a disorder that affects all family members. It increases marital conflict and interferes with the parents’ ability to focus on their children," said Beardslee.

Having a parent with an affective disorder is a potent risk factor for depression, and an estimated 50 percent of such children develop depression by the time they reach adolescence, according to Beardslee.

Thirty-six families were recruited from an HMO in the Boston area to participate in either the clinician-led intervention or lectures. At least one parent in each family had experienced an episode related to a major affective episode in the previous 18 months. The families were assessed on several clinical measures prior to the intervention and again at approximately 69 weeks. Families were included in the study if they had children between the ages of 8 and 15 who had never been treated for a psychiatric illness, according to the study published in the February 1997 Journal of the American Academy of Child and Adolescent Psychiatry.

A clinician met with the parents first and obtained a history and assessment of each family member before meeting with each child later. The parents were encouraged to hold a family meeting facilitated by the clinician to discuss particular concerns and give family members a chance to express theirs.

"Depression imposes a vale of silence upon the entire family, so when a family member starts to talk about the illness, it opens up communication in other areas," observed Beardslee.

More parents in the clinician-led group reported developing new coping strategies for their children to enhance their resiliency than the parents in the lecture group did. This included ensuring that the children were involved in relationships with peers and other adults and reassuring them that they were not responsible for their parent’s symptomatic behavior, according to Beardslee.

"A depressed parent often feels that he or she has damaged the children for life. Educating them about the disease and what actions they can take makes an enormous difference," said Beardslee