Non–medication intervention for depression that has been used with Latino adolescents

June 2004

Is there a non–medication intervention effective for depression that has been used with Latino adolescents?

Several reviews have concluded that there are very few well-controlled studies on the efficacy of various treatment modalities for childhood depression—especially using psychological and traditional psychotherapy approaches. The few studies and reviews available show that cognitive–behavioral therapy (CBT) and interpersonal psychotherapy (IPT) seem to be the most effective non psychopharmacological interventions in the treatment of depressed youth. Most of these studies have not included Latino youth, despite the fact that they are one of—if not the largest—minority group of children in this country. However, Latino youth on the main land and in Puerto Rico have been included in IPT studies with results that are more positive than CBT or being wait listed for treatment.

IPT is a short-term psychotherapy approach that has as its premise that unipolar, nonpsychotic depression can be explained by problems in interpersonal relationships. The primary goals are to identify and treat the depressive symptoms and identify the problem areas associated with the onset of the depression. The focus is on the present and future and the resolution of problems and disputes. The primary problem areas targeted by IPT are (a) grief, (b) interpersonal disputes, (c) role transitions, and (d) interpersonal deficits — socially isolated, socially unfulfilled, and chronically depressed. These are all issues that are often part of adolescent development. In IPT there are 12 weekly sessions that are divided into approximately three groups of 4 sessions each. Initial sessions (1 to 4) aim to obtain information about the symptoms of the youth's depression and its development; educate the youth, family, and if appropriate, the teacher about depression; explain what IPT is; evaluate interpersonal relationships; identify main problems; and with input from the youth and family, establish a treatment plan that includes a clear description of what is expected of the youth, family, and provider. The intermediate sessions (5 to 8) are aimed at helping the youth work on the selected interpersonal problem, monitor depressive feelings, and facilitate a positive therapeutic relationship. Assertiveness and relaxation trainings and role play are often included during this period. During the last 4 sessions (9 to 12), termination is discussed, feelings are acknowledge related to separation, the course of treatment and symptoms are reviewed, and the patient's interpersonal competence is recognized.

Manuals for this treatment can be obtained by contacting Laura Mufson, Ph.D. at Columbia University in New York; and Jeannette Rossello,Ph.D. at the University of Puerto Rico.

Technical Assistance Partnership for Child and Family Mental Health

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	June 2004 Is there a non–medication intervention effective for depression that has been used with Latino adolescents? Several reviews have concluded that there are very few well-controlled studies on the efficacy of various treatment modalities for childhood depression—especially using psychological and traditional psychotherapy approaches. The few studies and reviews available show that cognitive–behavioral therapy (CBT) and interpersonal psychotherapy (IPT) seem to be the most effective non psychopharmacological interventions in the treatment of depressed youth. Most of these studies have not included Latino youth, despite the fact that they are one of—if not the largest—minority group of children in this country. However, Latino youth on the main land and in Puerto Rico have been included in IPT studies with results that are more positive than CBT or being wait listed for treatment. IPT is a short-term psychotherapy approach that has as its premise that unipolar, nonpsychotic depression can be explained by problems in interpersonal relationships. The primary goals are to identify and treat the depressive symptoms and identify the problem areas associated with the onset of the depression. The focus is on the present and future and the resolution of problems and disputes. The primary problem areas targeted by IPT are (a) grief, (b) interpersonal disputes, (c) role transitions, and (d) interpersonal deficits — socially isolated, socially unfulfilled, and chronically depressed. These are all issues that are often part of adolescent development. In IPT there are 12 weekly sessions that are divided into approximately three groups of 4 sessions each. Initial sessions (1 to 4) aim to obtain information about the symptoms of the youth's depression and its development; educate the youth, family, and if appropriate, the teacher about depression; explain what IPT is; evaluate interpersonal relationships; identify main problems; and with input from the youth and family, establish a treatment plan that includes a clear description of what is expected of the youth, family, and provider. The intermediate sessions (5 to 8) are aimed at helping the youth work on the selected interpersonal problem, monitor depressive feelings, and facilitate a positive therapeutic relationship. Assertiveness and relaxation trainings and role play are often included during this period. During the last 4 sessions (9 to 12), termination is discussed, feelings are acknowledge related to separation, the course of treatment and symptoms are reviewed, and the patient's interpersonal competence is recognized. Manuals for this treatment can be obtained by contacting Laura Mufson, Ph.D. at Columbia University in New York; and Jeannette Rossello,Ph.D. at the University of Puerto Rico.