The effectiveness of an Attachment-Based Family Therapy on adolescent depression in Iran

10.18258/8248 ◽  
2016 ◽  
Author(s):  
Mahsa Movahed Abtahi Mahsa Movahed Abtahi
Keyword(s):  
Family Therapy ◽  
Adolescent Depression

scholarly journals Effectiveness of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2020 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Adolescent Depression ◽  
Depression Scale ◽  
Post Treatment ◽  
Treatment Manual ◽  
Future Research ◽  
Hamilton Depression Scale ◽  
Treatment As Usual

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed clinician-rated by blinded evaluators (Hamilton Depression Scale, HAMD)at baseline and post-treatment with the Hamilton Depression Scale (HAMD).and Sself-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment.Conclusion: ABFT was not associated with more favorable outcomes thannot superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s limitations and implementation challenges. These finding scall forContinued efforts to improve treatment for MDD in outpatient clinics are warranted . Policies on implementation of evidence based treatments already available are essential. Future research may focus onshould examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings.Trial Registration: Clinicaltrials.gov identifier: NCT01830088https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

scholarly journals Effectiveness of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2020 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Adolescent Depression ◽  
Depression Scale ◽  
Post Treatment ◽  
Treatment Manual ◽  
Future Research ◽  
Hamilton Depression Scale ◽  
Treatment As Usual

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the effectiveness of ABFT compared with Treatment as Usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9), with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were clinician-rated (Hamilton Depression Scale, HAMD) and self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority(63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment.Conclusion: ABFT was not associated with more favorable outcomes than TAU Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. These findings call for continued efforts to improve treatment for MDD in outpatient clinics. Policies on implementation of evidence based treatments already available are essential. Future research may focus on moderators of and mechanisms for individual differences to treatment response.Trial Registration: Clinicaltrials.gov identifier: NCT01830088https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

scholarly journals Efficacy of attachment-based family therapy compared to treatment as usual for suicidal ideation in adolescents with MDD

2020 ◽  
pp. 135910452098077
Author(s):  
Luxsiya Waraan ◽  
Erling W Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Lars Mehlum ◽  
Marianne Aalberg
Keyword(s):  
Family Therapy ◽  
Suicidal Ideation ◽  
Adolescent Depression ◽  
Treatment Manual ◽  
Parent Child Relationship ◽  
Treatment As Usual ◽  
Treatment Groups ◽  
Empirically Supported ◽  
Child Relationship ◽  
Clinically Depressed

Attachment-Based Family Therapy (ABFT) is the only empirically supported family therapy model designed to treat adolescent depression, including those at risk for suicide, and their families. ABFT aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. To study the effectiveness of ABFT compared with Treatment as Usual (TAU) in reducing suicidal ideation in clinically depressed adolescents. Sixty adolescents (86.7% girls), aged 13 to 18 years ( M = 14.9), with major depressive disorder referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions according to the treatment manual. Suicidal ideation was measured with the Suicidal Ideation Questionnaire-Junior at 4, 6, 8, 10, 12, 14, and 16 weeks. Linear mixed models were fitted to test our hypothesis, time was the only factor to have a significant effect on suicidal ideation t(31.05) = −3.32, p < .01. Participants in both treatment groups reported significantly reduced suicidal ideation, but the majority were still in the clinical range after 16 weeks of treatment. ABFT was not associated with more favorable outcomes than TAU. Findings must be interpreted with caution given the study limitations.

scholarly journals Effectiveness of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics 

2020 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Adolescent Depression ◽  
Depression Scale ◽  
Post Treatment ◽  
Treatment Manual ◽  
Future Research ◽  
Hamilton Depression Scale ◽  
Treatment As Usual

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment.Conclusion: ABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s limitations and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted . Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings.Trial Registration: Clinicaltrials.gov identifier: NCT01830088https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

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