lication trial highlights the concept that preventive interventions targeting the children of depressed parents may not be sufficient unless the depressed parent is also adequately treated.

As described in Chapter 4, parenting skills and practices are disrupted and impaired in parents with depression. Therefore, a third approach to preventive intervention for their children is to address parenting as a mediator of the effects of the depression. Many parent training approaches have demonstrated effectiveness on a range of child and parent outcomes (Kaminski et al., 2008; National Research Council and Institute of Medicine, 2009). However, only a few parenting interventions have been specifically designed to improve the quality of parenting by depressed parents or have been evaluated specifically in a population of depressed parents.

There is some evidence, however, on the relative effectiveness of parenting interventions for parents with depression in evaluations of more broadly targeted parenting interventions. On one hand, some parenting interventions have been shown not only to improve outcomes for children of depressed parents but also to reduce depressive symptoms in parents. On the other hand, elevated symptoms of depression have been found in some studies to limit the effectiveness of parenting interventions. Thus, although parents who are struggling with depressive symptoms may be less likely to benefit from efforts to improve their parenting skills, participation in parenting interventions can contribute to a reduction in parents’ depressive symptoms and improve child outcomes.

Many of the treatment and preventive interventions described earlier in this chapter and in Chapter 6 that target depression in postpartum women have not assessed outcomes for children or focused on the parenting relationship. However, there is a robust literature on approaches in early childhood that foster interactions between mothers and infants or toddlers, and some of these approaches have been evaluated in mothers with depression or depressive symptoms. In these evaluations, these interventions have shown positive effects on parent-child interactions, indicating that these interventions can be effective even in the presence of maternal depression and in both low-income mothers and more generalized populations. Some have also been shown to treat maternal depression.

Horowitz et al. (2001) evaluated interaction coaching in the setting of home visits for depressed mothers with the goal of improving maternal responsiveness or the mother’s ability to accommodate to an infant’s behavior