. "7 Prevention of Adverse Effects." Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press, 2009.
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Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention
relevance to Hispanics (Muñoz et al., 1995), African Americans (Napholz, 2005; Phillips, 2000), and American Indians (Manson and Brenneman, 1995) showed promising results. Similarly, many of the interventions described in this chapter, particularly those targeted to early childhood, were evaluated primarily in minority populations, and thus have demonstrated effectiveness in these groups.
In other cases, such as the Family Talk Intervention, trials subsequent to the pilot study have focused on culturally specific adaptations for new populations. As described earlier, the Family Talk Intervention was adapted for use with inner-city, single-parent, minority families with positive results (Podorefsky, McDonald-Dowdell, and Beardslee, 2001). The intervention approach has also been recently adapted for use with Hispanic clients, and a manual for the conduct of the intervention in Spanish has been developed. The modifications include delivering the intervention both in English and Spanish, a focus on acculturation stress and the immigration experience as well as depression, flexibility in delivering the sessions, and careful attention to treating the families with respect. An open trial involving nine families with pre- and postassessment receiving the clinician-centered intervention has shown that it is safe and feasible and led to significant changes in behaviors and attitudes toward the illness. The families also had high scores on a standard self-report rating of the parents’ therapeutic alliance with the therapist providing the intervention (D’Angelo et al., 2009).
Future work on interventions to serve families with depression can also draw on the example of successfully adapted interventions in related domains. For example, Beeber, Perreira, and Schwartz (2008) have adapted an intervention to increase social support for low-income mothers, including recently immigrated Latina women. The Incredible Years, a parenting program described earlier in this chapter, can also serve as an informative model for successful wide adaptation of a parenting intervention.
PREVENTION APPROACHES IN COMMUNITY SETTINGS
Community and faith-based organizations may offer an important setting for education and other prevention programs for families with depression, especially in some minority communities. In many rural and low-income communities, churches are the primary institutions of social support, and community settings may offer the most promise for access to needed interventions. However, there are important questions about capacity and whether organizations in these settings have the knowledge, education, and skilled staff necessary to implement programs.
Schools have been a more common setting for preventive interventions for children, including some parenting and family-focused interventions (National Research Council and Institute of Medicine, 2009). However,