when improvements in parents’ depression lead to improvements in parenting and, even further, in child functioning. We include an overview of studies of treatment for depression in parents as a preventive intervention for their children (Chapter 7).

Equally interesting, although less often studied, is how and when interventions designed to improve qualities of parenting or to improve couples’ relationship issues also lead to improvements in the parent’s depression and potential benefits for their children. We recognized these approaches as reflecting the two-generation perspective, which we judged to be a very promising approach to the problem of depression in parents.

In terms of parenting interventions, a recent review of parenting training interventions noted consistent evidence that depression in parents improves as a secondary benefit of such training, even when the depression per se is not a target of the intervention (Kaminski et al., 2008). Although the authors note that some of the studies’ designs did not always allow for ruling out that the depression may have improved even without the intervention, the findings are promising. Other studies targeted mothers with depression and intervened directly in their qualities of parenting (Cicchetti, Rogosch, and Toth, 2000; Gelfand et al., 1996; Lyons-Ruth et al., 1990).

In terms of couples’ relationship problems and discord, behavioral approaches to marital therapy have been found to be more effective for the treatment of depression than standard cognitive behavioral therapy targeting the depression per se (Baucom et al., 1998). We also found promising the new generation of marital therapies being designed to treat depression based on knowledge of the associations between depression and marital problems (Beach, Fincham, and Katz, 1998). We also noted a recent meta-analysis that found inconclusive evidence for the efficacy of couple therapy as a treatment for depression yet concluded that couple therapy may still be the treatment of choice when relational distress is predominant (Barbato and D’Avanzo, 2008)

A Developmental Framework

The implementation of a two-generation approach involves many challenges. Childhood is a period of rapid change and development, and the presence or absence of supportive parental behaviors can have lasting effects if they interfere with the children getting their stage-salient needs met. The impact and consequences of depression in parents can vary by both the age of the children in the family as well as the length, severity, and history of exposure to parental depression.

In the course of our work, we recognized the value of a developmental approach. That is, we understood that multiple aspects of concern about depression in parents would vary by the age of the children in the family at



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