Home Visiting and Maternal Depression: Seizing the Opportunities to Help Mothers and Young Children

Outlines the prevalence of maternal depression, treatment, and effect on children; mothers' views of depression; guidance on how home visiting programs could better identify and address the needs of depressed mothers; and lessons from existing programs

The Perceived Impact of Parental Depression on the Narrative Construction of Personal Identity: Reflections from Emerging Adults

This paper presents a narrative analysis of emerging adults’ perceptions of the impact of parental depression on themselves as they reflected back on their lives in their natal home. Archived interview narratives were analyzed from sixteen respondents from a preventive intervention study of depression in families. The perceptions of parental depression and the perceived impact of parental depression were found to fall into five perspectives: resistance (no impact), negativity (being disadvantaged), ambivalent perspectives (disadvantaged but also sensitized), acceptance (reconciling with loss), and, compassion (sensitivity and caregiving). The findings from the narratives indicated that the perceived impacts of parental depression spanned a spectrum of responses, not all of which were negative. Emerging adults with their own history of depression reported a more resistant or negative perceived impact of parental depression, and more boys than girls narrated perceived negative impacts of parental depression on the self. These perspectives on parental depression derived from the narratives offer clinicians and family therapists a means of understanding the impact of depression on emerging adults’ sense of self. Implications of language usage, such as tense and coherence, are also discussed

FAMILLE+: A Multifamily Group Program for Families with Parental Depression

Children living with a parent with a depressive disorder are at higher risk for low adaptive functioning, in terms of social, academic, emotional, and mental health problems (Reupert, Maybery & Kowalenko, 2012).This brief describes FAMILLE+, a multifamily group program for parents with major depressive disorder and their 7 to 11 years old children. Its purpose is to prevent the development of mental health problems in children and to promote family resilience and was specifically adapted to fit the children\u27s developmental (cognitive, attentional and socio-emotional) abilities

Family-Centered Preventive Intervention for Military Families: Implications for Implementation Science

In this paper, we report on the development and dissemination of a preventive intervention, Families OverComing Under Stress (FOCUS), an eight-session family-centered intervention for families facing the impact of wartime deployments. Specific attention is given to the challenges of rapidly deploying a prevention program across diverse sites, as well as to key elements of implementation success. FOCUS, developed by a UCLA-Harvard team, was disseminated through a large-scale demonstration project funded by the United States Bureau of Navy Medicine and Surgery (BUMED) beginning in 2008 at 7 installations and expanding to 14 installations by 2010. Data are presented to describe the range of services offered, as well as initial intervention outcomes. It proved possible to develop the intervention rapidly and to deploy it consistently and effectively

Increasing Understanding in Children of Depressed Parents: Predictors and Moderators of Intervention Response

We evaluated predictors and moderators of differential response to two family-based depression prevention programs for families with a depressed parent: a clinician-facilitated intervention and a lecture group intervention. Individual and family level variables were examined using regression analyses with generalized estimating equations. For the outcome of child understanding of depression, parental changes in child-related behaviors and attitudes predicted greater child understanding ( < 0.001). For the parent outcome of behavior and attitude change, across intervention conditions, younger parent age ( < 0.05), female parent gender ( < 0.01), more chronic and severe parental depression history ( < 0.05), lower SES ( < 0.05), and single-parent status ( < 0.05) were associated with better outcomes across conditions. Effect sizes were moderate, ranging from 0.4 to 0.7 SD. Family and marital functioning were not found to be predictors of any outcomes. When both parents were depressed at baseline, there was no difference in the clinician-versus lecture-based approach, and when only the father was depressed, families reported more changes with the clinician condition than with the lecture condition ( < 0.05). Findings from this study can help identify intervention strategies that are appropriate for different types of at-risk individuals and families

Developing family interventions for adolescent HIV prevention in South Africa.

Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352)

Primary Health Care Potential Home for Family-Focused Preventive Interventions

Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perceptions of parenting programs; (2) concerns about the expertise and legitimacy of sponsoring organizations to offer parenting advice; and (3) a paucity of stable, sustainable funding mechanisms. Primary healthcare settings are well positioned to overcome these barriers. Recent changes within health care make primary care settings an increasingly favorable home for family-focused prevention and suggest possibilities for sustainable funding of family-focused prevention programs. This paper discusses the existing advantages of primary care settings and lays out a plan to move toward realizing the potential public health impact of family-focused prevention through widespread implementation in primary healthcare settings

Mechanisms of Risk and Resilience in Military Families: Theoretical and Empirical Basis of a Family-Focused Resilience Enhancement Program

Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on military children and families and that the quality and functionality of familial relations is linked to force preservation and readiness. As a result, family-centered care has increasingly become a priority across the military health system. FOCUS (Families OverComing Under Stress), a family-centered, resilience-enhancing program developed by a team at UCLA and Harvard Schools of Medicine, is a primary initiative in this movement. In a large-scale implementation project initiated by the Bureau of Navy Medicine, FOCUS has been delivered to thousands of Navy, Marine, Navy Special Warfare, Army, and Air Force families since 2008. This article describes the theoretical and empirical foundation and rationale for FOCUS, which is rooted in a broad conception of family resilience. We review the literature on family resilience, noting that an important next step in building a clinically useful theory of family resilience is to move beyond developing broad “shopping lists” of risk indicators by proposing specific mechanisms of risk and resilience. Based on the literature, we propose five primary risk mechanisms for military families and common negative “chain reaction” pathways through which they undermine the resilience of families contending with wartime deployments and parental injury. In addition, we propose specific mechanisms that mobilize and enhance resilience in military families and that comprise central features of the FOCUS Program. We describe these resilience-enhancing mechanisms in detail, followed by a discussion of the ways in which evaluation data from the program’s first 2 years of operation supports the proposed model and the specified mechanisms of action

Development of a technology-based behavioral vaccine to prevent adolescent depression: A health system integration model

Efforts to prevent depression have become a key health system priority. Currently, there is a high prevalence of depression among adolescents, and treatment has become costly due to the recurrence patterns of the illness, impairment among patients, and the complex factors needed for a treatment to be effective. Primary care may be the optimal location to identify those at risk by offering an Internet-based preventive intervention to reduce costs and improve outcomes. Few practical interventions have been developed. The models for Internet intervention development that have been put forward focus primarily on the Internet component rather than how the program fits within a broader context. This paper describes the conceptualization for developing technology based preventive models for primary care by integrating the components within a behavioral vaccine framework. CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training) has been developed and successfully implemented within various health systems over a period of 14 years among adolescents and young adults aged 13–24.☆☆Disclosures: Benjamin W. Van Voorhees has served as a consultant to Prevail Health Solutions, Inc., Mevident Inc., San Francisco and Social Kinetics, Palo Alto, CA, and the Hong Kong University to develop Internet-based interventions. In order to facilitate dissemination, the University of Chicago agreed to grant a no-cost license to Mevident Incorporated (3/5/2010) to develop a school-based version. Neither Dr. Van Voorhees nor the university will receive any royalties or equity. Dr. Van Voorhees agreed to assist the company in adapting the intervention at the rate of $1000/day for 5.5 days. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).*Corresponding author at: Department of Pediatrics, University of Illinois at Chicago, Children\u27s Hospital, University of Illinois Hospital & Health Sciences System, 840 South Wood Street (MC 856), Chicago, IL 60612-7324. HHS Public Access Author manuscript Internet Interv. Author manuscript; available in PMC 2018 November 21. Published in final edited form as: Internet Interv. 2015 September ; 2(3): 303–313. doi:10.1016/j.invent.2015.07.004. Autho