Child Depression Treatment


What happens in child depression treatment? If you have read some of the symptoms of child depression and think that may describe your child you may now be thinking, how do professionals help children who are depressed?Research on therapy for child depression is scarce. There is some evidence that cognitive behavioral therapy, psycho education, and supportive counseling are effective. Below I will describe how I approach child depression treatment as an outpatient therapist and why.


Play Therapy

Child depression treatment must incorporate play therapy!  The younger or less cognitive the child is, the more play is necessary in therapy.    Play therapy focuses on encouraging children to verbalize their feelings and to learn how to express those feelings to their family and others who can help them.   Play is also a very effective way to assess children’s issues.  When   an adult seeks help for depression, the therapist asks what is making them sad or contributing to their depression.   With younger children we allow and encourage them to communicate this to us through expressive play. 

Supportive Therapy

Child depression treatment also must focus on building trusting relationships with children.  Children need to feel they have privacy in their therapy just like adults do.  They also need to feel respected, cared for, and listened to.   Supportive therapy focuses on developing the therapeutic relationship ( the relationship between the child and therapist  ) and on accurately assessing what the child is communicating about their experience.

Psychoeducation

Child depression treatment also must incorporate psycho- education (education about depression). Children and parents need to know that depression is an illness and that they are not to blame.  Research shows that education about depression in the context of therapy helps to begin the healing process.   This helps children to feel less out of control and parents to make better choices when interpreting their child’s behavior and selecting consequences.

 Risk and Resliency

Research shows there are certain risk ( click here) and  protective factors that help children to be successful despite some difficulties they may have.  Some of these factors include having good problem solving skills, perceiving oneself as competent, and being likable.  I believe when working with depressed children we need to bolster those protective forces.  This requires a careful analysis of the child’s strengths. Then we target those strengths that we can build upon and improve.

Environment

Assessing for contributors to the child’s depression is important.  At times there are changes parents or schools can make that improve the child’s odds of successfully recovering from depression and decrease the odds of a relapse.  It is important for the therapist and parents to brainstorm environmental factors that may be contributing to the child’s depression. 

Family Therapy

In child depression treatment, it may be necessary to incorporate several family members into the child’s therapy to assist in focusing on family interactions that may be contributing to the child’s depression.

Hope

It is important to maintain a hopeful and confident attitude when working with child depression.  In therapy the therapist can model the expectation that things will turn out well.   Parents can be trained to have a more hopeful attitude as well.

Problem Solving

Helping children to generate effective solutions to problems, and assisting them in doing this on a regular basis is a helpful component of depression treatment for children.  Once children learn there is an approach to solving problems effectively, and they have an opportunity to feel successful, they continue to feel empowered.  Depending on the child’s age, problem solving can be demonstrated with puppets, through stories or even music. Older children can be taught this skill more directly.  It is important to work on a problem that is important to the child and demonstrate that through their actions, they can affect the outcome positively.

Coping Skills

Teaching children that they can learn new and better skills to cope is an important part of child depression treatment.  For example   A child is keeping his feelings inside can learn that telling mom about it is a good coping skill.  A child that is crying in school or in front of peers can learn techniques to do this more privately so there is not social stigma.

Cognitve Behavioral Therapy

Cognitive behavioral therapy focuses on how thoughts affect our feelings and behaviors. This kind of therapy can help children to modify their thoughts so their feelings and behaviors are different.  Depending on the child’s age, this can be accomplished through story telling, artwork, puppet play or doll house play.   The goals of this kind of therapy are to challenge false negative ideas the child might have about the present and future, to foster a more positive view of the self and the future, to help the child begin to process information through a more positive lens.  We know that both children and adults who are depressed see the world as a much negative place, see themselves as having less control over their fate, and have a generally pessimistic view . In child depression treatment, cognitive therapy focuses on these issues.


Phases: Acute, Continuation, and Maintenance


Depression treatment for adults and children is typically categorized in this manner.  The acute phase is the beginning phase when the alleviation of symptoms is targeted.  The continuation phase is a phase of treatment which occurs after the child’s symptoms have dissipated. The goal during this phase is to with avoid a relapse.  The maintenance phase is to prevent further episodes.  Treatment should not just end if the child seems better. Depression relapse and re occurrence occurs often, so it’s best to keep a child in contact with the therapist, at less frequent intervals for continuing assessment and for the development of new skills to help avoid future depression.
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