Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2007 Jul 18;2007(3):CD006728.
doi: 10.1002/14651858.CD006728.

Family therapy for depression

H T Henken  1 , M J H Huibers, R Churchill, K Restifo, J Roelofs
Affiliations
Meta-Analysis

Family therapy for depression

H T Henken et al. Cochrane Database Syst Rev. .

Abstract

Background: People with depression often experience interpersonal problems. Family therapy for depression is a widely used intervention, but it is unclear whether this is an effective therapy for the treatment of depression.

Objectives: To assess the efficacy of family therapy for depression.

Search strategy: The following electronic databases were searched using a specific search strategy: CCDANCTR-Studies and CCDANCTR-References searched on 21/10/2005, The Cochrane Central Register of Controlled Trials, Medline (1966 to January 2005), EMBASE (1980 to January 2005), Psycinfo (1974 to January 2005). Reference lists of articles were also searched. Handsearches of relevant journals and bibliographies were conducted and first authors of included studies and experts in the field were contacted for further information.

Selection criteria: Included studies were randomised controlled and controlled clinical trials comparing family therapy with no intervention or an alternative intervention in which depression symptomatology was a main outcome measure.

Data collection and analysis: Methodological quality was independently assessed by two review authors using the Maastricht-Amsterdam Criteria List. The qualitative and quantitative characteristics of the selected trials were independently extracted by three review authors using a standardised data extraction form. Levels of evidence were used to determine the strength of the evidence available. It was not possible to perform meta-analyses because of the heterogeneity of the selected studies.

Main results: Three high-quality and three low-quality studies, involving 519 people with depression, were identified. The studies were very heterogeneous in terms of interventions, participants, and measuring instruments. Despite fairly good methodological quality and positive findings of some studies, evidence for the effectiveness of family therapy for depression did not exceed level 3 (limited or conflicting evidence), except for moderate evidence (level 2), based on the non-combined findings from three studies, indicating that family therapy is more effective than no treatment or waiting list condition on decreasing depression, and on increasing family functioning.

Authors' conclusions: The current evidence base is too heterogeneous and sparse to draw conclusions on the overall effectiveness of family therapy in the treatment of depression. At this point, use of psychological interventions for the treatment of depression for which there is already an evidence-base would seem to be preferable to family therapy. Further high quality trials examining the effectiveness and comparative effectiveness of explicitly defined forms of family therapy are required.

PubMed Disclaimer

Conflict of interest statement

None known.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

    1. Barbe RP, Bridge J, Birmaher B, Kolko D, Brent DA. Suicidality and its relationship to treatment outcome in depressed adolescents. Suicide and Life‐Threatening Behavior 2004;34(1):44‐55. - PubMed
    2. Barbe RP, Bridge JA, Birmaher B, Kolko DJ, Brent DA. Lifetime history of sexual abuse, clinical presentation, and outcome in a clinical trial for adolescent depression. Journal of Clinical Psychiatry 2004;65(1):77‐83. - PubMed
    3. Birmaher B, Brent DA, Kolko D, Baugher M, Bridge J, Holder D, et al. Clinical outcome after short‐term psychotherapy for adolescents with major depressive disorder. Archives of General Psychiatry 2000;57(1):29‐36. - PubMed
    4. Brent D. A clinical trial comparing three psychotherapies for adolescent depression: differential efficacy and predictors of outcome. WPA Thematic Conference Jerusalem. 1997; Vol. November 9.
    5. Brent DA, Baugher M, Birmaher B, Kolko DJ, Bridge J. Compliance with recommendations to remove firearms in families paticipating in a clinical trial for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry 2000;39(10):1220‐6. - PubMed
    6. Brent DA, Birmaher B, Kolko D, Baugher M, Bridge J. Subsyndromal depression in adolescents after a brief psychotherapy trial: course and outcome. Journal of Affective Disorders 2001;63(1‐3):51‐8. - PubMed
    7. Brent DA, Holder D, Kolko D, Birmaher B, Baugher M, Roth C, et al. A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy. Archives of General Psychiatry 1997;54(9):877‐85. - PubMed
    8. Brent DA, Kolko DJ, Birmaher B, Baugher M, Bridge J. A clinical trial for adolescent depression: predictors of additional treatment in the acute and follow‐up phases of the trial. Journal of the American Academy of Child and Adolescent Psychiatry 1999;38(3):263‐70. - PubMed
    9. Brent DA, Kolko DJ, Birmaher B, Baugher M, Bridge J, Roth C, et al. Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry 1998;37(9):906‐14. - PubMed
    10. Bridge JA, Barbe RP, Birmaher B, Kolko DJ, Brent DA. Emergent suicidality in a clinical psychotherapy trial for adolescent depression. In press. - PubMed
    11. Kolko DJ, Brent DA, Baugher M, Bridge J, Birmaher B. Cognitive and family therapies for adolescent depression: treatment specificity, mediation, and moderation. Journal of Consulting and Clinical Psychology 2000;68(4):603‐14. - PubMed
    12. Renaud J, Brent DA, Baugher M, Birmaher B, Kolko DJ, Bridge J. Rapid response to psychosocial treatment for depression: a two‐year follow‐up. Journal of the American Academy of Child and Adolescent Psychiatry 1998;37(11):1184‐90. - PubMed
    13. Stein D, Brent DA, Bridge J, Kolko D, Birmaher B, Baugher M. Predictors of parent‐rated credibility in a clinical psychotherapy trial for adolescent depression. Journal of Psychotherapy Practice and Research 2001;10(1):1‐7. - PMC - PubMed
    1. Diamond GS, Reis BE, Diamond GM, Siqueland L, Isaacs L. Attachment‐based family therapy for depressed adolescents: a treatment development study. Journal of American Child and Adolescent Psychiatry 2002;41(10):1190‐6. - PubMed
    1. Clarkin JF, Glick ID, Haas GL, Spencer JH, Lewis AB, Peyser J, et al. A randomised clinical trial of inpatient family intervention, V: results for affective disorders. Journal of Affective Disorders 1990;18:17‐28. - PubMed
    2. Glick ID, Clarkin JF, Haas GL, Spencer JH. Clinical significance of inpatient family intervention, VII: conclusions from a clinical trial. Hospital and Community Psychiatry 1993;44(9):869‐73. - PubMed
    3. Glick ID, Clarkin JF, Haas GL, Spencer JH Jr, Chen CL. A randomised clinical trial of inpatient family intervention, VI: mediating variables and outcome. Family Process 1991;30:85‐99. - PubMed
    4. Glick ID, Clarkin JF, Spencer JH, Haas GL, Lewis AB, Peyser J, et al. Inpatient family intervention: A controlled evaluation of practice, I. Preliminary results of the six‐month follow‐up. Archives of General Psychiatry 1985;42:882‐6. - PubMed
    5. Glick ID, Spencer JH, Clarkin JF, et al. A randomised clinical trial of inpatient family intervention, IV: Follow‐up results for subjects with schizophrenia. Schizophrenia Research 1990;3:187‐200. - PubMed
    6. Haas GL, Glick ID, Clarkin JF, Spencer JH, Lewis AB, Peyser J, et al. Inpatient family intervention: a randomised clinical trial, II: results at hospital discharge. Archives of General Psychiatry 1988;45:217‐24. - PubMed
    7. Spencer JH, Glick ID, Haas GL, Clarkin JF, Lewis AB, Peyser J, et al. A randomised clinical trial of inpatient family intervention, III: effects at 6‐month and 18‐month follow‐ups. American Journal of Psychiatry 1988;145(9):1115‐21. - PubMed
    1. Miller IW, Solomon DA, Ryan CE, Keitner GI. Does adjunctive family therapy enhance recovery from bipolar I mood episodes?. Journal of Affective Disorders 2004;82:431‐6. - PubMed
    1. Sanders MF, McFarland M. Treatment of depressed mothers with disruptive children: a controlled evaluation of cognitive behavioural family intervention. Behaviour Therapy 2000;31(1):89‐112.

References to studies excluded from this review

    1. Anderson CM, Griffin MD, Rossi A, Pagonis I, Holder DP, Treiber R. A comparative study of the impact of education vs. process groups for families of patients with affective disorders. Family Process 1986;25:185‐205. - PubMed
    1. Asarnow JR, Scott CV, Mintz J. A combined cognitive‐behavioural family education intervention for depression in children: a treatment development study. Cognitive Therapy and Research 2002;26(2):221‐9.
    1. Beardslee WR, Salt P, Porterfield K, Rothberg PC, Velde P van de, Swatling S, et al. Comparison of preventive interventions for families with parental affective disorder. Journal of the American Academy of Child and Adolescent Psychiatry 1993;32(2):254‐63. - PubMed
    2. Beardslee WR, Wright EJ, Salt P, Drezner K, Gladstone TRG, Versage EM, et al. Examination of children's responses to two preventive intervention strategies over time. Journal of the American Academy of Child and Adolescent Psychiatry 1997;36(2):196‐204. - PubMed
    1. Brodaty H, Andrews G. Brief psychotherapy in family practice. British Journal of Psychiatry 1983;143:11‐9. - PubMed
    1. Butler SF, Budman SH, Beardslee W. Risk reduction in children from families with parental depression: a videotape psychoeducation program. National Academies of Practice Forum 2000;2(4):267‐76.

References to ongoing studies

    1. Childhood depression Biomed‐funded psychotherapy outcome study: London, Athens, Helsinki.. Ongoing study Unknown.

Additional references

    1. AHCPR Depression Guideling Panel. Depression in Primary Care Vol 2. Treatment of Major Depression. Clinical Practice Guidelines 5. AHCPR Publication 93‐0551. Rockville, md: Department of Health and Human Services, 1993.
    1. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomised trials: explanation and elaboration. Annals of Internal Medicine 2001;134(8):663‐94. - PubMed
    1. Asarnow JS, Jaycox LH, Tompson MC. Depression in youth: psychosocial interventions. Journal of Clinical Child Psychology 2001;30(1):33‐47. - PubMed
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Pyshicatry 1961;4:561‐71. - PubMed
    1. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomised controlled trials. The CONSORT statement. JAMA 1996;276:637‐9. - PubMed