Middle school student, parent

The power of positive thinking is not a new concept, but researchers now say it can be an effective tool to prevent depression in middle school students. In a randomized clinical trial with 120 young people ages 11 to 15 years old, those who received group intervention with a focus on the positive showed greater decreases in depressive symptoms, compared with those who received individual support.

The study, “A Randomized Trial of the Positive Thoughts and Action Program for Depression among Early Adolescents,” was published April 5 in the Journal of Clinical Child & Adolescent Psychology.

Positive Thoughts & Actions

Carolyn McCarty, PhD, of Seattle Children’s Research Institute, led the 14-week study and designed the intervention program known as Positive Thoughts and Actions, which focused on cognitive-behavioral factors such as coping and problem-solving. This intervention helped young people learn how to manage stress, conflict, anger and strong emotions.

Student in the group intervention took part in weekly 50-minute sessions with four to six students either during the day or after school. Topics covered include: Changing the way we think and feel, STOP before responding, managing conflict & anger, making healthy decisions, and staying on track & celebrating. Parents were involved with their child via two home visits and two workshops conducted in the evenings at school.

Individual Support Program to prevent depression

Youth in the control group who received individual support answered questions about stress, depression and anxiety, personal control or hopelessness, coping strategies and support.

This intervention consisted of a 45 to 90-minute interview. The interviewer summarized and empathized with the student’s perspective, while formulating an overall sense of the youth’s strengths and needs. The student and interviewer then worked together on a brief action plan to address issues that the youth would like to change, and the student was asked to follow up with a school counselor or teacher for support. The interviewer called the youth’s parent to discuss the plan and areas of need in which the parent could be helpful, and also contacted the student’s chosen supportive school staff member.

For both groups, researchers also looked at broader outcomes, including personal adjustment—which incorporates self-esteem—school problems and interpersonal relationships.

Kids in study not yet diagnosed as depressed

McCarty said the aim of the study was to intervene with youth in this age range before depression becomes a big problem. “Students weren’t yet at the threshold of clinical depression, but indicated some early symptoms and stressors,” she said.

Youth were recruited from four Seattle public middle schools, from a total population of more than 2,600 seventh and eighth grade students.

What should parents, caregivers do?

Based on the team’s findings, McCarty said parents, teachers and caregivers should help kids with problem-solving and coping skills. “These are fundamental skills for managing issues that come up in life, and learning how to use them can provide an important impact on young people’s moods.”

Study limitations, reporting of depression

Researchers did not find differences for both groups in school problems, academic problems or relationships with other students. McCarty said this could be attributed to a need for more intervention. And she noted one caveat: Outcomes for depression were based on youth’s own reporting of symptoms. “They’re the best reporters of depression, however, because it’s hard to observe depression,” McCarty said. “Parents don’t typically see as much of a change as youth perceive in depressive symptoms.”

Dr. McCarty’s tips for parents to help prevent depression:

• Tune in to your child’s emotional life and how different situations make them feel. Be empathetic and listen to your child’s perspective.
• Teach your child how to problem solve. Look at a problem, and have him or her brainstorm potential ways to address it. Include creative ideas. Have your child make a choice after evaluating many different options, and then revisit the decision moving forward.
• Help your child set goals, specifically goals that are realistic (think baby steps), measurable and that can be changed.
• Talk with your child about how to manage really strong emotions. Encourage them to stop and let emotions settle down before responding to the situation.

Resources

Learn more about depression and Adolescent Behavioral Health at Seattle Children’s. Our Psychiatry and Behavioral Medicine team also works to diagnose, treat and prevent problems with emotions and behavior. We see young people up to age 18 – and sometimes longer, if they still need care from experts who treat children.

McCarty is also a research associate professor of pediatrics at the University of Washington. Co-authors on the study include: Elizabeth McCauley, PhD (Seattle Children’s Research Institute, University of Washington); Heather Violette (Seattle Children’s Research Institute), Mylien Duong (Seattle Children’s Research Institute), and Rick Cruz (University of Washington).