A Family Systems Approach to Addressing Depression in Children

Abstract

Children of all ages and around the globe can experience depressive symptoms. However, certain symptoms of depression can be expressed in distinct ways from depression in adulthood. While many individualistic approaches are utilized to treat depression in childhood, family systems modalities can be utilized with effectiveness since family factors can contribute to depressive symptoms (Ghandour et al., 2019). Family systems theories often examine and address the interactions between family members and the context in which the interactions occur. Specifically, structural family therapy has been demonstrated to be effective in reducing childhood depression symptomology (Jiménez et al., 2019). Structural family therapy focuses on boundaries, hierarchies, and subsystems within a cultural context. The purpose of this literature review is to propose that structural family therapy is appropriate for addressing depression in childhood. Additional discussion includes structural family therapy being appropriate for various cultures around the globe. Major depressive disorder is a common mental disorder affecting children of all ages (James et al., 2018) and becomes higher in prevalence for children who have entered puberty (Costello et al., 2006). Mental health problems in childhood, such as depression, have been shown to have a more negative effect (e.g., a reduction in work resulting in a lower SES outcome) in the person’s
adult life when compared to the effect of physical health issues (Delaney & Smith, 2012). Furthermore, depressive disorders were found to be one of the leading causes for disability in 2017 (James et al., 2018). Individuals who experienced depressive symptoms at an early onset typically had poorer quality of life, more depressive episodes, greater medical psychiatric comorbidity, more suicide attempts, and more significant symptoms severity than those with later ages of onset of major depressive disorder (Zisook et al., 2007). Given the research demonstrating the negative effect that early onset of depression has on an individual, it is imperative to consider interventions.

Family systems therapy has been demonstrated to be an effective approach for addressing depression in childhood (Jiménez et al., 2019; Tompson et al., 2017; Trowell et al., 2007). Due to the reliance of children on their caregivers, it is prudent to involve the family in addressing mental health concerns (Steinberg, 2001). While many approaches operate from an individualist approach (see Bernaras et al., 2019), consideration of the family is significant since children with a primary caregiver who rated their own mental health as fair or poor in mental or emotional health had an increased rate of depression at 13% (Ghandour et al., 2019). The purpose of this
literature review is to propose structural family therapy as an effective modality for treating children with depressive symptoms.