Family Communication and Treatment Benefit in a Comparative Efficacy Trial for Depressed and Suicidal Adolescent

Although parent and adolescent reports of the family environment have been found to moderate depressed and suicidal adolescents' response to treatment, much less is known about how observations of family interactions moderate treatment response. The current study examined baseline parent-adolescent communication using the Goal-Corrected Partnership in Adolescence Coding System (GPACS; Lyons-Ruth, Hennighausen, & Holmes, 2005) along with parent and adolescent reports of family environment. These pre-treatment family variables were tested as potential moderators of treatment response in a comparative efficacy trial of Attachment-Based Family Therapy (ABFT) and Family-Enhanced Non-Directive Supportive Therapy (FE-NST). One hundred and twenty-nine adolescents (82.9% female) were randomized to the two sixteen-week treatments. Adolescents who engaged in less cooperative and validating interactions with their parents reported greater reductions in depressive symptoms than adolescents who engaged in more cooperative and validating interactions with their parents. Rates of change in depressive symptoms were not moderated by treatment condition or by parent and adolescent reports of family conflict and cohesion. Implications for using observational assessments to identify adolescents most likely to benefit from ABFT and FE-NST are discussed.