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Published on Feb 08, 2010 in CHOP News
February 8, 2010 — Adolescents with suicidal thoughts and elevated depression had stronger and faster reduction of symptoms when treated with family therapy than with standard treatment in the community. Researchers from The Children's Hospital of Philadelphia reported these findings this month in the Journal of the American Academy of Child and Adolescent Psychiatry.
Suicide is the third leading cause of death in American adolescents, accounting for more than 1,300 deaths in youths between the ages of 12 and 18 in 2005. An additional one million teens attempt suicide each year, leading to high emotional and financial costs to families and the healthcare system. Unfortunately, very few treatment studies have focused on this vulnerable age group or identified treatments with proven results.
In this study, Attachment-based Family Therapy (ABFT), found that patients with severe suicidal thinking were at least four times more likely to have no suicide thinking at the end of the treatment or three months after treatment, than patients treated in the community.
Patients in ABFT also showed a more rapid decrease in depression symptoms and were retained in treatment longer than in community care, even with additional supports provided by the study. This is the first treatment study for teen suicidal ideation to show robust and statistically significant improvement over treatment as usual.
"Most treatment models mainly work with the adolescents alone, helping them to learn new coping and problem solving strategies," says study leader Guy S. Diamond, PhD, director of the Center for Family Intervention Science at the Children's Hospital of Philadelphia. "But adolescents are highly influenced by their parents. Family conflict, chaos, and strife can contribute to youth suicide, while at the same time family love, trust, and communication can buffer against it. This therapy aims to resolve family conflicts and promote family strengths so that the appropriate bond of attachment can protect youth from self harm."
The researchers studied 66 children between the ages of 12 and 17 who presented in primary care or emergency rooms with severe suicidal thinking and depressive symptoms. The average age was 15, about three quarters were African American and 83 percent were female. Parent participation was required.
"Parents are not viewed as the problem, but as the curative medicine," Diamond says. "They are the key to keeping lines of communication open in order to monitor against suicidal behavioral. And while no treatment is perfect for all patients, helping any family through a youth's suicide crisis is important."
Diamond says his team's future studies will focus on a broader population of patients, stronger comparison treatments, and long term outcomes to better assess treatment benefits.
A grant from the Centers for Disease Control and Prevention supported this research. Diamond's co-authors were Gregory Brown, PhD from the University of Pennsylvania; Matthew B. Wintersteen, PhD, from Thomas Jefferson University; Robert Gallop, PhD, from West Chester University; and Gary M. Diamond, PhD, from Ben-Gurion University of Negev, Israel; Karni Shelef, PhD, of Achva Academic College of Israel; and Suzanne Levy, PhD, from Children's Hospital.
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7 Important Things to Expect from Family Therapy
Teen mental health challenges are tough on the whole family. Family therapy provides an avenue through which family members can learn more about a loved one’s condition. What is family therapy? It’s a therapeutic modality that can be an extremely beneficial addition a teen’s ongoing mental health treatment.
Scientists have repeatedly demonstrated the power of family therapy. Research on family therapy shows that it can be an effective supplemental treatment for youth with anxiety, depression, ADHD, substance abuse, and other mental health conditions.
There are various types of family therapy. Several of these modalities fall under the category of family systems therapy, based on psychiatrist Murray Bowen’s family systems theory.
Once they get answers to the question, “What is family therapy?,” family members may have a number of additional questions regarding the process. Here are seven things to expect when beginning family therapy.
Before working with a family therapist, family members may feel nervous and resistant. However, family therapy—just like individual therapy and couples therapy—is most effective when each individual is committed to the process. In order to garner everyone’s support, it helps to first ensure that everyone understands how it works.
To help family members understand why the therapy process will be worthwhile, parents can provide examples of difficult situations, conflicts, and emotional challenges that the family might be able to navigate more smoothly with the guidance of an expert. It’s important to stress that the entire family can benefit from the process.
During family therapy, a mental health professional will help family members learn how to work together to support each person’s mental health. Therefore, family members should expect to spend a significant amount of time helping the therapist get to know everyone in the family. Hence, the family therapist will likely ask about common sources of stress or conflict in the family, any histories of trauma and abuse among family members, and other personal details that can be helpful in determining family therapy goals.
In order for family therapy to be productive, everyone involved must be honest and committed to the process. It is important for all family members to be attentive during each session and to openly share their thoughts and emotions.
The family therapist’s goal is to guide a family in assessing its problems and developing constructive strategies to overcome them. In doing so, the therapist will help family members develop their own vision of a stable and happy family unit. Furthermore, the therapist will support the family in creating a roadmap to get there. In some cases, a family therapist may begin this process by having each participant sign a contract promising to communicate respectfully during each session.
During therapy sessions, family members discuss the family’s significant conflicts and how they are typically addressed within the family unit. Then, with the help of the therapist, they look at how they might improve the way they communicate and work through challenges.
Family therapy can help family members learn how to share their thoughts and emotions clearly and respectfully. In addition to teaching healthy ways to resolve disagreement, therapy also assists individuals in learning how to advocate for themselves and their opinions in a constructive way. Family members spend time working on communication skills, such as speaking up politely or knowing when to say no.
When participating in family therapy as a part of a teen’s broader individual therapy and treatment strategy, parents and other family members will have an opportunity to learn about the teen’s mental health or addiction in depth. This process will help the entire family better understand and relate to the teen. Additionally, it can be effective in mitigating stress or concerns regarding the teen’s condition.
To truly benefit from family therapy, the entire family must be committed to integrating the lessons and insights from each session into their daily life. Moreover, the therapist will most likely assign tasks and family therapy goals for the family to work toward between sessions. These tasks might include making note of situations in which family members successfully employ coping skills or conflict resolution strategies.
Therefore, each family member can play a part in building a healthy, happier life together.
Crane, D & Morgan, Triston. (2007). The efficacy and effectiveness of family therapy.
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