Background
The role of parental depression as a risk-factor for youth depression
Preventive interventions for the offspring of parents with depression
The “GuG auf” intervention
The benefits of qualitative research
The current study
Methods
Design
Participants
Primary parenta | n | Mean (SD) | Min-Max | % |
---|---|---|---|---|
Age | 15 | 47.73 (5.27) | 37–54 | |
Gender (f/m) | 15 | 40/60 | ||
Highest level of Education (Secondary school/A-levels/undergraduate degree/PhD) | 15 | 6/27/47/20 | ||
Parents living together (y/n) | 13/1 | 93/7 | ||
Nationality: German (y/n) | 13/0 | 100/0 | ||
Depressive episode at start of intervention (yes/no) | 11/4 | 73/27 | ||
Number of previous depressive episodes | 12 | 7.10 (5.10) | 1–15 | |
Depression severity (BDI prior to intervention) | 15 | 20.47 (10.16) | 1–40 | |
Treated for depression prior to intervention (y/n) | 13/1 | 93/7 | ||
Partnerb | ||||
Age | 2 | 42.50 (2.12) | 41–44 | |
Gender (w/m) | 3 | 67/33 | ||
Highest level of Education (Secondary school/A-levels/undergraduate degree) | 3 | 33/33/33 | ||
Children | ||||
Age | 22 | 13.09 (2.41) | 9–17 | |
Gender (w/m) | 22 | 50/50 |
Procedure
Interviews
Focus group
Data analysis
Reflexivity
Results
Topic | Strengths | Limitations | Neutral comments |
---|---|---|---|
General acceptability | Generally “nice”, “important”, “helpful” or “encouraging” (N = 21) | Very tiring / time consuming (N = 17); most contents already familiar or self-evident (N = 8); expectations not met (N = 2) | Parents: Make future participants aware of time consuming nature (N = 6), of focus on children (N = 5), that they may benefit more if not currently depressed (N = 2) |
Parents: Would recommend intervention to other families (N = 18); interactivity (N = 6) | |||
Motivation for participating | Contributing to a research project (N = 3) | ||
Parents: Supporting their children (N = 10) | |||
Talking about depression | Opportunity to exchange experiences with other affected families (N = 10) | Children: Talked about depression with friends through intervention (N = 11) | |
Children: Positive experience (N = 21); most helpful aspect of intervention (N = 8) | |||
Parents: Easier to broach the subject of depression (N = 9); reduced guilt (N = 5); external source of information (N = 3) | |||
Children’s knowledge of depression (children’s view) | Gained new knowledge from intervention (N = 10) | Not learned anything new (N = 2) | |
Children’s coping with stress (children’s view) | Most helpful aspect of the intervention (N = 15); more in control of thoughts (N = 13); more relaxed now (N = 8); gained new knowledge (N = 6) | Not learned anything new (N = 7); could not control feelings any better (N = 7) | |
Parenting skills | Family activities increased as a result (N = 8); practised parenting strategies (N = 6); gave more attention and praise (N = 3); questioned automatic parenting behaviour (N = 2); structure and repetition of already familiar ideas (N = 2) | Children: Did not believe parenting style had changed (N = 11) | Had no prior expectations of learning anything new (N = 2) |
Implementation in everyday life | Intervention implemented (N = 10) | Not automatic enough (N = 8) | |
Children: Implemented stress coping strategies (N = 14) and would recommend them to a friend (N = 13); initial response to stress improved (N = 9) | |||
Parents: Family activities implemented (N = 4); increased self-reflection (N = 4); parenting strategies (N = 2) | |||
Logistics | Size of groups (N = 32); time slot (N = 32); location (N = 34) | Parents: Too intense (N = 6); too much homework (N = 2); not enough information and challenges (N = 3); did not adequately involve the whole family (N = 3) | Online content welcome but not necessary (N = 5); consistency of group leader important (N = 3) |
Children: Group separation (N = 15) | |||
Parents: Amount of information provided (N = 12) |
General acceptability
"It was encouraging, I think. It gave me courage, that you shouldn't immediately give up." (Child of family 14, transcribed)
"I wouldn’t say we’re all irrevocably super happy with each other, but it definitely paved a way." (Parent of family 5, transcribed)
"If you've got someone like that [currently in a depressive episode], then better tell them wait, wait a little bit, because they can't take in much (...). I'll be completely honest, if it'd been three or four months later, when my psychiatrist had stabilised me a bit, maybe it would've been better." (Parent of family 9, transcribed).
"Some advice was simply already, uh, being practised in the families. And if participation's voluntary, then it'll be mostly people who are already dedicated to their children, who don't just not care about their children." (Parent of family 10, transcribed).
First memories
"Even though I admittedly don't always immediately know what it means, there's of course these abbreviations, this A'APP. Things like that just stick." (Parent of family 14, transcribed).
Talking about depression
Before the intervention
"Before, you actually, I mean for my part tended to keep it secret, because you didn't want to put a strain on the child." (Parent of family 5, transcribed).
After the intervention
"Because you hear a lot about, well, this percentage of the population feels the same, but you uh, it's something different when those people are sitting in front of me and sharing their everyday experiences." (Parent of family 5, transcribed).
"Simply the, uh, distance to the topic was kind of gone afterwards and that helps of course, yes, I have to admit that helped me an incredible amount." (Parent of family 8, transcribed)
"Even if they know that already, it’s good if someone else tells them as well, and even more so if they don’t know." (Parent of family 6, transcribed)
"I remember when I was fourteen, fifteen, I wasn’t aware of how my mother was doing. And if someone had said – which I actually found trivial now – she isn’t this grumpy because of you (…), that probably would have helped me a lot." (Parent of family 5, transcribed)
Children’s knowledge of depression
"That depression is curable and that people still, you know, are normal. That they're just not mentally disturbed, numb people now." (Child of family 12, transcribed).
Evaluating new skills
Children’s coping with stress
Children were a little more sceptical about being able to influence their own feelings, with seven of them saying they could not influence their feelings any better now. Of note, a lot of children, especially the younger ones, seemed to have difficulty differentiating between their thoughts and their feelings."I used to think: $h!t! Now I think: Stay calm for now." (Child 1 of family 1, written notes).
Parenting skills
"To really take the time for the whole family. And not just like, 'yes, we could sometime', but actually planning it in more detail." (Parent of family 10, transcribed).
However, half of the children (N = 11) did not believe their parents had changed anything about their parenting style."Being able to try out such a reward system for a bit, or simply implementing certain parenting strategies that I’d heard of before in theory but just never really officially tried out." (Parent of family 5, transcribed)
Implementation in everyday life
"I think that doesn't just help people who, I don't know, have depression, but all people who get stressed sometimes." (Child 1 of family 5, transcribed).
"It's all such a shame (...). For some time we kept doing it, but then it kind of slipped away. You somehow forget about it in your daily routine." (Parent of family 13, transcribed).
Logistics
Another three would have liked for the intervention to strive to better involve the whole of the family, including the partner who did not actively partake."But I thought, better to continue without the homework than have great intentions and then say, I can’t do it, and quit." (Parent of family 6, transcribed)