Can caregiver depression bring a good parenting intervention down?The case of Parent-Child Interaction Therapy

Extract: Depressed caregivers who present for parenting assistance often display excess difficulties with maintaining positive parent-child interactions and report that they cannot manage their children’s problem behaviours. In addition to this, they often report other life stressors such as marital distress, lack of social support and/or socioeconomic disadvantage. This confluence of problems means that engaging depressed caregivers in parenting services can be challenging and depression is believed to impede successful intervention outcomes. For example, research has shown that depressed participants are at increased risk of intervention dropout and that they more often fail to maintain positive parenting behaviours (Assemany & McIntosh, 2002; Forehand, Furey & McMahon, 1984). However, others have suggested that engagement in parenting interventions in order to improve parent-child relationships may provide additional benefits such as reducing caregiver stress and depressive symptoms (Sameroff, 2004). In this randomised controlled trial of Parent-Child Interaction Therapy (PCIT), we assessed depression using three methods -- an interview, a self-report questionnaire and observation. We anticipated that nonattendance and attrition would be higher in depressed compared to nondepressed caregivers. In addition, those who attended 12 weeks of treatment (n = 68) were compared to those on a supported waitlist (n = 27); we expected that caregivers receiving PCIT would have greater declines in depressive symptoms than those on the waitlist. Participants were female caregivers (age M = 34, SD = 8.9) and their young children (ages 3 to 7)