Contextual Emotion-Regulation Therapy for Childhood Depression: Description and Pilot Testing of a New Intervention

• NCJ Number: 215165
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 8 Dated: August 2006 Pages: 892-903
• Author(s): Maria Kovacs Ph.D.; Joel Sherrill Ph.D.; Charles J. George M.S.; Myrna Pollock MSW; Rameshwari V. Tumuluru M.D.; Vincent Ho M.D.
• Date Published: August 2006
• Length: 12 pages
• Grant Number(s): 5R21 MH55244; 5P01MH56193
• Sponsoring Agency: National Institute of Mental Health
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America

Annotation

This study pilot tested the acceptability and effectiveness of contextual emotion-regulation therapy (CERT), a new developmentally tailored intervention for childhood depression that focuses on the self-regulation of dysphoria (an abnormal feeling of anxiety, discontent, and physical discomfort).

Abstract

Fifty-three percent of the 15 children who completed the CERT program had full remission of dysphoria, and 13 percent had partial remission at the time of completing treatment. It took an additional 6 to 12 months for another 40 percent of the children to achieve full remission, which shows the resistant nature of chronic depression. Self-reported depressive and anxiety symptoms significantly decreased by the end of treatment and remained in remission throughout follow-up (6 and 12 months). CERT enables clinicians to match an intervention to children's needs and symptoms regarding the regulation of their emotions, and the program was readily accepted by the children's families. The authors recommend a randomized trial of CERT. The relationships between stress and coping and between stress and depression, which have been extensively documented, provide a general framework for CERT. CERT is based in the belief that the dysfunctional self-regulation of distress and dysphoria, a key characteristic of depressed children, developmentally precedes the onset of depressive disorder. CERT treatment goals are to help the child recover from his/her current depressive disorder (symptom reduction) and become more skilled at regulating dysphoric emotions and in responding to distress-eliciting situations. This involves coping-skills training with an emphasis on adaptive emotion regulatory responses. The pilot test of CERT involved 20 children (ages 7-12; 35 percent girls) with diagnosed dysthymic disorder that had lasted for 2 years. The program involved a 30-session, 10-month treatment, with a 6-month and 12-month followup. Assessments were independent clinical evaluations and self-rated questionnaires. 1 table, 1 figure, and 40 references