Reductions in depressive symptoms among substance-abusing runaway adolescents and their primary caretakers: a randomized clinical trial

This study reports secondary outcome findings on depressive symptoms from a randomized clinical trial testing three interventions for substance-abusing runaway adolescents. In particular, the effect of a family systems therapy, Ecologically Based Family Therapy (EBFT), and two individual therapies, the Community Reinforcement Approach (CRA) and Motivational Enhancement Therapy (MET), on adolescent and primary caretaker (PC) depressive symptoms were compared. Findings showed that youth's depressive symptoms were significantly reduced in each treatment to 2 years postbaseline. However, the trajectory of change differed across treatments, with adolescents receiving MET showing a more rapid reduction in depressive symptoms but a quicker increase in symptoms compared with adolescents receiving EBFT. PCs receiving EBFT showed a statistically significant decline in depressive symptoms, but this was not observed for the CRA and MET conditions. These findings can be interpreted to favor EBFT, although future research is needed to test training and implementation strategies for family systems therapies in community-based runaway shelters.