Adaptation of preventive interventions for a low-income, culturally diverse community.
OBJECTIVE
To describe essential elements in the adaptation of a prevention approach with a high-risk urban sample, chosen to contrast sharply with the primarily middle-class sample in which it had been originally tested.


METHODS
Key elements of a preventive intervention for families with parental depression were adapted for use in the new context.


RESULTS
A sequence of alliance-building events was implemented, involving engagement at three levels: community, caregivers, and family. The prevention approach was modified to include an expanded approach to defining depression and resilience; greater flexibility on the part of the clinician; more intensive engagement between clinician and family, with a focus on immediate daily concerns; as well as awareness of cultural issues and responsiveness to the subject's experience of violence.


CONCLUSIONS
Core principles of helping family members to discuss the effects of depression and adversity on family life were affirmed.
Podorefsky
D L
DL
Department of Psychiatry, Children's Hospital and Judge Baker Children's Center, Boston, MA 02115, USA. podorefsky@a1.tch.harvard.edu
McDonald-Dowdell
M
M
Beardslee
W R
WR
D000293:Adolescent; D000328:Adult; D001900:Boston; D017028:Caregivers / Q000193:education / Q000523:psychology; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003156:Community Mental Health Services; D003466:Cultural Characteristics; D003863:Depression / Q000628:therapy*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000523:psychology*; D011322:Primary Prevention; D011614:Psychotherapy, Brief / Q000379:methods; D015406:Single Parent / Q000193:education / Q000523:psychology*; D012940:Social Problems / Q000517:prevention & control