Researchers from Vanderbilt University have performed a meta analysis on 20 years worth of study on interventions for depression and depressive symptoms. They found that of the three different types of interventions, universal, selective and indicated, the more targeted of the three, selective and indicated, have had greater effect sizes.
Universal interventions, when preventative intervention is presented to an entire population, are often difficult to assess, researchers said, because to see statistically significant results the sample size has to be enormous. But what was clear was that using universal intervention helps to remove the stigma that often is attached to depression or depression treatment. Universal interventions also had much lower dropout rates and require no pre-screening.
In contrast, Horowitz and Garber showed that selective programs, which target individuals who are more at risk for depression because of exposure to such factors as parental divorce, deaths, parental depression or alcoholism, or poverty, produced a significantly larger effect size in reducing depressive symptoms compared to universal programs. Selective programs usually involve a more diverse sample, are more varied in their delivery of information, and target other outcomes besides depression (e.g. academic improvement, parent-child relationship).
Indicated programs, which are used for individuals who are already showing signs and symptoms of depression and are at increased risk of experiencing clinical depression, also showed a significantly greater effect size than universal programs, said Horowitz and Garber. Like selective programs, indicated programs typically use small group format, teach cognitive techniques that emphasize reducing negative thinking, increase problem-solving skills and goal setting, and show participants how to look at events from another perspective.
For more information, see the American Psychological Association's press release here or check out the study when it appears in the June edition of Journal of Consulting and Clinical Psychology. |