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This multi-center, randomized controlled trial was conducted to evaluate the efficacy and long-term effects of a novel hybrid psychological intervention, which combines Resilience Theory with the Satir Model, for adolescents diagnosed with depression. The study compared this intervention to treatment as usual (TAU) to determine its impact on depressive symptoms, psychological resilience, self-esteem, and overall quality of life.
Adolescent depression is a significant and growing public health concern. Traditional therapies have limitations, highlighting a need for innovative, engaging interventions. This study was designed to address this gap by developing and testing a hybrid model that integrates the strengths-based approach of Resilience Theory with the systemic, humanistic principles of the Satir Model. The study hypothesized that this combined intervention would be more effective than standard care in not only alleviating depressive symptoms but also in building lasting psychosocial resources. A total of 420 adolescents with depression were randomized to either the 12-week hybrid intervention group or a control group receiving treatment as usual. The intervention program was structured in three modules focusing on self-awareness, skill-building, and future-orientation. Outcomes were assessed at baseline, immediately post-intervention (12 weeks), and at a 6-month follow-up to evaluate the sustainability of the effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental: Resilience-Satir Hybrid Intervention Group | Experimental | In addition to treatment as usual (TAU), participants received a structured 12-week group nursing intervention program. The program consisted of one 90-minute session per week, co-facilitated by trained psychiatric nurses. The intervention included three modules: Module 1 (Weeks 1-4) focused on safety and identifying emotions using Satir's "Iceberg" metaphor and personal strengths; Module 2 (Weeks 5-8) focused on building skills in problem-solving, cognitive reframing, and congruent communication; Module 3 (Weeks 9-12) focused on integrating skills and future-planning. |
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| Active Comparator: Treatment as Usual (TAU) Group | Active Comparator | Participants received standard care, which included regular psychiatric assessments, pharmacotherapy as deemed appropriate by the treating psychiatrist (primarily SSRIs), and routine nursing care. Routine care consisted of general health education, basic supportive communication, and monitoring of symptoms and side effects. No structured psychotherapy was provided. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Resilience-Satir Hybrid Intervention | Behavioral | A structured, 12-week, group-based psychological intervention integrating principles from Resilience Theory and the Satir Model to enhance coping skills, self-esteem, communication, and family dynamics. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Depressive Symptoms as Measured by the 17-item Hamilton Depression Rating Scale (HAMD-17) | A clinician-rated scale assessing the severity of depression. Total scores range from 0 to 52. A lower score indicates a better outcome. | Baseline, 12 weeks, 6-month follow-up |
| Change in Depressive Symptoms as Measured by the Montgomery-Ã…sberg Depression Rating Scale (MADRS) | A clinician-rated scale sensitive to changes in core depressive symptoms. Total scores range from 0 to 60. A lower score indicates a better outcome. | Baseline, 12 weeks, 6-month follow-up |
| Change in Depressive Symptoms as Measured by the Beck Depression Inventory-II (BDI-II) | A 21-item self-report questionnaire assessing the severity of depression. A lower score indicates a better outcome. | Baseline, 12 weeks, 6-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Psychological Resilience as Measured by the Resilience Scale for Chinese Adolescents (RSCA) | A 27-item self-report scale assessing personal strength and support strength. A higher score indicates better resilience. | Baseline, 12 weeks, 6-month follow-up |
| Change in Self-Esteem as Measured by the Feelings of Inferiority Scale (FIS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Hospital of Hebei Medical University | Shijiazhuang | Hebei | 050000 | China |
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| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| Treatment as Usual (TAU) | Other | Standard care for adolescent depression, including pharmacotherapy and routine nursing support, without structured psychotherapy. |
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A 36-item self-report scale measuring self-esteem. A higher score indicates higher self-esteem and a better outcome. |
| Baseline, 12 weeks, 6-month follow-up |
| Change in Coping Styles as Measured by the Simplified Coping Style Questionnaire (SCSQ) | A 20-item self-report measure assessing positive and negative coping styles. An increase in the positive coping subscale score indicates a better outcome. | Baseline, 12 weeks, 6-month follow-up |
| Change in Medication Adherence as Measured by the Medication Adherence Rating Scale (MARS) | A 10-item self-report scale assessing medication compliance behavior and attitudes. A higher score indicates better adherence. | Baseline, 12 weeks, 6-month follow-up |
| Change in Family Function as Measured by the Family APGAR Index | A 5-item screening tool to assess an individual's perception of family function (Adaptation, Partnership, Growth, Affection, Resolve). A higher score indicates better family function. | Baseline, 12 weeks, 6-month follow-up |
| Change in Social Support as Measured by the Perceived Social Support Scale (PSSS) | A 12-item scale measuring perceived support from family, friends, and significant others. A higher score indicates better perceived social support. | Baseline, 12 weeks, 6-month follow-up |
| Change in Quality of Life as Measured by the World Health Organization Quality of Life-BREF (WHOQOL-BREF) | A 26-item self-report a measure assessing quality of life across four domains: physical health, psychological health, social relationships, and environment. Higher scores indicate a better quality of life. | Baseline, 12 weeks, 6-month follow-up |