| Effective cognitive-behavioral treatments for childhood depression have developed over the last decade but many families face barriers to such care. Telemedicine increases access to psychological interventions by linking the child and the clinician using interactive televideo (ITV). The current study evaluated an 8-week, cognitive-behavioral therapy (CBT) intervention for childhood depression either face-to-face or over ITV. The telemedicine setup included two PC-based PictureTel systems at 128 kilibits/second.;Children were assessed for childhood depression using the mood section of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present Episode (K-SADS-P). Thirty-eight families enrolled in the study and were randomized to either face-to-face or ITV treatment. Twenty-eight families completed the intervention. At pre- and post-treatment, the parent completed the Beck Depression Inventory-II (BDI-II) and the Behavior Assessment System for Children (BASC). The child completed the Children's Depression Inventory (CDI) and the BASC.;The 28 study completers differed significantly from the 10 noncompleters on the following factors: fewer "other" ethnicity, more ADHD symptoms, and fewer parent depressive symptoms. The CBT treatment across the two conditions was effective. The significant Time main effects (p < .05) included: CDI total score, Parent BASC Externalizing composite, Parent BASC Internalizing composite, Parent BASC Behavior Symptom Index, Child BASC Critical Items, Child BASC School Problems composite, Child BASC Clinical composite, Child BASC Adjustment composite, Child BASC Emotional Symptom Index, and Child BASC Depression subscale. The significant Group by Time interaction effects (p < .05) were a faster rate of decline in the CDI total score for the ITV group and a faster rate of decline in the Child School Problems composite in the ITV group. The overall remission from depression based on post-evaluation with the KSADS-P was 82% and did not significantly differ across delivery method.;In addition, the families in the ITV condition reported high satisfaction with the treatment on the Telemedicine Satisfaction Questionnaire and reported little difficulty hearing or seeing the therapist. The results suggest that telemedicine provides an effective alternative delivery system for treating childhood depression. Future studies may address implementing the CBT over ITV in the community and over different technologies. |
