Pilot Study of Group Interpersonal Psychotherapy for Depression Among Young People With Chronic Illness.

OBJECTIVE: Interpersonal psychotherapy (IPT) is an evidence-based treatment for depression, demonstrating efficacy with adolescents and young adults. Social support is proposed to be an important treatment component and may be helpful for adolescents and young adults with chronic illness. The authors sought to assess the feasibility of delivering IPT to this population and to examine changes in depressive symptoms and perceived social support. METHODS: An open-label feasibility trial of group-based IPT was conducted for adolescents and young adults with chronic illness (N=17). The 12-session group IPT was concurrent with group members' individual psychotherapy, and group IPT was focused on providing support in navigating interpersonal challenges related to the participants' chronic illness. Participants completed questionnaires assessing depressive symptoms and social support before treatment, midtreatment (6 weeks), and after treatment (12 weeks). Generalized estimating equation models, adjusted for repeated measures, were used to assess changes in depressive symptoms and social support over the course of treatment. RESULTS: Deidentified clinical examples illustrated how IPT was practiced in a community mental health setting. Evidence for the feasibility of group IPT was mixed. Although participants had poor session attendance, there was a significant decrease in depressive symptoms (ß=-2.94, 95% CI=-5.30 to -0.59, p=0.014) and a significant increase in perceived social support (ß=4.24, 95% CI=0.51 to 7.98, p=0.026) by the end of treatment. CONCLUSIONS: IPT may help address depressive symptoms and enhance social support among adolescents and young adults with chronic illness. Further research and adaptation are needed to address feasibility challenges in delivering group IPT to this population.

Cell phone support to improve medication adherence among solid organ transplant recipients.

For many adolescent and young adult solid organ transplant recipients, medication non-adherence is a mortal issue. This study investigated the feasibility, acceptability, and potential efficacy of a 12-week cell phone support intervention to improve immunosuppressant medication adherence. A small sample (N = 8) of non-adherent adolescent and young adult transplant recipients, aged 15-20.5 years, was enrolled. Cell phone support consisted of short calls each weekday including medication reminders, discussion of needs, problem-solving support, and promotion of clinic and community resources. Changes in adherence were measured by self-report and laboratory values, and intervention acceptability, adherence barriers, social support, depression, and substance use were assessed by self-report. Pre-post effect sizes showed medium-to-large improvements in adherence, lasting through a 12-week follow-up assessment. There were also small-to-medium changes in adherence barriers, social support, and depression. However, acceptability and feasibility were limited, due to a low rate of enrollment by eligible male participants. Cell phone support interventions may promote medication adherence among adolescents and young adults. Cell phone support warrants further investigation, including a randomized controlled trial to evaluate efficacy.

"Our lives aren't over": A strengths-based perspective on stigma, discrimination, and coping among young parents.

The current study conducted interviews and focus groups with twenty-four diverse 16-25 year-old parents to elicit in-depth narratives about experiences related to parenting status. Parents were recruited from a case management program in the Southwestern United States supporting high school graduation and workforce employment (for mothers and fathers, respectively). Young parents disclosed experiences of shame, stigma, and discrimination associated with perceptions about their "fitness" to be a parent and moral judgment. Themes arose that revealed the positive, adaptive ways that participants coped with potentially deleterious experiences with a focus on their role as a parent and role model for their children. Our findings highlight positive meaning-making and resiliency of young parents when confronted with discrimination and systemic barriers, with many participants focusing on the benefits of parenthood within a unique developmental context. Further, implications for program development, provider trainings, and public policy and advocacy efforts for young parents are discussed.