in 12 weekly parent training sessions focused on improving parent-child interaction and child compliance.

In another, more recent, example of a parenting program with a demonstrated effect on depression in parents, DeGarmo, Patterson, and Forgatch (2004) found that changes in parenting by single or separated mothers led to subsequent reductions in their sons’ (mean age 8 years at baseline) externalizing and internalizing behavior problems. Changes in the sons’ behavior problems in turn led to reductions in mothers’ depressive symptoms over a period of 2.5 years. Thus, in this intervention, the effects of teaching parenting skills on maternal depressive symptoms were mediated by the decrease in children’s behavior problems. Tonge et al. (2006) also found that a parent education and behavior management intervention led to improvements in parents’ depression. This intervention for parents of children with autism led to a reduction on the depression measure of the General Health Questionnaire for parents who began the trial with high levels of depressive symptoms. Effects on child outcomes were not reported.

These studies provide evidence that teaching parenting skills—such as responsive and nurturing behavior, effective use of positive reinforcement, consistency in responding to child behavior, positive interactions with the child, promoting social skills—not only can improve outcomes for children but also can contribute to reductions in parents’ depressive symptoms, similar to interventions to improve parent-child interactions in infancy and early childhood. Kaminski et al. (2008) note that an increased sense of self-efficacy that results from improvement in parenting skills and reductions in children’s behavior problems may contribute directly to reductions in parents’ depressive symptoms. However, it is also possible that parenting interventions help to mobilize parents to seek additional mental health services that are responsible for reducing their depressive symptoms. Most of these parent training programs evaluating effects on depression in parents have not been targeted to parents with depression. Rather, they have been targeted to parents of children with behavioral problems or clinical diagnoses or parents experiencing additional stressors, such as separation. It is therefore not clear how well these results can be generalized to a broader population of families.

There is also some evidence that parental depression can reduce the effectiveness of some parenting programs, as was seen with the home visiting and early childhood programs described above. The Incredible Years, for example, is a training program that includes components for parents, teachers, and children designed to promote social, emotional, and academic competence, to reduce children’s aggression and behavioral problems, and to prevent them from developing conduct problems. Two randomized trials in Head Start have shown that the Incredible Years Parenting Training Program resulted in significant improvement in parent-child interactions



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