Volume 22, Issue 4 p. 224-231
Original Article

Mitigating depression among orphaned and vulnerable adolescents: a randomized controlled trial of interpersonal psychotherapy for groups in South Africa

Tonya R. Thurman

Tonya R. Thurman

Tulane International LLC, 23 Belmont Road, 7700 Cape Town, South Africa

Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA

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Johanna Nice

Johanna Nice

Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA

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Tory M. Taylor

Tory M. Taylor

Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA

Tulane School of Public Health, New Orleans, LA, USA

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Brian Luckett

Brian Luckett

Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA

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First published: 26 September 2017
Citations: 11

Abstract

Background

Children and adolescents affected by HIV are at elevated risk of depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa.

Method

A cluster randomized controlled trial wherein adolescents ages 14–17 enrolled in community-based programming for HIV-affected and vulnerable families were randomly assigned by geographic cluster to participate in a 16-session IPTG intervention or the standard of care (n = 489). Baseline and postintervention surveys conducted with enrollees included standardized depression screening. Utilizing an intent-to-treat design, mixed effects models were performed to examine treatment effects for all participants and potential moderators including gender and baseline depression level (Clinical Trials registration: ClinicalTrials.gov NCT02386878).

Results

While 23% of adolescents in the intervention group did not attend any IPTG sessions, average attendance was 12 out of 16 possible sessions among participants. The intervention was not associated with changes in depression symptomology.

Conclusions

Results underscore the importance of mitigating participation barriers prior to intervention roll-out and the need for increased evidence for psychological health interventions to mitigate depression among orphaned and vulnerable adolescents. This intervention and the study selectively targeted at-risk adolescents versus using diagnostic mental health criteria for enrollment; more research is needed to identify the potential benefits and disadvantages of these approaches.