Identifying depressed children : a qualitative analysis of child and parent responses to depression screening and assessment

This qualitative interview study explored the responses of child participants and their primary caregivers to the experience of completing a multi-stage screening process designed to identify depressed youth. Participants were sixteen girls ages 9 to 11 and caregivers of twelve of the girls. The child participants selected for this study were those who reported symptoms of a depressive disorder at the initial stages of screening without receiving diagnosis of a depressive disorder at the final stage of screening. Qualitative interviews were completed separately with child participants and their caregivers using a semi-structured interview format. A grounded theory approach was used to analyze interview transcripts and generate an integrated explanation of child and caregiver responses to depression screening and assessment (Strauss & Corbin, 1998). Results of this study indicate that depression screening and assessment serves the function of creating a forum for the child perspective by raising the child‘s emotional state and concerns to the attention of both the child and the parent. The child participants in this study reported experiencing emotional distress or a sense of burden prior to the first stage of screening. A process of reflecting on their emotions, beliefs, and stressors began as child participants completed screening questionnaires, followed by a sense of relief or improved mood in response to talking with interviewers during a brief interview. The forum for the child perspective expanded as parents received interviewer feedback about child emotions and concerns and began to assess the information in light of their own observations and situational factors. The extent to which parent and child maintained the forum for the child perspective through sustained communication about the child‘s emotions and concerns influenced the type and intensity of interventions subsequently introduced by parents. The chief means through which depression screening affected the child participants was through enhancing their understanding of themselves, promoting positive coping processes, facilitating parent/child communication, and influencing parent perceptions and the parenting agenda.