The Depressed Child

Douglas A. Riley’s book, The Depressed Child: A Parent’s Guide for Rescuing Kids, explores the nature of depression along with some of the most common negative statements that children with depression tell themselves as a part of their “internal program” or their belief system. Riley provides a concise overview of the nature of depression.  He has 20 years of experience treating children for depression and has realized that most children who are depressed need their parents, and a therapist, to help them navigate through the depression.  Through this book he helps parents examine their child’s faulty thought process, so they may help their child make a conscious choice, through hard work and cognitive behavioral therapy, to change their way of thinking.

The chapters describe each of several beliefs that depressed children think and perceive about life and themselves. The chapters include: “Death is an Option,” “I am Made of Inferior Stuff,” “My Mistakes are Proof that I am Worthless,” “No One will Ever Like Me,” “The “F” Word,” “I Can’t Live without This Person,” “I Must Be Going Crazy,” “My Parent Didn’t Love Me Enough,” “Substances Will Make Me Happy,” and “Nothing will Ever Change.”  The author also includes chapters on “Planning the Rescue Mission,” “Building Treatment Strategies,” and a brief chapter on “Associated Disorders.”

Throughout the book, Riley challenges a series of commonly held beliefs (denoted by each chapter) held by children, about their lives and relationships that have led them into depression. He skillfully challenges the beliefs through a variety of highly effective cognitive behavioral therapy techniques. For example, in the chapter, “I Must be Going Crazy” the author describes strategies to help kids deal with hearing voices (he discriminates between auditory hallucinations and voices of beliefs or negative thoughts). These strategies can be generalized to help deal with other faulty/negative beliefs. For example he says to imagine the negative thought/negative voice as a monster. Imagine the monster, two inches tall, running around, screaming, roaring, and shaking its fists. Visualize taking your foot and squishing this monster like a bug. This visualization exercise gives the child hope and a voice and helps her regain a sense of control. The thought, or voice, loses all power.

In each chapter Riley provides a list of the beliefs behind a main belief such as “substances will make me happy.” He describes that when depression and substance abuse are combined, kids’ thinking becomes more blunted and pessimistic. He explains that the therapist/or parent must first challenge the belief system of the child and then provide replacement beliefs. He states that reprogramming is difficult, so it is best to start these discussions about their beliefs early in life.

Riley discusses the question of what causes depression. He states that there are three main factors: How a person thinks, outside factors and a biochemical imbalance. Once the cause is determined, the therapist is able to make a plan of action. In conjunction with the therapists plan, the parent can learn how to talk to a child about what he is thinking and may be able to help him replace his depression causing thoughts with more productive ways of thinking. Riley describes that in addition to cognitive therapy the child may also need anti-depressants and supportive therapy to help cope with outside factors that may be affecting the child¹s depressive state.

Riley indicates how a faulty belief system leads to new faulty beliefs that leads to dangerous behaviors and or a depressive state of mind. He does not focus on where to place the blame for kids who are depressed. Instead he takes a highly organized, straightforward approach to helping kids challenge their own negative belief system. Once he is able to help kids realize how their beliefs are baseless, they are then one step closer to forming a new belief system based on reality.

The chapter “Building a treatment Strategy” describes treatment strategies of which parents should be aware. Riley provides information regarding the different types of mental health practitioners, inpatient vs. outpatient treatment, medication, and evaluation of the treatment process. Riley also provides three test case scenarios in order for the reader to test their clinical judgment. I found this chapter to provide highly reliable information that may be helpful to parents searching for the most appropriate treatment for their child.
In Riley’s final chapter he includes a “few kind words about depression.” Here he expresses how he struggles with the grief of when kids he has worked with have committed suicide. He states that fortunately not many kids who are depressed reach this point of desperation. Riley explains how parents are given a chance to help their kids when depression is strong enough to catch their attention. His experience is that most parents are surprised at how much information their children will share if they are only asked.

Riley describes that the journey to helping children must be taken on with the joint cooperation between therapist and parent. He emphasizes that the nature of depression is pervasive and that if the cognitive behavioral approach is not reinforced in the home, the treatment will not be as effective. He also reinforces some common-sense advice to parents about setting firm limits and helping their kids make better decisions.

Riley states, “in order to rescue your child from cognitive depression, you have to help him understand that the way he is thinking is what is actually causing him to be depressed. In order to help him escape depression, we will have to show him, sometimes quite dramatically, that his thinking is faulty.” Riley explores the idea that if a child has a thought-based cause for depression, then he needs to be given the tools to replace depression-causing thoughts with more productive ways of thinking.

Riley skillfully explains from a “strengths” perspective the cognitive behavioral approach to helping kids and families break free from depression. He encourages children to recognize that they have the ability to change. He provides children and families struggling with depression hope that their situation can improve and the tools for a lifetime of improved mental health.

© 2002 Monique Thorton

Monique Thornton earned her MSW in 1993 from the University of Kansas, and is the mother of a 5-year-old with Asperger Syndrome.