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.

Categories: ChildhoodDisorders, Depression