Assignment task:
Agency:
Program: Functional Family Therapy (FFT)
Selecting the appropriate measure to evaluate depressive symptoms in the Functional Family Therapy (FFT) program is one of the most crucial steps in developing a robust and meaningful program evaluation. Because my evaluation centers on short-term reduction in depressive symptoms, the measure I select must be developmentally appropriate for youth ages 11 -18, culturally sensitive, practical for community-based clinicians, and aligned with evidence-based practice. I am currently considering two possible measures: the Patient Health Questionnaire 9 Modified for Adolescents (PHQ-A) and the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Need Assignment Help?
PHQ-A (Patient Health Questionnaire-Adolescent Version)
The PHQ-A is a widely used, brief, 9-item self-report measure assessing core depressive symptoms in adolescents. It has strong empirical support, is aligned with DSM-5 criteria, and is commonly used in youth mental health evaluations (Richardson et al., 2017).
Pros:
It is very brief and easy to administer, which is ideal for FFT sessions where time is limited. Strong evidence of validity for adolescents ages 11-17, making it appropriate for my population (Richardson et al., 2017). It is available free/public domain, which is essential for agencies with limited resources. It has a minimal reading load, supporting youth with lower literacy.
Cons:
Some items may require additional explanation for younger adolescents. Self-report tools can be influenced by social desirability or reluctance to disclose symptoms in front of caregivers. Cultural differences may influence how depressive symptoms are expressed, potentially affecting item interpretation (Alegría et al., 2019).
CES-DC (Center for Epidemiologic Studies Depression Scale-Child Version)
The CES-DC is a 20-item measure designed for ages 6-17 and captures emotional, behavioral, and cognitive components of depression.
Pros:
Covers a broader range of symptoms than the PHQ-A, which may be helpful for youth with trauma histories (Ebesutani et al., 2018). Strong psychometric support in diverse cultural groups; important since Tides Family Services works with families experiencing socioeconomic and racial/ethnic disparities. Also free to use, making it feasible for a community agency.
Cons:
Longer (20 items), which may be burdensome in home-based sessions. May require more reading support for adolescents with literacy challenges. Requires slightly more staff time to score and interpret.
Practical Considerations
FFT clinicians already administer structured assessments during intake and discharge, but they often have heavy caseloads and work in homes where distractions are common. Therefore, feasibility, including brevity and ease of scoring, is extremely important. Additionally, because FFT serves many families with trauma exposure, low socioeconomic status, or system involvement, the measure must be sensitive to cultural expressions of distress and youth who may underreport symptoms due to mistrust or stigma (Kerig & Becker, 2021).
Measure I Am Leaning Toward and Why
I am strongly leaning toward selecting the PHQ-A for the program evaluation. While both measures are evidence-based and free to use, the PHQ-A's brevity, strong psychometric support, and alignment with DSM-based depressive criteria make it the most realistic and clinically efficient choice for Tides Family Services. It allows FFT clinicians to collect meaningful data without overburdening families or interrupting rapport-building. Additionally, because depressive symptoms in FFT clients are often present alongside behavioral dysregulation and family conflict, the PHQ-A provides a clear, focused indicator of emotional change that aligns well with the evaluation design and FFT's outcome monitoring practices (Sexton & Turner, 2023). The CES-DC is valuable, but the PHQ-A better fits the real-world demands of home-based family therapy, staff capacity, and program flow.
References:
Alegría, M., Green, J. G., McLaughlin, K. A., & Loder, S. (2019). Disparities in child and adolescent mental health and mental health services in the U.S. Psychiatric Services, 70(1), 27-30.
Ebesutani, C., Okamura, K., Higa-McMillan, C., & Chorpita, B. F. (2018). A psychometric analysis of the CES-DC in diverse youth samples. Journal of Affective Disorders, 227, 351-359.
Kerig, P. K., & Becker, S. P. (2021). Trauma and juvenile delinquency: Complex trauma and pathways to system involvement. Journal of Trauma & Dissociation, 22(2), 113-131.
Richardson, L. P., McCauley, E., McCarty, C. A., Grossman, D. C., Myaing, M., Zhou, C., & Katon, W. (2017). Predictors of depression persistence among adolescents. Pediatrics, 140(6), e20170174.
Sexton, T. L., & Turner, C. W. (2023). Functional Family Therapy: Updated evidence supporting its effectiveness for youth with emotional and behavioral difficulties. Journal of Family Psychology, 37(2), 155-167.