What tools are there for screening for depression?
It is important to clarify what is meant by screening. Screening is not diagnosing. Screening is a way to learn whether symptoms are present and how severe they are. Students who score above the cutoff should be referred for a more thorough evaluation by a physician and/or psychologist. The referral to a physician is important because there are some medical conditions that will produce symptoms similar to depression, and those should be ruled out and/or treated. There are several well-researched screening tools that are available and easy to use in the school setting. All are self-report measures. Each will be briefly described here, and the reader is encouraged to contact publishers or go to publishers' websites for further information. Counselors may wish to compare costs, ease of scoring, and psychometric properties in deciding which inventory would be most useful in their setting.
The Children's Depression Inventory (CDI) is appropriate for use with children and adolescents, ages 7 – 17, and is written at a first grade level. It has 27 items in the regular form, and also is available in a 10-item brief form of the most important items. This screening inventory has three statements after each stem, and the child marks the one that is most like him/her. It is quick to administer and score, and is also available in a Spanish version.
Reynolds Child Depression Scale (RCDS) can be used with children ages 8 – 12. The Reynolds Adolescent Depression Scale (RADS) is designed for use with 13 – 18-year-olds. The children's scale is written at 2nd grade reading level, and the adolescent scale is written at third grade level. Each has 30 items, with easy administration and scoring procedures. The children's scale is available in Spanish.
The Beck Depression Inventory for Youth (BDI-Y) is one of the Beck Inventories of Emotional and Social Impairment that are designed for use with children ages 7 – 14, and the 20 items are written at second grade level. Students respond to statements by indicating how frequently a statement is true for them. No Spanish version is available.
The Center for Epidemiological Studies – Depression Scale for Children (CES-DC) is appropriate for adolescents ages 12 – 18, is written at a sixth grade reading level, and has 20 items. Scoring is straightforward.
What can school counselors do about depression?
The first step for the school counselor is to educate oneself and be alert for danger signals among students. Screening all students is not a recommended practice, but screening those students who exhibit one or more symptoms or behaviors described in Part I of this article is a helpful practice. The counselor must adhere to all ethical standards, including informed consent, when administering screening measures. If the student scores above the cutoff for the particular inventory, the school counselor must inform the parent or guardian, and recommend that a full physical and psychological evaluation would be in the child's best interest.
Counselors also need to educate teachers and other staff members that these behaviors and signals, which may be disruptive to learning, may also be clues that a child has an undiagnosed depressive disorder. Teachers are in daily contact with students, and may be the first to observe changes, or see a drawing or writing that is cause for concern. Encouraging teachers to work with counselors and refer these students is an important contribution to prevention efforts.
Parents also need information and education about depression. Many pamphlets and fact sheets are available, and some can be obtained online. Include such information in newsletters, when speaking at parent information programs, and in building a library of useful books that can be loaned to parents. These are all ways to partner with parents in helping their children.
Offering to communicate with treatment providers in order to learn what strategies might be most applicable in school is a way to form important links. Finally, offering support to students who are depressed is an essential service. That support might involve monitoring progress, checking with the student regularly, and/or inviting the student to be in a support group if appropriate.
There is some evidence that depression is appearing at younger ages in recent years. Because depression interferes with a student's academic, social, emotional, and behavioral functioning, school counselors must be active in identifying children who may have this disorder.
Since depression in children is linked to increased risk of suicidal thoughts and behaviors, early intervention for depression is an effective measure to prevent suicide in youth. Suicide is the third leading cause of death in adolescents, and the sixth for 5- to 14-year-olds. Treatment has been found to be effective with children and adolescents, so identifying and referring students may be a matter of life and death.
References And Resources
American Psychiatric Association. (2000). Diagnostic And Statistical Manual Of Mental Disorders (4th ed. text revision). Washington, DC.
Beck, J., Beck A. T., & Jolly, J. (2001). Beck Depression Inventory For Youth. San Antonio, TX: Harcourt Assessments, Inc.
Fendrich, M., Weissman, M. M., & Warner, V. (1990). Screening For Depressive Disorder In Children And Adolescents: Validating The Center For Epidemiologic Studies Depression Scale For Children. American Journal of Epidemiology, 131, 538-551.
Kovacs, M. (1992). Children's Depression Inventory. Tonawanda, NY: Multi-Health System.
Reynolds, W.M. (1989). Reynolds Child Depression Scale. Odessa, FL: Psychological Assessment Resources, Inc.
Reynolds, W. M. (1986). Reynolds Adolescent Depression Scale. Odessa, FL: Psychological Assessment Resources, Inc.
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The incidence of childhood depression has increased dramatically in the last 15 years, and it is affecting younger children than ever before. This storybook helps children ages 5-10 to learn about depression and what to do about it. The main character, Sara, is depressed for a variety of reasons but she gets help from a combination of individual and group counseling. Sometimes she still gets sad, but now she knows how to make herself feel better. To find out how you can purchase this tool to help children who are depressed, click here!
ABOUT DR. SHERI BAUMAN
Dr. Sheri Bauman is an Assistant Professor in the Department of Educational Psychology at the University of Arizona, Tucson, Arizona. She can be reached by email at firstname.lastname@example.org
ABOUT THE AMERICAN SCHOOL COUNSELOR ASSOCIATION
Professional school counselors everywhere share the same vision to support their schools by serving their students. School counselors know that guiding students toward personal and social development leads to improved academic achievement. Through their partnership with principals and teachers, school counselors help prepare today's students to become tomorrow's adults.
The American School Counselor Association (ASCA) responds to school counselors' unique needs, helping them grow individually as professionals and providing them with real tools to guide their students. As an international nonprofit organization founded in 1952, ASCA has the benefit of foresight and hindsight. It has grown to fit counselors' changing needs through social and educational movements from desegregation to standardized testing. Responding to the needs of counselors as voiced by counselors has enabled ASCA to remain vital and forward-thinking.
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