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Does Acceptance of the Relational Reframe Predict Adolescent Depression and Suicidal Ideation Outcomes?
Journal article   Peer reviewed

Does Acceptance of the Relational Reframe Predict Adolescent Depression and Suicidal Ideation Outcomes?

Nele Bergers, E Stephanie Krauthamer Ewing, Daniel T Vader, Tara Santens, Suzanne Levy, Nadia van der Spek, Claudi Bockting, Guy Diamond and Guy Bosmans
Journal of marital and family therapy, v 52(3), e70153
Jul 2026
DOI: https://doi.org/10.1111/jmft.70153
PMID: 42290466
Featured in Collection :   Drexel's Newest Publications

Abstract

Adolescent Adolescent Behavior - psychology Depression - psychology Depression - therapy Family Therapy - methods Female Humans Male Mother-Child Relations - psychology Object Attachment Suicidal Ideation
Attachment-based family therapy (ABFT) is an evidence-based systemic treatment for adolescent depression and suicidality. The first session focuses on shifting therapy goals from behavior management to relational repair. This study explores whether making this shift is associated with adolescent treatment outcomes. First-session recordings from an ABFT randomized controlled trial were coded for shifts in content (from an individual to a relational understanding of symptoms) and affect (from defensive to vulnerable emotions or hopefulness). Greater maternal responsivity to the relational reframe and stronger maternal acceptance of the relational contract were associated with greater reductions in adolescents' depressive symptoms. In contrast, adolescent scores on these measures were not associated with depressive symptom change, and although suicidal ideation decreased in the overall study, neither adolescent nor maternal scores on these measures predicted changes in suicidal ideation. Findings suggest that early maternal engagement with the relational focus of ABFT may be an indicator of subsequent improvement in adolescent depression.

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