Objective: To describe essential elements in the adaptation of a prevention approach with a high-risk urban sample, chosen to contrast sharply with the primarily middle-class sample in which it had been originally tested.
Method: Key elements of a preventive intervention for families with parental depression were adapted for use in the new context.
Results: A sequence of alliance-building events was implemented, involving engagement at three levels: community, caregivers, and family. The prevention approach was modified to include an expanded approach to defining depression and resilience; greater flexibility on the part of the clinician; more intensive engagement between clinician and family, with a focus on immediate daily concerns; as well as awareness of cultural issues and responsiveness to the subject's experience of violence.
Conclusion: Core principles of helping family members to discuss the effects of depression and adversity on family life were affirmed.