Maternal depression is one of the most well-documented risk factors for child and adolescent depression, but little work has focused on how to reduce this risk. Although a few interventions have been developed and tested, implementing targeted prevention efforts with depressed mothers and their children is not common practice. The increased risk of depression for children of depressed mothers is so clear, however, professionals can no longer “sit on the sidelines” without initiating specific prevention efforts with this population. To do so requires a paradigm shift—moving from a focus on individual treatment to a prevention approach that engages the entire family as the unit of care. The purpose of this paper is to draw on existing literature to highlight potential “pathways to prevention” for children of depressed mothers. Recommendations for initiating these pathways based on family lifecycle stage, point of contact, and service setting are presented and discussed. 1. Introduction Decades of research has shown that maternal depression is one of the most potent risk factors for child and adolescent depression, (e.g., [1–5]), with lifetime estimates suggesting that half of children growing up with a depressed parent will be diagnosed with a depressive disorder by age 20 [6]. Very little work, however, has focused on how to reduce this risk. The few studies that have tested prevention interventions in children of depressed parents have reported promising results [7, 8], yet a preventative approach with this population is not common practice [9]. A recent report [10] highlights the urgent need to improve prevention of mental, emotional, and behavioral disorders among youth. The report notes that, “interventions before the disorder occurs offer the greatest opportunity to avoid the substantial costs to individuals, families, and society that these disorders entail” (p. 1). The risk of depression for children of depressed mothers is clear. Children of depressed mothers are up to 6 times more likely than other children to develop depression [11, 12]. More specifically, a recent study reports that 41.5% of children of postnatally depressed mothers experienced depression by age 16 as compared to 12.5% of children of nondepressed mothers [13]. Another recent study demonstrates that maternal depression is one of two key factors to distinguish young children (age 5 and under) with high levels of anxiety and depressive symptoms from other children (the other factor was difficult temperament at 5 months) [14]. With maternal depression arguably one of the most
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