| Principles and tasks | Description |
| Meet with the family | Include as many family members as can come and are interested in helping. |
| Elicit everyone's view | All family members should discuss their perception of the family's problems, whether related to the depression or not. |
| Assess couples/family functioning | Evaluate how the family communicates, solves problems, connects emotionally with each other, assigns family responsibilities, and sets family rules. |
| Focus on strengths | Identify and reinforce family strengths. |
| Evaluate motivation for change | Ensure that families are committed to working together on their problems. |
| Assess safety | Ensure that the depressed patient is not suicidal and that there is no family violence. |
| Psychoeducation | Teach families about depression, including signs and symptoms, etiology, course of illness, and available treatments. |
| Prioritize problems | Determine with the family which of their problems they want to address. Prioritize problems related to safety. |
| Negotiate expectations | Establish clinician's expectations for the treatment process, eg, compliance with meetings and working on assigned tasks. Family members should negotiate expected changes with each other. |
| Set realistic expectations | Expectations about change and outcome should be realistic and achievable. |
| Focus on behaviors and not feelings | Feelings cannot be changed and are difficult to measure. Behaviors are more amenable to change and can be evaluated more objectively. |
| Include some general goals | Communicate directly and clearly, support and fulfill appropriate roles as spouse and parent, and reduce criticism, blame, and hostility. |
| Support increased level of activity | The depressed patient should gradually increase participation in activities first within the home and then outside of the home, including greater levels of physical activity. |
| Provide feedback | Inform the family when they are doing well and point out difficulties they are experiencing in making changes. |
