Thienemann M, Martin J, Cregger B, Thompson H B, Dyer-Friedman J
Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94305, USA.
J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1254-60. doi: 10.1097/00004583-200111000-00004.
Concerns about isolation, compromised development, partial pharmacotherapy response, therapist scarcity, and inadequate cognitive-behavioral therapy (CBT) adherence led the authors to adapt a CBT protocol to a group format for adolescents with obsessive-compulsive disorder (OCD). A naturalistic, open trial of group CBT for adolescent OCD is described. The authors predicted symptom improvement and format acceptability.
Over a 1 -year period, 18 adolescents aged 13 to 17 years with OCD received 14-week group CBT based on March and Mulle's OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual in four consecutive sessions of five to nine patients. Eighty-three percent had undergone at least one medication trial, and 78% had previous CBT experience.
OCD symptoms measured by the Children's Yale-Brown Obsessive Compulsive Scale improved significantly, both statistically and clinically. Adolescents consistently shared information and designed exposure interventions for themselves and others during sessions. Repeated self-report measures confirmed adolescents' satisfaction with therapy.
This pilot study demonstrates that a manual-based treatment protocol may be exported for clinical use, adaptable for the end-user's needs, and palatable to adolescent patients. Clinical improvement and patient satisfaction justify further investigation in a controlled study.
由于担心隔离、发育受损、部分药物治疗反应不佳、治疗师短缺以及认知行为疗法（CBT）依从性不足，作者将一种CBT方案改编为针对患有强迫症（OCD）青少年的团体形式。本文描述了一项针对青少年强迫症的团体CBT自然主义开放性试验。作者预测了症状改善情况和形式可接受性。
在1年的时间里，18名年龄在13至17岁的患有强迫症的青少年接受了为期14周的团体CBT，该疗法基于March和Mulle所著的《儿童与青少年强迫症：认知行为治疗手册》，分四期连续进行，每期有五至九名患者。83%的患者至少接受过一次药物试验，78%的患者有过CBT治疗经历。
通过儿童耶鲁-布朗强迫症量表测量的强迫症症状在统计学和临床上均有显著改善。青少年在治疗过程中始终分享信息，并为自己和他人设计暴露干预措施。重复的自我报告测量证实了青少年对治疗的满意度。
这项初步研究表明，基于手册的治疗方案可用于临床，能适应最终用户的需求，且青少年患者易于接受。临床改善和患者满意度证明有必要在对照研究中进一步开展调查。
