Psychiatry. 2019 Summer;82(2):113-127. doi: 10.1080/00332747.2018.1560584. Epub 2019 Feb 8.
: To evaluate potential differences in therapeutic outcomes between youths who completed a full course of treatment as planned compared to youths who terminated treatment prematurely. : Using longitudinal data from the National Child Traumatic Stress Network (NCTSN) Core Data Set, the present study examined demographic characteristics, trauma history, scores on standardized measures, and ratings of functional impairment and behavior problems in a large clinical sample of children and adolescents exposed to trauma who received treatment at NCTSN centers across the United States. Baseline and follow-up data were used to compare treatment completers (= 3,108) and noncompleters ( = 4,029). : Both treatment completers and noncompleters received benefits from treatment by NCTSN mental health providers in that both groups showed significant decreases in mean scores from baseline to follow-up on all standardized measures. However, compared to noncompleters, treatment completers showed three types of significantly greater benefit at follow-up. These included: (a) greater rates of decline (i.e., steeper slopes) on all outcome measures; (b) greater reductions in the odds of falling within the clinical range on standardized measures; and (c) greater reductions in the odds of exhibiting functional impairment and behavior problems at follow-up. In contrast, compared to treatment completers, noncompleters reported significantly higher rates of lifetime exposure to community violence, psychological maltreatment, physical abuse, neglect, sexual abuse, and sexual assault. : These findings underscore the value of incorporating engagement and retention strategies in treatments for traumatized youths to maximize therapeutic benefit and raise the standard of care.
: 评估完成全程治疗的青少年与提前终止治疗的青少年之间治疗效果的潜在差异。: 使用国家儿童创伤应激网络(NCTSN)核心数据集的纵向数据,本研究调查了大量接受 NCTSN 中心治疗的创伤后儿童和青少年的人口统计学特征、创伤史、标准化测量得分,以及功能障碍和行为问题的评级。使用基线和随访数据比较了治疗完成者(=3108)和未完成者(=4029)。: 治疗完成者和未完成者都从 NCTSN 心理健康提供者的治疗中受益,因为两组在所有标准化测量上的平均分都从基线到随访显著下降。然而,与未完成者相比,治疗完成者在随访时有三种明显更大的获益。这包括:(a)所有结果测量的下降率更高(即斜率更陡);(b)标准化测量中处于临床范围的几率降低幅度更大;(c)功能障碍和行为问题的几率降低幅度更大。相比之下,与治疗完成者相比,未完成者报告称一生中接触社区暴力、心理虐待、身体虐待、忽视、性虐待和性侵犯的比率显著更高。: 这些发现强调了在治疗创伤后青少年时纳入参与和保留策略的重要性,以最大化治疗效果,并提高护理标准。