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简短、非药物干预儿科焦虑症:荟萃分析和证据基础状况。

Brief, Non-Pharmacological, Interventions for Pediatric Anxiety: Meta-Analysis and Evidence Base Status.

机构信息

Department of Psychology, Arizona State University.

Department of Psychology, Stony Brook University.

出版信息

J Clin Child Adolesc Psychol. 2020 Jul-Aug;49(4):435-459. doi: 10.1080/15374416.2020.1738237. Epub 2020 Apr 14.

Abstract

In 1998, Ost published [One-session treatment of specific phobias-a rapid and effective method] [in Swedish] giving rise to the idea that brief, intensive, and concentrated psychosocial interventions could exhibit public health impact. At this juncture, and per criteria of the Society for Clinical Child and Adolescent Psychology, there are data supporting that brief, non-pharmacological intervention [prescriptions] for pediatric anxiety can be considered well-established or probably efficacious. In addition, data from 76 randomized controlled trials ( = 17,203 youth) yield an overall mean effect size of 0.19 on pediatric anxiety outcomes (pre-post). Note, however, that effect sizes vary significantly. These data point to the capacity for clinical change coming from in-vivo exposures for specific phobias (3 h, one session), CBT with social skills training (3 h, six sessions for indicated prevention and early intervention), and CBT-based parent training (~6 h, eight digital modules with clinician support). Given such evidence, we recommend efforts be made to establish ways to position such treatment innovations for rapid deployment facilitated by high-quality training, monitoring, technical assistance, and ongoing disclosures.

摘要

1998 年,Ost 发表了[一次性治疗特定恐惧症——一种快速有效的方法][瑞典语],这引发了一个想法,即短暂、密集、集中的心理社会干预措施可能会产生公共卫生影响。在这个时候,根据临床儿童和青少年心理学协会的标准,有数据支持简短的、非药物干预[处方]可以被认为是有效的。此外,来自 76 项随机对照试验(= 17203 名青少年)的数据显示,儿科焦虑症的总体平均效应大小为 0.19(前后)。然而,请注意,效果大小差异很大。这些数据表明,特定恐惧症的现场暴露(约 3 小时,一次疗程)、基于认知行为疗法的社交技能训练(3 小时,针对有指征的预防和早期干预的 6 次疗程)以及基于认知行为疗法的家长培训(6 小时,8 个带有临床医生支持的数字模块)可以带来临床变化。鉴于这些证据,我们建议努力建立方法,通过高质量的培训、监测、技术援助和持续披露,为快速部署此类治疗创新创造条件。

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