Jørring Nina Tejs, Gjessing Jensen Karsten
Unit for Psychotherapy, Child and Adolescent Mental Health Services, Capital Region of Denmark, Glostrup, Denmark.
Child and Adolescent Mental Health Centre, Capital Region of Denmark, Glostrup, Denmark.
Scand J Child Adolesc Psychiatr Psychol. 2018 Oct 18;6(2):107-114. doi: 10.21307/sjcapp-2018-012. eCollection 2018.
Little research has been undertaken on children and adolescents with psychiatric co-morbidity and this group is seldom subject to evidence-based treatment. Equally, there has been little research on creating an evidence base for Narrative Therapy, which means that narrative family therapy (NFT) is seldom available to children and adolescents with a psychiatric disorder.
A single group clinical design was used to examine the efficacy of NFT for children and adolescents with different diagnoses.
Families receiving NFT from the Family Therapy Team (FTT) at the Child and Adolescent Mental Health Services (CAMHS) of the Capital Region of Denmark filled out psychometric measurements before and after treatment. Patients evaluated the burden of symptoms using Beck's Youth Inventory (BYI), and parents evaluated their personal agency in relationship to their child's psychiatric disorder using Parent Activation Measurement (PAM).
We analyzed data from 48 patients and found a significant increase in median BYI measures of Self-Concept (40.5 to 46.0, = 0.002) with an effect size of 0.60, decreases in BYI Depression Index (58.0 to 54.0, = 0.030) with an effect size of -0.41, decreases in BYI Disruptive Behaviour Index (48.0 to 43.0, = 0.030) with an effect size of -0.38, and a significant increase in PAM from 56.4 to 68.5, = 0.001 with an effect size of 0.61.
Results from this study suggest that NFT has a direct positive effect on patients' own evaluation of the burden of symptoms, and parents' perceived personal agency regarding their child's distress.
针对患有精神疾病共病的儿童和青少年的研究较少,并且这一群体很少接受循证治疗。同样,关于为叙事疗法建立循证基础的研究也很少,这意味着患有精神疾病的儿童和青少年很少能获得叙事家庭疗法(NFT)。
采用单组临床设计来检验NFT对不同诊断的儿童和青少年的疗效。
在丹麦首都地区儿童和青少年心理健康服务中心(CAMHS)的家庭治疗团队(FTT)接受NFT治疗的家庭,在治疗前后填写了心理测量量表。患者使用贝克青少年量表(BYI)评估症状负担,父母使用父母激活测量量表(PAM)评估他们在孩子精神疾病方面的个人能动性。
我们分析了48名患者的数据,发现自我概念的BYI中位数显著增加(从40.5增至46.0,P = 0.002),效应量为0.60;BYI抑郁指数下降(从58.0降至54.0,P = 0.030),效应量为 -0.41;BYI破坏性行为指数下降(从48.0降至43.0,P = 0.030),效应量为 -0.38;PAM从56.4显著增至68.5,P = 0.001,效应量为0.61。
本研究结果表明,NFT对患者自身对症状负担的评估以及父母对孩子痛苦的个人能动性认知有直接的积极影响。