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青少年临床环境中心理治疗干预的效果及结果预测因素

Effectiveness and Predictors of Outcome for Psychotherapeutic Interventions in Clinical Settings Among Adolescents.

作者信息

Gergov Vera, Lindberg Nina, Lahti Jari, Lipsanen Jari, Marttunen Mauri

机构信息

Department of Adolescent Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Department of Forensic Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

出版信息

Front Psychol. 2021 Feb 16;12:628977. doi: 10.3389/fpsyg.2021.628977. eCollection 2021.

Abstract

BACKGROUND

The aim of this study was to investigate the effectiveness of psychotherapeutic interventions for clinically referred adolescents, as well as to examine whether sociodemographic, clinical, or treatment-related variables and patients' role expectations predict treatment outcome or are possible predictors of treatment dropout.

METHOD

The study comprised 58 adolescents (mean age 14.2, 65.5% female) suffering from diverse psychiatric disorders referred to psychotherapeutic interventions conducted in outpatient care. The outcome measures, The Beck Depression Inventory, and the Clinical Outcomes in Routine Evaluation - Outcome Measure were filled in at baseline and at 3-, 6-, and 12-month follow-ups. Possible predictors were assessed at baseline.

RESULTS

The results indicate that the mean level of symptoms and psychological distress decreased during the treatment, most reduction occurring in the first 6 months. The frequency of treatment sessions was the strongest predictor of good outcome. Adolescents with a higher level of externalizing problems or lower level of expectations for their own active role in treatment seem to have a higher risk of dropping out.

CONCLUSION

Offering intensive treatment for a shorter period might be the most efficient way to gain symptom reduction and decrease psychological distress in psychotherapeutic interventions with adolescents. Being aware of externalizing behavior and increasing the adolescents' own agency during the assessment could strengthen commitment and result in the adolescent benefiting more from treatment.

摘要

背景

本研究的目的是调查心理治疗干预对临床转诊青少年的有效性,以及检查社会人口统计学、临床或治疗相关变量和患者的角色期望是否能预测治疗结果或是否是治疗退出的可能预测因素。

方法

该研究包括58名青少年(平均年龄14.2岁,65.5%为女性),他们患有各种精神疾病,被转诊至门诊进行心理治疗干预。在基线以及3个月、6个月和12个月随访时填写结果测量指标,即贝克抑郁量表和常规评估中的临床结果-结果测量指标。在基线时评估可能的预测因素。

结果

结果表明,治疗期间症状和心理困扰的平均水平有所下降,大部分下降发生在最初6个月。治疗疗程的频率是良好结果的最强预测因素。外化问题水平较高或对自己在治疗中的积极作用期望较低的青少年似乎有更高的退出风险。

结论

在对青少年进行心理治疗干预时,提供较短时间的强化治疗可能是减轻症状和减少心理困扰的最有效方法。在评估过程中意识到外化行为并增强青少年自身的能动性可以增强其参与度,从而使青少年从治疗中获益更多。

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