基于课堂的认知行为疗法：“勇敢之旅”的大规模非随机对照试验
Classroom-based cognitive behavioural therapy: a large-scale non-randomised controlled trial of the 'Journey of the Brave'.
作者信息
Urao Yuko, Ohira Ikuyo, Koshiba Takako, Ishikawa Shin-Ichi, Sato Yasunori, Shimizu Eiji
机构信息
Research Centre for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.
出版信息
Child Adolesc Psychiatry Ment Health. 2021 Apr 24;15(1):21. doi: 10.1186/s13034-021-00374-6.
BACKGROUND
In Japan, 'Journey of the Brave', a cognitive behavioural therapy (CBT)-based anxiety preventive education programme, was previously developed and its effectiveness examined in two small-scale controlled trials. These studies had some limitations, including a small number of participants and not having regular classroom teachers as programme facilitators. Therefore, we conducted a large-scale controlled trial, with teachers as programme implementers.
METHODS
Twenty-seven elementary schools participated: 1622 and 1123 children were allocated to the intervention and control groups, respectively. The intervention group received a programme comprising ten 45-min sessions, while the control group underwent the regular school curriculum. Anxiety symptoms among participants were assessed using the Spence Children's Anxiety Scale (SCAS) at three stages (pre-intervention, post-intervention, and follow-up).
RESULTS
Following primary analysis, estimated mean changes in SCAS from baseline to follow-up were - 4.91 (95% CI - 5.91, - 3.90) in the intervention group and - 2.53 (95% CI - 3.52, - 1.54) in the control group; the group difference was 2.37 (95% CI 1.42, 3.33, p < 0.0001). Children in the intervention group showed significant reduction in their anxiety score versus children in the control group.
CONCLUSIONS
The results showed a statistically significant anxiety score reduction in the intervention group, thus verifying the programme's effectiveness. Trial registration The University Hospital Medical Information Network (UMIN): UMIN000032517. Registered 10 May 2018-Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037083.
背景
在日本，先前开发了一项名为“勇敢之旅”的基于认知行为疗法（CBT）的焦虑预防教育计划，并在两项小规模对照试验中检验了其有效性。这些研究存在一些局限性，包括参与者数量少以及没有正规的课堂教师作为计划实施者。因此，我们进行了一项大规模对照试验，由教师作为计划实施者。
方法
27所小学参与其中：分别将1622名和1123名儿童分配到干预组和对照组。干预组接受了一个由十节45分钟课程组成的计划，而对照组则接受常规学校课程。在三个阶段（干预前、干预后和随访）使用斯宾斯儿童焦虑量表（SCAS）评估参与者的焦虑症状。
结果
经过初步分析，干预组从基线到随访时SCAS的估计平均变化为-4.91（95%CI -5.91，-3.90），对照组为-2.53（95%CI -3.52，-1.54）；组间差异为2.37（95%CI 1.42，3.33，p<0.0001）。与对照组儿童相比，干预组儿童的焦虑得分显著降低。
结论
结果显示干预组的焦虑得分在统计学上有显著降低，从而验证了该计划的有效性。试验注册 大学医院医学信息网络（UMIN）：UMIN000032517。2018年5月10日注册——追溯注册，https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037083。
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