Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
Z Kinder Jugendpsychiatr Psychother. 2022 Nov;50(6):436-446. doi: 10.1024/1422-4917/a000883. Epub 2022 Jun 15.
Highly-controlled, randomized controlled trials have provided considerable evidence for the efficacy of outpatient cognitive-behavioral therapy (CBT) for patients with school absenteeism and anxiety disorders. However, the effectiveness of outpatient CBT under routine-care conditions for youth with school absenteeism remains unproven. This observational study used file records to analyze the changes under routine CBT in a sample of = 49 clinically referred adolescents aged 11 to 18 years with school absenteeism and mental disorders who were being treated in a university outpatient clinic. At the start and end of treatment, we assessed the severity of school absenteeism as well as mental health problems as rated by parents and by the adolescents themselves. The analysis yielded a statistically highly significant decline in school absenteeism (large effect, Cohen's = 0.80) and in mental health problems (small-to-large effect, Cohen's = 0.33 to = 0.82). However, a substantial proportion of the sample remained in the clinical range at the end of treatment. These findings suggest that CBT is effective for adolescents with school absenteeism when administered under routine-care conditions, though the results must be interpreted with caution because of the lack of a control condition.
高度控制、随机对照试验为门诊认知行为疗法（CBT）治疗逃学和焦虑障碍患者的疗效提供了大量证据。然而，在常规护理条件下，门诊 CBT 对逃学的青少年的有效性仍未得到证实。本观察性研究使用档案记录分析了在常规 CBT 下治疗的一个样本中 49 名患有逃学和精神障碍的 11 至 18 岁青少年的变化情况，这些青少年在一所大学门诊诊所接受治疗。在治疗开始和结束时，我们评估了父母和青少年自己评定的逃学严重程度以及心理健康问题的严重程度。分析结果显示，逃学（大效应，Cohen's = 0.80）和心理健康问题（小到中到大效应，Cohen's = 0.33 至 = 0.82）均有统计学上显著下降。然而，治疗结束时，样本中仍有相当一部分人处于临床范围内。这些发现表明，在常规护理条件下，CBT 对逃学的青少年有效，但由于缺乏对照条件，结果必须谨慎解释。
