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基于团体的简短跨诊断认知行为疗法对内化问题青少年的可行性和疗效

The Feasibility and Efficacy of a Group-Based, Brief Transdiagnostic Cognitive-Behavioral Treatment for Adolescents with Internalizing Problems.

作者信息

Skarphedinsson Gudmundur, Karlsson Gunnar Karl

机构信息

Faculty of Psychology, University of Iceland, Sæmundargata 12, 102, Reykjavik, Iceland.

Primary Health Care Clinic, Hraunbæ 115, 110, Reykjavik, Iceland.

出版信息

Child Psychiatry Hum Dev. 2025 Feb;56(1):224-235. doi: 10.1007/s10578-023-01552-7. Epub 2023 Jun 9.

Abstract

The present study aimed to assess the efficacy of a group-based, brief transdiagnostic cognitive-behavioral therapy (CBT) program for adolescents with internalizing problems, such as anxiety and depressive disorders, seeking help in a primary health care clinic in Iceland. The group-based CBT program consisted of eight weekly 110-min sessions covering psychoeducation, cognitive restructuring, behavioral activation, exposure, problem-solving, social skills, and mindfulness. The study recruited 53 participants, who were randomly assigned to either receive the group treatment or be placed on a wait-list for monitoring purposes. Measures were taken at baseline, during treatment (week 4), at posttreatment (week 8), and at 2-, 4-month, and 1-year follow-ups. The primary outcome measures were the self-reported total scores of total anxiety and depression using the Revised Children's Anxiety and Depression Scale (RCADS). The study found a significant effect of time and time * treatment interaction on the depression and anxiety total scores. The secondary outcome measures, RCADS parent-rated depression and anxiety total scores, did not show significant effects of time * treatment interaction. However, during naturalistic follow-up, a significant reduction in parent-reported depression and anxiety total scores was observed. The study also observed good treatment adherence, as well as high satisfaction among parents and youth. The results suggest that this group-based, brief transdiagnostic CBT group treatment is feasible and effective in reducing depressive and anxiety symptoms in adolescents with internalizing problems and highlights the importance of addressing comorbidity in treatment.

摘要

本研究旨在评估一种基于团体的简短跨诊断认知行为疗法(CBT)项目对患有内化问题(如焦虑症和抑郁症)的青少年的疗效,这些青少年在冰岛的一家初级保健诊所寻求帮助。基于团体的CBT项目包括为期八周、每周110分钟的课程,涵盖心理教育、认知重构、行为激活、暴露、问题解决、社交技能和正念。该研究招募了53名参与者,他们被随机分配接受团体治疗或被列入等待名单以进行监测。在基线、治疗期间(第4周)、治疗后(第8周)以及2个月、4个月和1年随访时进行测量。主要结局指标是使用修订版儿童焦虑和抑郁量表(RCADS)自我报告的焦虑和抑郁总分。研究发现时间和时间治疗交互作用对抑郁和焦虑总分有显著影响。次要结局指标,即RCADS家长评定的抑郁和焦虑总分,未显示出时间治疗交互作用的显著影响。然而,在自然随访期间,观察到家长报告的抑郁和焦虑总分显著降低。该研究还观察到良好的治疗依从性,以及家长和青少年的高度满意度。结果表明,这种基于团体的简短跨诊断CBT团体治疗在减少患有内化问题的青少年的抑郁和焦虑症状方面是可行且有效的,并突出了在治疗中解决共病问题的重要性。

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