了解未接受教育、就业或培训（NEET）的年轻成年人的心理治疗效果、影响效果的因素，以及可以采取哪些措施来改善这些效果。
Understanding the psychological therapy treatment outcomes for young adults who are not in education, employment, or training (NEET), moderators of outcomes, and what might be done to improve them.
机构信息
Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
iCope - Camden & Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
出版信息
Psychol Med. 2023 May;53(7):2808-2819. doi: 10.1017/S0033291721004773. Epub 2021 Nov 25.
BACKGROUND
To determine: whether young adults (aged 18-24) not in education, employment or training (NEET) have different psychological treatment outcomes to other young adults; any socio-demographic or treatment-related moderators of differential outcomes; and whether service-level changes are associated with better outcomes for those who are NEET.
METHODS
A cohort was formed of 20 293 young adults treated with psychological therapies in eight Improving Access to Psychological Therapies services. Pre-treatment characteristics, outcomes, and moderators of differential outcomes were compared for those who were and were not NEET. Associations between outcomes and the following were assessed for those that were NEET: missing fewer sessions, attending more sessions, having a recorded diagnosis, and waiting fewer days between referral and starting treatment.
RESULTS
Those who were NEET had worse outcomes: odds ratio (OR) [95% confidence interval (CI)] for reliable recovery = 0.68 (0.63-0.74), for deterioration = 1.41 (1.25-1.60), and for attrition = 1.31 (1.19-1.43). Ethnic minority participants that were NEET had better outcomes than those that were White and NEET. Living in deprived areas was associated with worse outcomes. The intensity of treatment (high or low) did not moderate outcomes, but having more sessions was associated with improved outcomes for those that were NEET: odds (per one-session increase) of reliable recovery = 1.10 (1.08-1.12), deterioration = 0.94 (0.91-0.98), and attrition = 0.68 (0.66-0.71).
CONCLUSIONS
Earlier treatment, supporting those that are NEET to attend sessions, and in particular, offering them more sessions before ending treatment might be effective in improving clinical outcomes. Additional support when working with White young adults that are NEET and those in more deprived areas may also be important.
背景
目的在于确定：未接受教育、就业或培训的（18-24 岁）年轻人（NEET）与其他年轻人相比，是否具有不同的心理治疗结果；任何社会人口统计学或治疗相关的调节因素是否会导致不同的结果；以及对于那些 NEET 的人来说，服务水平的变化是否与更好的结果相关。
方法
从八个改善心理治疗服务获取途径的服务中形成了一个队列，该队列由 20293 名接受心理治疗的年轻人组成。比较了 NEET 和非 NEET 年轻人的治疗前特征、结果和调节因素。对于那些 NEET 的人，评估了以下因素与结果之间的关联：错过的治疗次数较少、参加的治疗次数较多、记录的诊断、转诊和开始治疗之间的等待天数较少。
结果
NEET 的年轻人的结果更差：可靠恢复的优势比（OR）[95%置信区间（CI）]为 0.68（0.63-0.74），恶化的 OR 为 1.41（1.25-1.60），脱落的 OR 为 1.31（1.19-1.43）。少数民族 NEET 参与者的结果优于白人 NEET 参与者。生活在贫困地区与较差的结果相关。治疗的强度（高或低）并不调节结果，但增加治疗次数与 NEET 患者的结果改善相关：可靠恢复的几率（每增加一次治疗）为 1.10（1.08-1.12），恶化的几率为 0.94（0.91-0.98），脱落的几率为 0.68（0.66-0.71）。
结论
对于那些 NEET 的人来说，尽早开始治疗、支持他们参加治疗，特别是在结束治疗之前为他们提供更多的治疗次数，可能会有效改善临床结果。对于与白人 NEET 年轻人以及那些生活在较贫困地区的人合作时，提供额外的支持可能也很重要。
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