Clinical Educational and Health Psychology, University College London, London, UK.
J Clin Psychol. 2024 May;80(5):968-1002. doi: 10.1002/jclp.23653. Epub 2024 Feb 8.
This qualitative review sought to explore how young people (YP) conceptualize positive outcomes from cognitive-behavioral therapy (CBT) and what YP perceive to be the facilitators and barriers to positive outcomes.
A systematic literature search was conducted in June 2021 using six online databases. Studies were included if qualitative data were collected from participants who were aged up to 25, had internalizing mental health difficulties, and had received in-person CBT from trained practitioners.
Nineteen studies were included. The Gough Weight of Evidence framework was used to assess methodological and topical quality and relevance. A thematic synthesis identified 34 conceptualizations of positive outcomes, 57 facilitators, and 49 barriers. Descriptive and analytical themes were identified. In line with the review's pragmatic perspective, the latter were worded as practice recommendations: acknowledge YP's perspectives on outcomes, teach tangible CBT techniques, balance autonomy and support, frame CBT as "upskilling," explore nuanced barriers to engagement, and consider the power of group dynamics.
This review established the range of YP's views about positive outcomes from CBT, as well as facilitators and barriers to achieving these. Findings should prompt CBT practitioners to reflect and consider how their practice might be shaped through reports from YP as experts by experience.
本定性综述旨在探讨年轻人如何理解认知行为疗法（CBT）的积极结果，以及他们认为促进和阻碍积极结果的因素有哪些。
2021 年 6 月，我们使用六个在线数据库进行了系统文献检索。纳入标准为：定性数据来自年龄在 25 岁以下、存在内化性心理健康问题且接受过经过培训的从业者提供的面对面 CBT 的参与者。
共纳入 19 项研究。我们使用 Gough 证据权重框架评估了方法学和主题质量以及相关性。主题综合分析确定了 34 种积极结果的概念化、57 个促进因素和 49 个障碍。描述性和分析性主题也被确定。根据综述的实用主义观点，后者被表述为实践建议：承认年轻人对结果的看法，教授切实可行的 CBT 技术，平衡自主性和支持，将 CBT 定义为“技能提升”，探索参与的细微障碍，并考虑团体动力的力量。
本综述确立了年轻人对 CBT 积极结果的看法范围，以及实现这些结果的促进因素和障碍。研究结果应促使 CBT 从业者反思并考虑如何通过经验丰富的年轻人的报告来塑造他们的实践。
