Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.
Res Child Adolesc Psychopathol. 2024 Sep;52(9):1397-1412. doi: 10.1007/s10802-024-01196-8. Epub 2024 May 13.
School attendance problems (SAPs) are associated with negative short- and long-term outcomes. Despite high prevalence of SAPs, there is a shortage of evidence-based interventions. Existing approaches often target either school refusal or truancy, leaving a gap in effective interventions addressing both types of SAPs. This randomized controlled trial (RCT) assessed the effectiveness of Back2School (B2S), a modular transdiagnostic cognitive behavioral therapy (CBT) for SAPs, compared to treatment as usual (TAU). Outcomes included youths' school attendance and mental health. A group (B2S, TAU) × time (Pre, Post, 3-Month Follow-Up) design involving 152 youths (B2S; n = 74, TAU; n = 78) with SAPs (i.e., ≥ 10% absence in the past three months), aged 6-16 years (M = 12.2, SD = 2.2, males = 60%) were used. B2S comprised three months of CBT with youths, parents, and school involvement, while TAU comprised public and/or private intervention services. On average, youths in B2S received 15.0, (SD = 3.9) hours of intervention, while those in TAU received 13.4, (SD = 21.6). Intervention effects were investigated using mixed linear models. Both B2S and TAU exhibited significant within-group improvements in school attendance, with no significant differences between them. However, the B2S group significantly outperformed TAU in reducing youths' emotional problems, conduct problems, problems with peers, the overall impact of problems, and increasing youths self-efficacy for attending school and parent self-efficacy for dealing with a SAP. This RCT represents the first evaluation of a modular transdiagnostic CBT for youths displaying SAPs, showing significant mental health and self-efficacy benefits. (Clinical trial registration: ClinicalTrials.gov: NCT03459677).
学生缺课问题（SAP）与短期和长期的负面结果有关。尽管 SAP 的患病率很高，但缺乏基于证据的干预措施。现有的方法通常针对拒绝上学或逃学，而在解决这两种类型的 SAP 的有效干预措施方面存在差距。这项随机对照试验（RCT）评估了 Back2School（B2S）的有效性，B2S 是一种针对 SAP 的模块化跨诊断认知行为疗法（CBT），与常规治疗（TAU）相比。结果包括青少年的上学率和心理健康。涉及 152 名患有 SAP（即在过去三个月内缺勤率≥10%）的青少年（B2S；n=74，TAU；n=78）的组（B2S、TAU）×时间（预、后、3 个月随访）设计，年龄在 6-16 岁之间（M=12.2，SD=2.2，男性=60%）。B2S 包括三个月的 CBT，涉及青少年、父母和学校，而 TAU 包括公共和/或私人干预服务。平均而言，B2S 中的青少年接受了 15.0 小时的干预（SD=3.9），而 TAU 中的青少年接受了 13.4 小时的干预（SD=21.6）。使用混合线性模型研究干预效果。B2S 和 TAU 均显示出在上学率方面的显著组内改善，且两组之间没有显著差异。然而，B2S 组在减少青少年的情绪问题、行为问题、同伴问题、问题的总体影响以及增加青少年上学的自我效能感和父母处理 SAP 的自我效能感方面的表现明显优于 TAU。这项 RCT 是对表现出 SAP 的青少年进行模块化跨诊断 CBT 的首次评估，显示出显著的心理健康和自我效能感获益。（临床试验注册：ClinicalTrials.gov：NCT03459677）。
