Foo Cheryl Yunn Shee, Hui Tianyi, Ngaiman Nur Khairunisa Binte, Dahjalarrajah Darshan S/O, Chua Yi Chian, Lee Yi Ping, Abdin Edimansyah, Vaingankar Janhavi Ajit, Tang Charmaine
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Psychosis, Institute of Mental Health, Singapore
BMJ Open. 2024 Dec 20;14(12):e081603. doi: 10.1136/bmjopen-2023-081603.
There are insufficient scalable, evidence-based treatments to meet increasing mental health needs of young people. Offering interim, brief interventions for young persons with psychological distress can improve access to care and mitigate adverse effects of long waiting times. This study tests the efficacy of solution-focused brief therapy (SFBT), a strength-based, goal-directed intervention, in adolescents and young adults at a community-based youth mental health service in Singapore.
This is a fully powered, randomised, single-centre, two-arm, parallel, superiority, controlled trial. From September 2023 to March 2025, the study will recruit 124 participants (aged 16-30) presenting at a national youth mental health service in Singapore (CHAT, Centre of Excellence for Youth Mental Health) with clinically assessed general psychological distress, subthreshold or prodromal symptoms, or a first episode of a mood disorder. Participants will be excluded if they have high risk of suicide, psychosis, cognitive impairments, or current psychological treatments. Participants will be randomised in a 1:1 ratio to receive six-session, case manager delivered SFBT or treatment as usual (TAU) case management, and be followed up for 3 months post-intervention. Participants receiving SFBT are hypothesised to have greater improvements in self-reported psychological distress, from baseline to 8 weeks, compared with the control group. Secondary outcomes are self-reported depression and anxiety symptoms, and functional impairment. The study will also explore whether SFBT is associated with increased self-efficacy and decreased hopelessness, decreased downstream referrals post-intervention, and sustained clinical gains 3 months post-intervention compared with TAU. Adverse events and clinical deterioration will be recorded and reported.
The Institute of Mental Health (IMH) Institutional Research Review Committee (reference 822-2022) and the Singapore National Health Group Domain Specific Review Board (DSRB) (reference 2023/00052) have approved the study protocol. Findings will be published in international, peer-reviewed scientific journals. Summaries will be disseminated to study funders, mental healthcare systems administrators, and clinicians.
ISRCTN13671612 https://doi.org/10.1186/ISRCTN13671612.
目前缺乏足够的可扩展、基于证据的治疗方法来满足年轻人日益增长的心理健康需求。为有心理困扰的年轻人提供临时的简短干预措施，可以改善获得护理的机会，并减轻长时间等待带来的不利影响。本研究在新加坡一家社区青年心理健康服务机构中，测试聚焦解决短期治疗（SFBT）（一种基于优势、目标导向的干预措施）对青少年和青年成年人的疗效。
这是一项样本量充足、随机、单中心、双臂、平行、优效性对照试验。从2023年9月至2025年3月，该研究将招募124名年龄在16至30岁之间、在新加坡一家国家青年心理健康服务机构（CHAT，青年心理健康卓越中心）就诊、经临床评估存在一般心理困扰、阈下或前驱症状，或首次发作情绪障碍的参与者。如果参与者有自杀高风险、精神病、认知障碍或正在接受心理治疗，则将其排除。参与者将按1:1的比例随机分组，接受由个案管理员提供的为期六节的SFBT或常规治疗（TAU）个案管理，并在干预后随访3个月。假设与对照组相比，接受SFBT的参与者从基线到8周自我报告的心理困扰会有更大改善。次要结局包括自我报告的抑郁和焦虑症状以及功能损害。该研究还将探讨与TAU相比，SFBT是否与自我效能感增加和绝望感降低、干预后下游转诊减少以及干预后3个月持续的临床获益相关。将记录并报告不良事件和临床恶化情况。
精神卫生研究所（IMH）机构研究审查委员会（参考编号822 - 2022）和新加坡国家卫生集团特定领域审查委员会（DSRB）（参考编号2023/00052）已批准该研究方案。研究结果将发表在国际同行评审科学期刊上。研究摘要将分发给研究资助者、精神卫生保健系统管理人员和临床医生。
ISRCTN13671612 https://doi.org/10.1186/ISRCTN13671612
