Baruch G, Gerber A, Fearon P
Brandon Centre for Counselling and Psychotherapy for Young People, London, UK.
Br J Med Psychol. 1998 Sep;71(3):233-45. doi: 10.1111/j.2044-8341.1998.tb00988.x.
The present study examined the difference between young people who terminated treatment prematurely and who continued in treatment. One hundred and thirty-four young people (ages 12 to 24 years) who attended a community-based psychotherapy centre for psychoanalytic psychotherapy between 1 April 1993 and 31 March 1996 comprised the sample. It was predicted that drop-outs would consist of younger adolescents who were referred, who show a high score for externalizing problems such as aggression and delinquency and a low score for internalizing problems such as anxiety and depression. It was also predicted that continuers would be older, self-referred and show a high score for internalizing problems and a low score for externalizing problems. The results indicated significant differences between drop-outs and continuers: drop-outs were younger, had greater externalizing problems, school problems and presented with moderate to severe hyperkinetic or conduct disorder. Continuers were older, had fewer externalizing problems, were self-referred and were likely to be treated by supportive therapists. Since age was the most significant predictor of attendance, the sample was separated into younger adolescents and older adolescents and the same analyses repeated. In the younger group ethnic minority status, and being treated by a supportive therapist predicted continuing in treatment and a diagnosis of conduct disorder predicted premature termination. The clinical implications of the present findings for the delivery of psychotherapy services to young people are discussed.
本研究考察了过早终止治疗的年轻人与继续接受治疗的年轻人之间的差异。样本包括1993年4月1日至1996年3月31日期间在一家社区心理治疗中心接受精神分析心理治疗的134名年轻人(年龄在12至24岁之间)。研究预测,辍学者将包括被转诊的较年轻青少年,他们在诸如攻击和犯罪等外化问题上得分较高,而在诸如焦虑和抑郁等内化问题上得分较低。研究还预测,继续接受治疗者年龄较大,是自我转诊,在内化问题上得分较高,在外化问题上得分较低。结果表明,辍学者和继续接受治疗者之间存在显著差异:辍学者年龄较小,有更严重的外化问题、学校问题,并且表现出中度至重度的多动或品行障碍。继续接受治疗者年龄较大,外化问题较少,是自我转诊,并且可能由支持性治疗师进行治疗。由于年龄是出勤率最重要的预测因素,因此将样本分为较年轻青少年和较年长青少年,并重复进行相同的分析。在较年轻的组中,少数族裔身份以及由支持性治疗师进行治疗可预测继续接受治疗,而品行障碍的诊断则可预测过早终止治疗。本文讨论了这些研究结果对为年轻人提供心理治疗服务的临床意义。