Durlak J A, Wells A M
Department of Psychology, Loyola University Chicago, Illinois 60626, USA.
Am J Community Psychol. 1998 Oct;26(5):775-802. doi: 10.1023/a:1022162015815.
Evaluated the outcomes of 130 indicated preventive interventions (secondary prevention) mental health programs for children and adolescents that seek to identify early signs of maladjustment and to intervene before full-blown disorders develop. Results indicate such programs significantly reduce problems and significantly increase competencies. In particular, behavioral and cognitive-behavior programs for children with subclinical disorders (mean ESs in the 0.50s) appear as effective as psychotherapy for children with established problems and more effective than attempts to prevent adolescent smoking alcohol use, and delinquency. In practical terms, the average participant receiving behavioral or cognitive-behavior intervention surpasses the performance of approximately 70% of those in a control group. Of particular interest was the high mean effect (0.72) achieved by programs targeting incipient externalizing problems which are customarily the least amenable to change via traditional psychotherapeutic efforts when they reach clinical levels. Priorities for future research include greater specification of intervention procedures, assessment of treatment implementation, more follow-up studies, and identifying how different participants respond to early intervention.
评估了130项针对儿童和青少年的指定预防干预措施（二级预防）心理健康项目，这些项目旨在识别适应不良的早期迹象，并在全面疾病发展之前进行干预。结果表明，此类项目显著减少了问题，并显著提高了能力。特别是，针对亚临床障碍儿童的行为和认知行为项目（平均效应大小在0.50左右）似乎与针对已出现问题儿童的心理治疗一样有效，并且比预防青少年吸烟、饮酒和犯罪的尝试更有效。实际上，接受行为或认知行为干预的平均参与者超过了对照组中约70%的人的表现。特别令人感兴趣的是，针对初期外化问题的项目取得了较高的平均效应（0.72），而这些问题通常在达到临床水平时最不易通过传统心理治疗努力改变。未来研究的重点包括更详细地说明干预程序、评估治疗实施情况、更多的随访研究，以及确定不同参与者对早期干预的反应。
