The present study investigates treatment satisfaction (TS) rated by multiple informants (patient, parent, therapist) following routine outpatient cognitive-behavioral therapy (CBT) within a large sample (n = 965) of clinically referred adolescents aged 11-20 years. Moreover, potential predictors of TS were analyzed (patient-related variables, mental disorder characteristics, socio-demographic factors and treatment variables). Overall, our results show a high treatment satisfaction in patient, parent and therapist ratings, with the therapists being the most critical raters (completely/predominantly satisfied: 87.8% in patient, 92.0% in parent, and 64.0% in therapist ratings). Correlations between the three raters were only small to moderate, but statistically significant. Regression analysis examining differential effects found that mental disorder characteristics (parent- and patient-reported symptoms at post) and treatment variables (especially cooperation of patients and parents as rated by therapists) explained most of the variance in TS, whereas patient-related or socio-demographic variables did not emerge as relevant predictors of TS. The amounts of explained variance were R = 0.594 in therapist rating, R = 0.322 in patient rating and R = 0.203 in parent rating.

Zusammenfassung. Die deutschsprachige Fassung der Teacher’s Report Form (TRF) erfasst Verhaltens- und emotionale Auffälligkeiten bei fünf- bis 18-Jährigen. Studienziel ist es, die Testgüte in einer Feldstichprobe aus Grundschulen zu überprüfen, Alters- und Geschlechtseffekte zu untersuchen sowie einen Vergleich mit den Skalenwerten der US-Stichprobe herzustellen. Fragebögen von 529 Schülern, die an 32 Grundschulen im Kölner Stadtgebiet erhoben wurden, konnten ausgewertet werden. Die Stichprobe bestand aus 54% Jungen; die vier Grundschulklassen waren mit ähnlichen Anteilen repräsentiert. Die internen Konsistenzen waren überwiegend zufrieden stellend. Die gefundenen Geschlechtseffekte legen eine geschlechtsspezifische Normierung wie im amerikanischen Original nahe. Im Vergleich zur US-Normstichprobe schätzten deutsche Lehrer ihre Schüler signifikant auffälliger ein. Das Verfahren hat sich in dieser ersten Untersuchung an einer Feldstichprobe hinsichtlich der internen Konsistenz der Skalen weitgehend bewährt. Eine Anwendung in der klinischen Praxis ist daher möglich. Eine Überprüfung weiterer Reliabilitätsmaße sowie eine deutsche Normierung sind notwendig.

Few studies have examined the effectiveness of outpatient cognitive-behavioral therapy (CBT) delivered in routine care settings for children and adolescents with mental disorders. This observational study examined changes in behavioral and emotional problems of adolescents with mental disorders during routine outpatient CBT delivered at a university outpatient clinic and compared them with a historical control group of youths who received academic tutoring of comparable length and intensity. Assessments were made at the start and end of treatment (pre- and post-assessment) using parent ratings of the German versions of the Child Behavior Checklist (CBCL) and self-ratings of the Youth Self-Report (YSR) scale. For the main analysis, 677 adolescents aged 11‒21 years had complete data. Changes from pre- to post-assessment showed significant reductions in mental health problems on both parent- and self-ratings. Pre- to post-effect sizes (Cohen's d) were small-to-medium for the total sample (d = 0.23 to d = 0.62) and medium-to-large for those adolescents rated in the clinical range on each (sub)scale at the start of treatment (d = 0.65 to d = 1.48). We obtained medium net effect sizes (d = 0.69) for the CBCL and YSR total scores when patients in the clinical range were compared to historical controls. However, a substantial part of the sample remained in the clinical range at treatment end. The results suggest that CBT is effective for adolescents with mental disorders when administered under routine care conditions but must be interpreted conservatively due to the lack of a direct control condition.

Objective:To assess long-term effectiveness of guided self-help for parents of children with ADHD under routine care conditions. Method: 6- to 12-year-old children diagnosed with ADHD were enrolled in an observational study on a 1-year telephone-assisted parent-administered behavioral intervention. N = 136 families who completed the intervention participated in a follow-up assessment. Pre-, post-, and follow-up data were analyzed by repeated measures ANOVA with planned contrasts. Clinical significance was analyzed according to the reliable change index. Results: Child ADHD symptoms (primary outcome), oppositional defiant disorder (ODD) symptoms, overall behavioral problems, and quality of life improved during the intervention. There was a further improvement in ADHD symptoms at follow-up, with a medium effect size. Improvements during treatment in ODD symptoms, overall behavioral problems, and quality of life were maintained at follow-up. Conclusion: The findings suggest that telephone-assisted self-help interventions may result in a long-term reduction of child behavior problems.

These results indicate that guided self-help programs for families with children with ADHD are effective, also as an addition to pharmacological treatment.