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.

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.

Zusammenfassung. Die Komplexität von Zwangsstörungen macht eine umfassende Diagnostik erforderlich. Die Diagnostik von Zwangsstörungen ist in eine multimodale Verhaltens- und Psychodiagnostik integriert, die eine detaillierte Erfassung der individuellen Zwangssymptomatik, einschließlich ihrer aufrechterhaltenden Bedingungen, Beeinträchtigungen, komorbiden Störungen und Probleme impliziert. Die spezifischen Aspekte des diagnostischen Vorgehens bei Kindern und Jugendlichen mit Zwangsstörungen sowie deren Bezugspersonen (einschließlich Beziehungsaufbau, Exploration familiärer Beziehungen, der Zwangssymptomatik sowie komorbider Auffälligkeiten des Kindes bzw. Jugendlichen und psychischer Auffälligkeiten der Bezugspersonen, Exploration eines gemeinsamen Störungskonzeptes, Behandlungsziele und Behandlungsplanung) werden dargelegt. Die deutschsprachigen spezifischen diagnostischen Verfahren, einschließlich neuer Verfahren, werden detailliert beschrieben.

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Cognitive-behavioral interventions can be difficult to implement in daily routine, which is often essential for generalizing treatment effects to natural settings. Furthermore, there is a lack of adequate care options concerning habit reversal training for children with Tourette’s disorder. The objective of this study is to evaluate therapeutic online coaching via videoconferencing in the natural environment of children with Tourette’s disorder in addition to face-to-face therapy (blended therapy). Online coaching took place twice a week for a maximum of 12 weeks. In a single-case study (n = 5; patients aged 8–11 years), the first results were obtained for exploratory purposes, especially with regard to the feasibility and reduction of symptoms and impairment. Various outcome measures were assessed (severity of symptoms, impairment, practical implementation, and satisfaction). Despite some principal limitations, the findings provide first hints that blended therapy is feasible and improves symptoms in some children with tics.Clinical Trial Registration: [https://clinicaltrials.gov/], identifier [DRKS00017199].