Background: This study aims to investigate effectiveness of a 6-week, transdiagnostic cognitive behavioral therapy (CBT) for anxiety and depression in adolescents, the Structured Material for Therapy (SMART), in naturalistic settings of child and adolescent mental health outpatient services (CAMHS). Methods: A randomized controlled trial with waiting list control (WLC) was performed at three community CAMHS in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% girls) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to SMART or to WLC. Results: In the treatment group (CBT), 32.9% improved in the main outcome measure (SDQ), compared to 11.6% in the WLC. Clinically significant and reliable change was experienced by 17.7% in the CBT condition, compared to 5.8% in the WLC. No patients deteriorated. Statistically significant treatment effects were achieved for internalization symptoms, anxiety symptoms and general functioning. Conclusions: These promising findings indicate that SMART may be considered as a first step in a stepped care model for anxiety and/or depression treatment in CAMHS. The recovery rates imply that further investigations into the effectiveness of brief treatments should be made. Furthermore, there is a need for more comprehensive second-stage treatments for some of these patients.

Background: Instruments for monitoring the clinical status of adolescents with emotional problems are needed. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) according to theory measures problems/ symptoms, well-being, functioning and risk. Documentation of whether the theoretical factor structure for CORE-OM is applicable for adolescents is lacking. Methods: This study examined the factor structure and psychometric properties of the CORE-OM based on two samples of adolescents (age 14-18): youths seeking treatment for emotional problems (N = 140) and high school students (N = 531). A split half approach was chosen. An exploratory factor analysis (EFA) was performed on the first half of the stratified samples to establish the suitability of the model. A Confirmatory Factor Analysis (CFA) with the chosen model from the EFA was performed on the second half. Internal consistency and clinical cutoff scores of the CORE-OM were investigated. Results: The best fitting model only partially confirmed the theoretical model for the CORE-OM. The model consisted of five factors: 1) General problems, 2) risk to self, 3) positive resources 4) risk to others and 5) problems with others. The clinical cutoff score based on the all-item total was higher than in an adult sample. Both the all-item total and general problems cutoff scores showed gender differences. Conclusion: The factor analysis on CORE-OM for adolescents resulted in a five-factor solution, and opens up for new subscales concerning positive resources and problems with others. A 17-item solution for the general problems/ symptoms scale is suggested. We advise developers of self-report instruments not to reverse items, if they do not intend to measure a separate factor, since these seem to affect the dimensionality of the scales. Comparing means for gender in non-clinical samples should not be done without modification of the general emotional problem and the positive resources scales. Slightly elevated CORE-OM scores (up to 1.3) in adolescents may be normal fluctuations.

The Scandinavian countries, and not least of them Norway, have long remained strongholds of Lutheranism. That is, in outward appearance, for the Norwegian State Church counts among its members an unusually large proportion of formal adherents, people who are baptised and ‘confirmed’ in the Lutheran State Church, but who remain for the rest of their lives totally indifferent in religious matters, never attending Church services, or otherwise manifesting any interest whatsoever.This general apathy has now begun to react on the State Church in a marked degree. Methodists and other Free Church sects have steadily increased their influence and numbers, and have drawn over a large proportion of members, who are recruited from the same classes as in England, namely from among prosperous tradesmen and the best section of the working class population.Catholicism, on the other hand, here as elsewhere, makes her primary appeal to the intellectual section of the community, but as the first movement broadens and deepens, she sweeps with her people of all ranks and conditions.The first establishment of the Catholic Church in Norway was made in 1856, in Oslo, then Christiania, under the patronage of St. Olaf, the saint who brought Christianity to the heathen Norsemen. Since then Churches and chapels have sprung up in the larger towns throughout the country, and Norway numbers at present nineteen Catholic churches and twenty chapels.