Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

Nilsen, Toril Sørheim; Handegård, Bjørn Helge; Eisemann, Martin; Kvernmo, Siv

doi:10.1186/s13034-016-0098-3

Cited by 10 publications

(9 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seven studies were excluded because additional information was not provided by the corresponding authors on request. 28,29,[69][70][71][72][73] A total of 38 studies remained, relating to 44 independent study samples ( Figure 1).…”

Section: Search Flowmentioning

confidence: 99%

“…27 There may be several person-and treatmentrelated variables that act as moderators, including but not limited to problem type, comorbidity, treatment length, and outcome informant. [28][29][30][31][32][33] Outcome moderation within this context warrants further investigation and is crucial for delineating the factors that may enhance or reduce clinical effectiveness in routine practice. This information may prove to be decisive in enabling clinicians to be prescriptive in their choice of treatment based on the likely outcome on an individual basis.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

Bear

Edbrooke‐Childs

Norton

et al. 2020

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

Objective: Depression and anxiety are the most prevalent mental health problems in youth, yet almost nothing is known about what outcomes are to be expected at the individual level following routine treatment. This paper sets out to address this gap by undertaking a systematic review of outcomes following treatment as usual (TAU) with a particular focus on individual-level outcomes. Method: MEDLINE, Embase and PsycInfo were searched for articles published between 1980 and January 2019 that assessed TAU outcomes for youth depression and anxiety accessing specialist mental health care. Meta-analysis considered change at both group-level preÀpost effect size (ES) and individual-level recovery, reliable change, and reliable recovery. Temporal analysis considered stability of primary and secondary outcomes over time. Subgroup analysis considered the moderating effect of informant; presenting problem; study design; study year; mean age of youth; use of medication; intervention dosage and type of treatment offered on outcomes. A protocol was preregistered on PROSPERO (CRD42017063914). Results: Initial screening of 6,350 publications resulted in 38 that met the inclusion criteria, and that were subsequently included in meta-analyses. This resulted in a final full pooled sample of 11,739 young people (61% of whom were female, mean age 13.8 years). The preÀpost ES (Hedges' g) at first/final outcome (13/26 weeks) was À0.74/À0.87. The individual-level change on measures of self-report was 38% reliable improvement, 44% no reliable change, and 6% reliable deterioration. Outcomes varied according to moderators, informant, problem type and dosage. Conclusion: Poor data quantity and quality are limitations, but this is the first study that indicates likely rates of reliable improvement for those accessing TAU. We propose the need for improved reporting of both individual-level metrics and details of TAU to enable greater understanding of likely current outcomes from routine care for youths with depression and anxiety in order to allow the potential for further improvement of impact.

show abstract

Section: Search Flowmentioning

confidence: 99%

mentioning

confidence: 99%

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

Bear

Edbrooke‐Childs

Norton

et al. 2020

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

show abstract

“…Even studies using exclusively diagnosed samples (d = 0.09) and studies on clinically referred youths (d = 0.17) showed low and non-significant ES values [34]. Despite the importance of quality assurance in routine practice, most CAMHS do not evaluate patients clinical change systematically [35]. A report from the Child and Outcomes Research Consortium (CORC) 2013-2016 with patients receiving treatment over six months in one of our participating CAMHS, showed improvement in many patients, however as many as 27% deteriorated [36].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14–17 years old in child and adolescent mental health services (CAMHS)

et al. 2020

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…Turning to the clinic-based literature for potential guidance, there have been several studies examining predictors of clinic-based delivery of CBT for youth anxiety. However, reviews of the literature in this area have also failed to show a consistent pattern of results (Nilsen et al, 2016; Cook, 2014; Lundkvist-Houndoumadi et al, 2014; Walczak et al, 2018), and suggest that predictors of outcome for youth anxiety programs vary according to a range of factors, including the ways in which predictors and outcome are measured, the specific type of anxiety disorder, the content of treatment, the length of follow-up being examined, and the mode of treatment delivery.…”

Section: Introductionmentioning

confidence: 99%

Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety

Spence

March

Donovan

2019

Internet Interventions

View full text Add to dashboard Cite

BackgroundAlthough self-help, internet-based cognitive behaviour therapy (ICBT) can produce significant reductions in anxiety for many young people, a sizable proportion show low program adherence and continue to show anxiety problems after treatment. It is important that we identify factors that predict those most likely to complete program sessions and benefit from self-help ICBT so that we can better match interventions to individual needs, and inform program design and development.ObjectiveThis study examined the role of social support in predicting treatment adherence and outcome among youth enrolled in an open-access, internet-delivered, CBT intervention targeting anxiety.MethodsParticipants were 3684 young people (aged 7 to 17 years) who reported elevated levels of anxiety symptoms when registering for the program. Treatment adherence was assessed as number of treatment sessions completed. Treatment response was evaluated as change in self-reported anxiety symptoms. Youth-reported social support (from friends, family and a special person) at pre-treatment was examined as a hypothesized predictor of adherence and outcome after controlling for baseline anxiety, gender, and age, with age being examined as a moderator.ResultsLinear regression analyses showed that participants with greater social support, from all sources, tended to show greater program adherence, although the proportion of explained variance was small. Age moderated the effect of family support upon adherence, such that greater family support was associated with greater number of sessions completed only for older youth. Greater family and total support were associated with greater reductions in anxiety, irrespective of participant age, but again the percent of variance explained was small. Younger participants were more likely to complete more sessions and to show greater reductions in anxiety. Those with higher pre-treatment anxiety tended to complete fewer sessions but demonstrated greater reductions in anxiety.ConclusionsThe findings highlight the need to consider ways to enhance treatment adherence and outcome of those engaging in self-help ICBT for youth anxiety problems, particularly when social support is low.

show abstract

Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

Cited by 10 publications

References 57 publications

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14–17 years old in child and adolescent mental health services (CAMHS)

Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety

Contact Info

Product

Resources

About