Predictors of Treatment Outcome for Parent-Led, Transdiagnostic Cognitive Behavioral Therapy for Youth with Emotional Problems Related to the COVID-19 Pandemic

IF 1.7 4区心理学 Q3 PSYCHOLOGY, DEVELOPMENTAL Child & Youth Care Forum Pub Date : 2024-01-04 DOI:10.1007/s10566-023-09789-y

David B. Riddle, Andrew G. Guzick, Alison Salloum, Sarah Kennedy, Asim Shah, Wayne K. Goodman, David S. Mathai, Alicia W. Leong, Emily M. Dickinson, Daphne M. Ayton, Saira A. Weinzimmer, Jill Ehrenreich-May, Eric A. Storch

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Abstract

Background

A brief, parent-led, transdiagnostic cognitive behavioral therapy (CBT) approach demonstrated utility among youth struggling with emotional problems during the COVID-19 pandemic. Homework completion between sessions is directly associated with psychotherapy treatment outcomes in non-parent-led CBT interventions. The present study sought to examine the relationship between homework completion and treatment response in a parent-led transdiagnostic CBT protocol.

Objective

The first aim was to determine if completion of between session CBT homework was associated with change in symptom severity. The second aim was to determine if pre-treatment anxiety severity, social anxiety severity, and depressive symptoms were associated with treatment outcomes.

Methods

One-hundred twenty-nine parents of youth (ages 5–13) with significant emotional problems received 6 sessions of telehealth parent-led CBT during the COVID-19 pandemic. Data on children’s anxiety symptomology, clinical severity, homework compliance, depression, family relationships, perceptions on the impacts of the pandemic, treatment response, and therapists rating of symptom improvement were collected.

Results

Homework completion explained 9% of the variance in symptom improvement at post-treatment. Greater homework completion was associated with a significantly higher odds of treatment response (OR = 1.52, p = .001). Child anxiety severity, depressive symptoms, family relationships, and perceptions on the impacts of the COVID-19 pandemic were not significantly related to treatment outcome.

Conclusions

Completion of homework predicted treatment outcomes in parent-led, transdiagnostic CBT for youth with emotional problems during the COVID-19 pandemic, while controlling for parent-rated anxiety, depression, family relationships, and COVID-related distress. Enhancing and targeting homework compliance between CBT sessions should be a central element of parent-led treatment.

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针对与 COVID-19 大流行有关的青少年情绪问题的家长主导型跨诊断认知行为疗法的治疗结果预测因素

背景在 COVID-19 大流行期间，一种简短的、由家长主导的跨诊断认知行为疗法（CBT）方法在与情绪问题作斗争的青少年中显示出效用。在非家长主导的 CBT 干预中，疗程之间的家庭作业完成情况与心理治疗效果直接相关。本研究旨在探讨在家长主导的跨诊断 CBT 方案中，家庭作业完成情况与治疗反应之间的关系。第二个目的是确定治疗前的焦虑严重程度、社交焦虑严重程度和抑郁症状是否与治疗结果有关。方法在 COVID-19 大流行期间，129 名有严重情绪问题的青少年（5-13 岁）的家长接受了 6 次由家长主导的远程医疗 CBT 治疗。收集的数据包括儿童的焦虑症状、临床严重程度、家庭作业依从性、抑郁、家庭关系、对大流行影响的看法、治疗反应以及治疗师对症状改善情况的评分。家庭作业完成度越高，治疗反应的几率就越大（OR = 1.52，p = .001）。儿童焦虑严重程度、抑郁症状、家庭关系以及对COVID-19大流行影响的看法与治疗结果无显著关系。结论在控制家长评定的焦虑、抑郁、家庭关系以及COVID相关困扰的情况下，家庭作业的完成情况可预测由家长主导的、针对COVID-19大流行期间有情绪问题的青少年的跨诊断CBT治疗结果。在CBT疗程之间加强和有针对性地完成家庭作业应成为家长主导型治疗的核心要素。

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来源期刊

Child & Youth Care Forum PSYCHOLOGY, DEVELOPMENTAL-

CiteScore

3.60

自引率

5.60%

发文量

期刊介绍： Child & Youth Care Forum is a peer-reviewed, multidisciplinary publication that welcomes submissions – original empirical research papers and theoretical reviews as well as invited commentaries – on children, youth, and families. Contributions to Child & Youth Care Forum are submitted by researchers, practitioners, and clinicians across the interrelated disciplines of child psychology, early childhood, education, medical anthropology, pediatrics, pediatric psychology, psychiatry, public policy, school/educational psychology, social work, and sociology as well as government agencies and corporate and nonprofit organizations that seek to advance current knowledge and practice. Child & Youth Care Forum publishes scientifically rigorous, empirical papers and theoretical reviews that have implications for child and adolescent mental health, psychosocial development, assessment, interventions, and services broadly defined. For example, papers may address issues of child and adolescent typical and/or atypical development through effective youth care assessment and intervention practices. In addition, papers may address strategies for helping youth overcome difficulties (e.g., mental health problems) or overcome adversity (e.g., traumatic stress, community violence) as well as all children actualize their potential (e.g., positive psychology goals). Assessment papers that advance knowledge as well as methodological papers with implications for child and youth research and care are also encouraged.