Telehealth-Delivered Radically Open Dialectical Behavior Therapy for Adolescents (RO DBT-A): A Pilot Mixed-Methods Study.

IF 2.3 Q2 PSYCHOLOGY, CLINICAL AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-06-15 Epub Date: 2024-03-20 DOI:10.1176/appi.psychotherapy.20230025

Molly Fennig, Uchechukwu Agali, Melinda Looby, Kirsten Gilbert

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Abstract

Objective: Disorders related to overcontrol frequently first appear during adolescence, are highly comorbid, and show limited treatment response, necessitating the adaptation of radically open dialectical behavior therapy (RO DBT; a transdiagnostic treatment targeting overcontrol) for adolescents (RO DBT-A). This study tested the preliminary efficacy of telehealth-delivered RO DBT-A in a heterogeneous clinical sample of youths.

Methods: The sample consisted of 20 female participants ages 13-21 with elevated overcontrol; most were White (75%) and non-Hispanic/Latino (80%). RO DBT-A was provided over 20 weeks via skills group and individual sessions (N=13 participants). Participants seeking other treatment or no treatment formed the control group (N=7). Outcomes included self-reported symptoms and overcontrol. Follow-up interviews were analyzed by using inductive, contextualist thematic analysis to examine participant perceptions and reasons for dropout.

Results: The RO DBT-A group showed significant improvements in depression (t=-1.78, df=10, p=0.011) and quality of life (QOL; Wilcoxon W=75, p=0.021) compared with the control group. From baseline to posttreatment, youths receiving RO DBT-A demonstrated significant improvements in maladaptive overcontrol (t=2.76, df=12, p=0.043), anxiety (t=2.91, df=12, p=0.043), depression (Wilcoxon signed rank V=82.5, p=0.043), and QOL (t=-3.01, df=12, p=0.043). Qualitative analysis revealed themes related to treatment barriers, facilitators, and timing.

Conclusions: The findings provide preliminary evidence supporting telehealth-delivered RO DBT-A in targeting overcontrol, decreasing symptomatology, and improving QOL in a heterogeneous clinical sample of youths. Qualitative follow-ups highlighted that dropout was driven by barriers related to therapy (e.g., structure- and therapist-related issues) and the timing of RO DBT-A compared with other treatments.

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远程医疗提供的青少年彻底开放式辩证行为疗法（RO DBT-A）：混合方法试点研究。

目的：与过度控制有关的障碍经常在青少年时期首次出现，具有高度并发性，而且治疗效果有限，因此有必要针对青少年调整彻底开放的辩证行为疗法（RO DBT；一种针对过度控制的跨诊断疗法）（RO DBT-A）。本研究测试了远程医疗提供的 RO DBT-A 在异质临床青少年样本中的初步疗效：样本由 20 名年龄在 13-21 岁、过度控制能力较强的女性参与者组成；其中大部分是白人（75%）和非西班牙裔/拉丁美洲人（80%）。通过技能小组和个人课程（N=13 名参与者）提供了为期 20 周的 RO DBT-A。寻求其他治疗或未接受治疗的参与者组成对照组（N=7）。结果包括自我报告的症状和过度控制。通过使用归纳式、情境主义主题分析法对后续访谈进行分析，以研究参与者的看法和辍学原因：与对照组相比，RO DBT-A 组在抑郁（t=-1.78，df=10，p=0.011）和生活质量（QOL；Wilcoxon W=75，p=0.021）方面有显著改善。从基线到治疗后，接受 RO DBT-A 的青少年在适应不良过度控制（t=2.76，df=12，p=0.043）、焦虑（t=2.91，df=12，p=0.043）、抑郁（Wilcoxon 符号秩 V=82.5，p=0.043）和 QOL（t=-3.01，df=12，p=0.043）方面均有显著改善。定性分析揭示了与治疗障碍、促进因素和时机相关的主题：研究结果提供了初步证据，支持远程医疗提供的 RO DBT-A 在针对过度控制、减少症状和改善 QOL 方面对不同临床样本的青少年的作用。定性随访突出表明，与其他治疗方法相比，辍学是由与治疗相关的障碍（如与结构和治疗师相关的问题）以及 RO DBT-A 的时间安排造成的。

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来源期刊

AMERICAN JOURNAL OF PSYCHOTHERAPY PSYCHOLOGY, CLINICAL-

CiteScore

2.90

自引率

4.00%

发文量

期刊介绍： Founded in 1939, the American Journal of Psychotherapy (AJP) has long been a leader in the publication of eclectic articles for all psychotherapists. Transtheoretic in reach (offering information for psychotherapists across all theoretical foundations), the goal of AJP is to present an overview of the psychotherapies, subsuming a host of schools, techniques, and psychological modalities within the larger domain of clinical practice under broad themes including dynamic, behavioral, spiritual, and experiential.