A randomized controlled effectiveness trial of transdiagnostic treatment and measurement-based care for adolescents with emotional disorders in community clinics.
Jill Ehrenreich-May, Amanda Jensen-Doss, Lauren Milgram, David Rosenfield, Ashley M Shaw, Jamie LoCurto, Monica Nanda Robinson, E B Caron, Phyllis Lee, Golda S Ginsburg
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引用次数: 0
Abstract
Objective: This article presents primary outcomes from the Community Study of Outcome Monitoring for Emotional Disorders in Teens, a two-site, randomized controlled trial comparing the effectiveness of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Adolescents plus measurement-based care (UP-A), measurement-based care alone (TAU+), and treatment as usual (TAU) in community mental health clinics. Method: A total of 174 clinicians were randomized to implement TAU (n = 49), TAU plus an MBC measure (TAU+; n = 63), or UP-A plus MBC (UP-A; n = 62). In addition, 196 adolescents were randomized to receive 16 weeks of either TAU (n = 68), TAU+ (n = 60), or UP-A (n = 68). Independent evaluator-, self-, and caregiver-reported adolescent anxiety and depression symptoms were measured at baseline and Weeks 8, 16, and 28 postenrollment. Results: Adolescents in all groups showed improvement over time, and compared with TAU, adolescents receiving TAU+ and UP-A conditions improved more quickly on adolescent-report measures only. There were no treatment group differences observed on independent evaluator (primary outcome) or caregiver-report measures. In post hoc analyses, moderators of treatment response included treatment duration and complexity of symptom presentation. Conclusions: In one of the largest adolescent-focused, community-located psychotherapy trials conducted in the United States, transdiagnostic treatment plus measurement-based care and measurement-based care alone conferred some adolescent-reported symptom benefits compared with treatment as usual, although adolescents in all conditions exhibited improvements in anxiety and depression. Future directions for subsequent adolescent psychotherapy effectiveness trials for anxiety and depression are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
目的本文介绍了 "青少年情感障碍结果监测社区研究"（Community Study of Outcome Monitoring for Emotional Disorders in Teens）的主要结果。这是一项两地随机对照试验，比较了青少年情感障碍跨诊断治疗统一方案（Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Adolescents）加测量护理（UP-A）、单纯测量护理（TAU+）和社区心理健康诊所常规治疗（TAU）的有效性。方法：共有174名临床医生被随机分配实施TAU（49人）、TAU加MBC测量（TAU+；63人）或UP-A加MBC（UP-A；62人）。此外，196名青少年被随机分配接受为期16周的TAU（68人）、TAU+（60人）或UP-A（68人）治疗。在基线期和接受治疗后的第8、16和28周，对独立评估人、自我和护理人报告的青少年焦虑和抑郁症状进行了测量。结果显示与TAU相比，接受TAU+和UP-A治疗的青少年在青少年报告的症状方面改善得更快。在独立评估者（主要结果）或照顾者报告的指标上，没有观察到治疗组的差异。在事后分析中，治疗反应的调节因素包括治疗持续时间和症状表现的复杂性。结论在美国进行的规模最大的一项以青少年为中心的社区心理治疗试验中，与常规治疗相比，跨诊断治疗加测量型护理和单纯测量型护理在青少年报告的症状方面有一些益处，尽管所有条件下的青少年在焦虑和抑郁方面都有所改善。本文讨论了针对焦虑和抑郁的青少年心理治疗有效性试验的未来方向。(PsycInfo Database Record (c) 2025 APA，保留所有权利）。
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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