A randomized trial of telehealth mindfulness-based cognitive therapy and cognitive behavioral therapy groups for adolescents with mood or attenuated psychosis symptoms.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2023-04-01 Epub Date: 2023-01-16 DOI:10.1037/ccp0000782

Marc J Weintraub, Danielle Denenny, Megan C Ichinose, Jamie Zinberg, Georga Morgan-Fleming, Monica Done, Robin D Brown, Carrie E Bearden, David J Miklowitz

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Abstract

Objectives: There is substantial evidence that cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) improve symptoms and functioning in adults with mood and psychotic disorders. There has been little work directly comparing these treatments among adolescents with early-onset mood or psychosis symptoms.

Method: We conducted a randomized controlled trial comparing remotely administered group CBT to group MBCT for adolescents (ages 13-17) with a mood disorder or attenuated psychosis symptoms. Adolescents attended nine sessions over 2 months; their parents attended parallel groups focused on the same skill practices. Participants were assessed for psychiatric symptoms and functioning at posttreatment and 3 months posttreatment.

Results: Sixty-six youth (M_age = 15.1 years, SD = 1.4; 44 females [66.7%]) initiated the trial (32 in CBT and 34 in MBCT), with 54 retained at posttreatment and 53 at the 3-month follow-up. The treatments were associated with comparable improvements in adolescents' mood, anxiety, attenuated psychosis symptoms, and psychosocial functioning over 5 months. CBT was associated with greater improvements than MBCT in emotion regulation and well-being during the posttreatment period. MBCT (compared to CBT) was associated with greater improvements in social functioning among adolescents with greater childhood adversity. Both treatments had comparable rates of retention, but youth and parents reported more satisfaction with CBT than MBCT.

Conclusions: The beneficial effect of both treatments in a group telehealth format is encouraging. Due to our limited sample, future research should investigate whether adolescents' history of adversity and treatment preferences replicate as treatment moderators for youth with mood or psychosis symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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针对有情绪或减轻精神病症状的青少年的远程健康正念认知疗法和认知行为疗法小组的随机试验。

目的：有大量证据表明，认知行为疗法（CBT）和正念认知疗法（MBCT）可改善患有情绪障碍和精神病的成年人的症状和功能。而在有早发情绪或精神病症状的青少年中，很少有直接比较这些疗法的研究：我们进行了一项随机对照试验，比较了对患有情绪障碍或精神病症状较轻的青少年（13-17 岁）进行的远程团体 CBT 和团体 MBCT 治疗。青少年在 2 个月内参加了 9 个疗程；他们的父母也同时参加了以相同技能练习为重点的小组。参与者在治疗后和治疗后 3 个月接受精神症状和功能评估：66名青少年（年龄=15.1岁，SD=1.4；44名女性[66.7%]）参加了试验（32人参加了CBT，34人参加了MBCT），54人在治疗后保留了下来，53人在3个月的随访中保留了下来。在5个月的治疗过程中，青少年的情绪、焦虑、减轻的精神病症状和社会心理功能得到了类似的改善。在治疗后阶段，CBT 比 MBCT 在情绪调节和幸福感方面有更大的改善。与 CBT 相比，MBCT 对童年逆境较多的青少年的社会功能改善更大。两种疗法的保留率相当，但青少年和家长对 CBT 的满意度高于 MBCT：结论：两种治疗方法在小组远程保健形式中的有益效果令人鼓舞。由于我们的样本有限，未来的研究应调查青少年的逆境史和治疗偏好是否也是影响有情绪或精神病症状的青少年治疗的因素。(PsycInfo Database Record (c) 2023 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

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.