CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial
CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial
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DOI：
10.1176/appi.ajp.2020.20050548
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发表时间：
2021-04-01
影响因子：
17.7
通讯作者：
Spuij, Mariken
中科院分区：
文献类型：
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作者：
Boelen, Paul A.;Lenferink, Lonneke I. M.;Spuij, Mariken
目的：持续性悲伤障碍是ICD-11新收录的疾病，与DSM-5新收录的持续性复杂丧亲障碍相似。虽然认知行为疗法（CBT）可以成功地治疗成年人的长期悲伤障碍，但目前还没有证据表明CBT干预可以成功地缓解儿童和青少年的这种障碍。这项随机临床试验的目的是检查CBT程序的影响，CBT悲伤帮助，与非指导性支持咨询的影响相比，儿童和青少年的长期悲伤障碍。共有134名儿童和青少年患有长期悲伤障碍（平均年龄13.10岁[SD=2.84]，平均37.79个月[SD=36.23]前失去亲人）被随机分配接受CBT悲伤帮助（N=74）或支持性咨询（N=60）。这两种治疗条件包括与儿童和青少年的九次单独会议，以及与父母或照顾者的五次咨询会议。儿童和青少年完成的措施，长期的悲伤障碍，抑郁症，创伤后应激障碍（PTSD），和他们的父母或照顾者完成的措施，他们的孩子的问题行为治疗前，治疗后立即，和3，6，和12个月后treatment.Results：两种治疗方法产生了中度至大型的影响大小，在长期的悲伤障碍和大多数其他结果的措施。与支持性咨询相比，CBT悲伤帮助导致在所有治疗后评估的长期悲伤障碍症状显着减少，它是更成功的缓解抑郁症，PTSD症状，和内化问题6和12个月后treatment.Conclusions：长期悲伤障碍及其症状在丧亲儿童和青少年可以有效地治疗CBT干预。CBT悲伤帮助相对于支持性咨询的上级长期效果表明，这种治疗成功地加强了儿童和青少年面对丧亲之痛带来的挑战。
Objective: Prolonged grief disorder was newly included in ICD-11 and resembles persistent complex bereavement disorder, newly included in DSM-5. Although prolonged grief disorder in adults can be successfully treated by cognitive-behavioral therapy (CBT), there is no evidence yet that CBT interventions can successfully alleviate the disorder in children and adolescents. The goal of this randomized clinical trial was to examine the effects of a CBT program, CBT Grief-Help, for prolonged grief disorder in children and adolescents in comparison with the effects of nondirective supportive counseling.Methods: A total of 134 children and adolescents with prolonged grief disorder (mean age, 13.10 years [SD=2.84], bereaved a mean of 37.79 months [SD=36.23] earlier) were randomly assigned to receive either CBT Grief-Help (N=74) or supportive counseling (N=60). Both treatment conditions encompassed nine individual sessions with children and adolescents paralleled by five counseling sessions with parents or caretakers. Children and adolescents completed measures of prolonged grief disorder, depression, and posttraumatic stress disorder (PTSD), and their parents or caretakers completed measures of their children's problem behavior before treatment, immediately after treatment, and 3, 6, and 12 months after treatment.Results: Both treatments yielded moderate to large effect sizes across prolonged grief disorder and most other outcome measures. Compared with supportive counseling, CBT Grief-Help resulted in significantly greater reductions in prolonged grief disorder symptoms at all posttreatment assessments, and it was more successful in alleviating depression, PTSD symptoms, and internalizing problems 6 and 12 months after treatment.Conclusions: Prolonged grief disorder and its symptoms in bereaved children and adolescents can be effectively treated by CBT interventions. The superior long-term effects of CBT Grief-Help relative to supportive counseling suggest that this treatment successfully strengthens children and adolescents in facing challenges brought about by bereavement.