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Schools-based digital therapy for adolescent social anxiety disorder.

基于学校的青少年社交焦虑症数字疗法。

基本信息

批准号：
MR/W02389X/1
负责人：
Eleanor Leigh
金额：
$ 128.04万
依托单位：
University of Oxford
依托单位国家：
英国
项目类别：
Fellowship
财政年份：
2022
资助国家：
英国
起止时间：
2022 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FW02389X%2F1
关键词：
Schools based digital therapy adolescent

项目摘要

Many everyday activities, like walking in a busy area and speaking on the phone, are anxiety-provoking for people with social anxiety disorder (SAD). SAD is common: almost 1 in 10 people will be affected by it in their lifetime and it is characterised by an intense fear of being watched and judged by others. SAD interferes with relationships and work and can lead to other serious mental health problems such as depression. For adults with SAD, powerful and accessible treatment is available: cognitive therapy for SAD (CT-SAD) is the leading treatment and recommended for the NHS. An internet-version (iCT-SAD) achieves similar large effects as face-to-face treatment with 70% less therapist time. This means that trained therapists can treat around three times as many patients as they can when offering traditional face-to-face therapy. But SAD nearly always starts before adulthood and so effective and accessible interventions are needed in adolescence. The standard treatment for adolescent SAD is a psychological therapy (exposure-based CBT) that is used to treat all anxiety problems. However, adolescents with SAD do much less well with this treatment than those with other anxiety problems. My recent research has shown that with minimal adaptations to the adult treatment, iCT-SAD is a promising treatment for adolescents. This suggests that iCT-SAD could improve outcomes for adolescents with SAD, while saving therapist time so more people can be treated with existing resources. In the fellowship I aim to ensure iCT-SAD meets the needs of socially anxious adolescents and test out its use in routine services. To realise this aim, two key issues need to be addressed: First iCT-SAD needs to be adapted further to enhance its effectiveness and acceptability for adolescents. The way that socially anxious adolescents behave in classroom settings and with their peers keeps social anxiety going and is linked to academic and relationship problems. Based on clinical and experimental knowledge, I will develop new modules to target these two adolescent-specific factors ('Social Anxiety in the Classroom' and 'Peer Problems'). Experiments will compare the effect of each module vs. no module amongst socially anxious adolescent participants. Those who received a module will give feedback to identify any further refinements to be made before the modules are integrated into iCT-SAD. Adolescents and families have told us that they also want to be able to access iCT-SAD via a smartphone application (app). Young people explained that this would make it easier to use therapy skills 'in the moment' and keep on top of learning, and parents want to learn how to support their child in treatment and access this information on their phones. An adolescent app that complements iCT-SAD and a separate parent app will be co-developed with adolescents, families, and software developers. Second is that so far iCT-SAD has been delivered by highly trained clinical psychologists working in specialist research settings, but adolescents with SAD are seen by practitioners with relatively little training working in school mental health services. Consultation with service leads, practitioners, and training providers will identify any refinements needed to iCT-SAD to make it easy to deliver in these services. A feasibility trial of internet CT-SAD compared to standard care will look at whether treatment and trial procedures are practical and whether they are acceptable to young people, families, and practitioners.The research will produce a digital treatment for adolescents with SAD that can be delivered in routine services. If a larger study confirms that it is helpful, then clinical services would benefit from fewer onward referrals to CAMHS and later adult services, and it would improve the lives of young people and their families: after treatment one young person told us, "I am about to start uni. I could never have imagined being able to do that before".

许多日常活动，如在忙碌地区散步和打电话，都会引起社交焦虑症（SAD）患者的焦虑。SAD很常见：近十分之一的人在其一生中会受到它的影响，其特征是强烈害怕被他人观察和评判。SAD会干扰人际关系和工作，并可能导致其他严重的心理健康问题，如抑郁症。对于患有SAD的成年人，可以提供强大且易于获得的治疗：SAD的认知疗法（CT-SAD）是主要的治疗方法，并推荐给NHS。互联网版本（iCT-SAD）实现了与面对面治疗相似的巨大效果，治疗时间减少了70%。这意味着经过培训的治疗师可以治疗的患者数量是传统面对面治疗的三倍。但SAD几乎总是在成年前开始，因此在青春期需要有效和可获得的干预措施。青少年SAD的标准治疗是一种心理治疗（基于焦虑的CBT），用于治疗所有焦虑问题。然而，与其他焦虑问题相比，SAD青少年在这种治疗中的表现要差得多。我最近的研究表明，iCT-SAD对成人治疗的适应性很小，是一种有前途的青少年治疗方法。这表明iCT-SAD可以改善患有SAD的青少年的结果，同时节省治疗师的时间，以便更多的人可以利用现有资源进行治疗。在奖学金中，我的目标是确保iCT-SAD满足社交焦虑青少年的需求，并测试其在日常服务中的使用。为了实现这一目标，需要解决两个关键问题：首先，iCT-SAD需要进一步调整，以提高其有效性和青少年的可接受性。社交焦虑的青少年在课堂环境中和与同龄人的行为方式使社交焦虑持续下去，并与学术和关系问题有关。基于临床和实验知识，我将开发新的模块来针对这两个特定的因素（“课堂社交焦虑”和“同伴问题”）。实验将比较社交焦虑青少年参与者中每个模块与无模块的效果。收到模块的人将提供反馈，以确定在将模块纳入iCT-SAD之前需要做的任何进一步改进。青少年和家庭告诉我们，他们也希望能够通过智能手机应用程序（app）访问iCT-SAD。年轻人解释说，这将使“当下”更容易使用治疗技能并保持学习，父母希望学习如何支持他们的孩子接受治疗并在手机上获取这些信息。一个补充iCT-SAD的青少年应用程序和一个单独的家长应用程序将与青少年、家庭和软件开发人员共同开发。其次，到目前为止，iCT-SAD是由在专业研究环境中工作的训练有素的临床心理学家提供的，但患有SAD的青少年是由在学校心理健康服务中接受过相对较少培训的从业者看到的。咨询服务领导者、从业者和培训提供者将确定iCT-SAD所需的任何改进，以使这些服务易于交付。互联网CT-SAD与标准治疗相比的可行性试验将研究治疗和试验程序是否实用，以及它们是否为年轻人，家庭和从业者所接受。该研究将为患有SAD的青少年提供可以在常规服务中提供的数字治疗。如果一个更大的研究证实它是有帮助的，那么临床服务将受益于更少的转介到CAMHS和后来的成人服务，它将改善年轻人及其家庭的生活：治疗后，一个年轻人告诉我们，“我即将开始大学。我以前从来没有想象过能够做到这一点”。