Engagement and Alliance in CBT for Depressed Adolescents

抑郁青少年认知行为治疗的参与和联盟

• 批准号: 6612926
• 负责人: STEPHEN R SHIRK
• 金额: $ 16.57万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6612926
• 关键词: adolescence (12-20); audiotape; behavior test; behavioral /social science research tag; clinical depression; clinical research; clinical trials; cognitive behavior therapy; experience; handbook; health care service evaluation; health care service utilization; human data; human subject; human therapy evaluation; interview; major depression; mental health personnel; method development; motivation; outcomes research; patient care personnel relations; patient oriented research; suicide; therapy compliance

DESCRIPTION (provided by applicant): A major threat to treatment efficacy is the dilution of treatment strength through early drop out, sporadic attendance, and marginal participation. This problem represents a significant public health concern given the high rates of attrition and sporadic attendance in child clinic settings. As a result, children and adolescents who do not receive adequate exposure to active treatment components are unlikely to benefit from empirically supported treatments. We propose that the therapeutic alliance and therapist behaviors that facilitate alliance formation are critical for reducing drop out, promoting regular attendance, and maximizing active participation in sessions. Thus, empirically supported treatments should be complemented with empirically based engagement interventions that contribute to alliance formation, and to evaluate the contribution of engagement interventions and alliance to treatment completion, regular attendance, active participation, and treatment outcome in an open trial of CBT for adolescent depression. The proposal involves two studies. The first involves the development and evaluation of observational measures of therapist engagement interventions, therapy alliance, and treatment participation from audio recordings of completed, controlled trial of CBT for depressed and suicidal adolescents. The second study involves the evaluation of associations among engagement interventions, alliance, participation, treatment continuation/attendance, and outcome in an open trial of an empirically supported treatment, cognitive-behavioral therapy, for adolescent depression. An explicit mediational model of therapy process will be evaluated. The identification of effective engagement interventions into manualized treatments for adolescent depression, specifically, and potentially into manuals for a range of adolescent disorders. It is expected that empirically based guidelines for treatment engagement will be essential for the transportation of empirically supported treatments from research to clinical settings.

描述（由申请人提供）：治疗有效性的主要威胁是通过早期脱落、零星就诊和边际参与稀释治疗强度。 鉴于儿童诊所的高自然减员率和零星就诊率，这一问题是一个重大的公共卫生问题。 因此，没有充分接触活性治疗成分的儿童和青少年不太可能从经验支持的治疗中获益。 我们建议，治疗联盟和治疗师的行为，促进联盟的形成是至关重要的减少辍学，促进定期出席，并最大限度地积极参与会议。 因此，经验支持的治疗应该辅之以有助于联盟形成的基于经验的参与干预措施，并在CBT开放试验中评估参与干预措施和联盟对治疗完成、定期就诊、积极参与和治疗结果的贡献。青少年抑郁症。 这项建议涉及两项研究。 第一个涉及到治疗师参与干预，治疗联盟和治疗参与的观察措施的开发和评估，从录音完成，对照试验的CBT抑郁症和自杀的青少年。 第二项研究涉及参与干预，联盟，参与，治疗继续/出席，并在一个开放的试验结果的经验支持的治疗，认知行为疗法，青少年抑郁症之间的协会的评估。 一个明确的中介模型的治疗过程将进行评估。 确定有效的参与干预措施，用于青少年抑郁症的手动治疗，特别是，并可能用于一系列青少年疾病的手册。 预计基于经验的治疗参与指南将是必不可少的运输经验支持的治疗从研究到临床环境。