Mental Health Intervention for Teens Coping with Parental Military Deployment

描述（由申请人提供）：本申请是根据NIMH PAR-06-248“从干预开发到服务：探索性研究赠款（R34）"提交的。军事人员总数超过350万，其中约43%有子女。部署周期可能与抑郁症，焦虑和儿童行为问题以及军人配偶的心理困扰有关。此外，在部署和重返社会期间，家庭成员的健康可能影响到军人的身心功能。虽然研究和联邦资金一直致力于为返回的服务成员开发治疗方法，但对军人家庭子女心理健康问题的干预方案尚未进行测试。与罗得岛国民警卫队和预备队的家庭准备计划合作，本提案的目的是为经历抑郁，焦虑和/或与军事部署周期的部署和重新整合阶段相关的行为问题的青少年制定认知行为治疗方案。该方案将通过修改NIH资助的用于治疗青少年心理健康问题的认知行为方案来创建，该方案具有初步证明的疗效（PI，C。Esposito-Smythers）。该项目有三个主要目标：1）为经历与部署周期相关的心理健康问题的青少年制定手动干预方案; 2）在12个家庭中完善和试点干预方案; 3）在随机试点试验中测试干预措施。为了实现这些目标，提出了一个两步序列的治疗开发。阶段Ia包括初始手册开发、焦点小组、治疗师培训和开放试点试验。Ib期包括一项随机初步试验。将通过罗得岛家庭准备计划招募72名青少年及其护理人员，并将其随机分配到实验性干预或非指导性支持治疗的门诊护理。实验干预包括 12个青少年小组会议，解决与部署周期相关的抑郁，焦虑和行为问题，12个家长小组会议，解决压力管理和育儿技巧。非指导性支持性治疗条件包括12次青少年小组会议和12次家长小组会议，其中涉及患者发起的讨论，重点是围绕军事部署和重返社会的问题。将在治疗后和3个月随访时评估结局。本研究的长期目标是为经历与部署周期的部署和重新整合阶段相关的心理健康问题的青少年军人提供有效的门诊干预。

DESCRIPTION (provided by applicant): This application is being submitted in response to NIMH PAR-06-248 entitled "From Intervention Development to Services: Exploratory Research Grants (R34)". The total number of military personnel is over 3.5 million and approximately 43% have children. The deployment cycle can be associated with depression, anxiety, and behavior problems in children as well as psychological distress in the military spouse. Further, the health of family members can affect the physical and psychological functioning of the military service member during the deployment and re-integration periods. While research and federal funding has been dedicated toward developing treatments for the returning service member, intervention protocols for mental health problems in the children of military families have not been tested. In collaboration with the Family Readiness Program of the Rhode Island National Guard & Reserves, the purpose of this proposal is to develop a cognitive behavioral treatment protocol for adolescents experiencing depression, anxiety, and/or behavior problems associated with the deployment and re-integration phases of the military deployment cycle. This protocol will be created by modifying an NIH funded cognitive behavioral protocol for the treatment of adolescent mental health problems with initial demonstrated efficacy (PI, C. Esposito-Smythers). There are three primary aims in this project: 1) develop the manualized intervention protocol for adolescents experiencing mental health problems associated with the deployment cycle; 2) refine and pilot the intervention protocol with 12 families; and 3) test the intervention in a randomized pilot trial. To accomplish these aims, a two step sequence of treatment development is proposed. Stage Ia includes initial manual development, focus groups, therapist training, and an open pilot trial. Stage Ib includes a randomized pilot trial. Seventy-two adolescents and their caretakers will be enrolled through the Rhode Island Family Readiness program and randomly assigned to the experimental intervention or non-directive supportive therapy for their outpatient care. The experimental intervention includes 12 adolescent group sessions which address depression, anxiety, and behavior problems associated with the deployment cycle and 12 parent group sessions that address stress management and parenting skills. The non-directive supportive therapy condition includes 12 adolescent and 12 parent group sessions which involve patient initiated discussions focused on issues surrounding military deployment and re-integration. Outcome will be assessed at post-treatment and 3 month follow-up. The long term objective of this research is to yield an effective outpatient intervention for teens of military service members experiencing mental health problems associated with the deployment and re-integration phases of the deployment cycle.