A meta-analysis of school-based interventions for anxious and depressed youth using QUORUM guidelines was conducted. Studies were located by searching electronic databases, manual effort, and contact with expert researchers. Analyses examined 63 studies with 8,225 participants receiving cognitive-behavioral therapy (CBT) and 6,986 in comparison conditions. Mean pre-post effect sizes indicate that anxiety-focused school-based CBT was moderately effective in reducing anxiety (Hedge's g = 0.501) and depression-focused schoolbased CBT was mildly effective in reducing depression (Hedge's g = 0.298) for youth receiving interventions as compared to those in anxiety intervention control conditions (Hedge's g = 0.193) and depression intervention controls (Hedge's g = 0.091). Predictors of outcome were explored. School-based CBT interventions for youth anxiety and for youth depression hold considerable promise, although investigation is still needed to identify features that optimize service delivery and outcome.
Objective: The aim of this study was to examine parents' early understanding of medication for attentiondeficit=hyperactivity disorder (ADHD) in relation to decisions to initiate and continue treatment for their child. Methods: Qualitative, semistructured telephone interviews were conducted with 48 parents of children newly diagnosed with ADHD. Parents were recruited from inner city, outpatient primary care, and mental health clinics affiliated with a large university hospital. Data were analyzed using grounded theory. Results: Parents' initial perspectives of the appropriateness, anticipated effects, and symbolic meaning of medication were classified by four typologies (illness oriented, problem oriented, generally acceptable, unacceptable). In this sample, 29% of parents believed medication was required to treat the illness and 20% believed medication was unacceptable. Except for the unacceptable group, nearly all of the parents in the other groups initiated medication shortly after diagnosis. More than 80% of the illness-and problem-oriented groups used medication at 6 months; this fell to 64% and 78%, respectively, at 12 months. Only half of the unacceptable group ever used medication for their child. Conclusions: Parents' views of ADHD medication may be predictive of continuity of treatment. Increasing physician awareness of parent preferences for managing their child's ADHD problems may lead to care management plans that maximize continuity.
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