A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14–17 years old in child and adolescent mental health services (CAMHS)

Abstract

Background: This study aims to investigate effectiveness of a 6-week, transdiagnostic cognitive behavioral therapy (CBT) for anxiety and depression in adolescents, the Structured Material for Therapy (SMART), in naturalistic settings of child and adolescent mental health outpatient services (CAMHS). Methods: A randomized controlled trial with waiting list control (WLC) was performed at three community CAMHS in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% girls) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to SMART or to WLC. Results: In the treatment group (CBT), 32.9% improved in the main outcome measure (SDQ), compared to 11.6% in the WLC. Clinically significant and reliable change was experienced by 17.7% in the CBT condition, compared to 5.8% in the WLC. No patients deteriorated. Statistically significant treatment effects were achieved for internalization symptoms, anxiety symptoms and general functioning. Conclusions: These promising findings indicate that SMART may be considered as a first step in a stepped care model for anxiety and/or depression treatment in CAMHS. The recovery rates imply that further investigations into the effectiveness of brief treatments should be made. Furthermore, there is a need for more comprehensive second-stage treatments for some of these patients.

Association Between Parental Parenting Style Disparities and Mental Health: An Evidence From Chinese Medical College Students

“…Actually, there was some evidence, which had implied that the parental parenting style disparities might associate with children's and adolescents' mental health. First, in the theory of cognitive dissonance ( 14 ), cognitive dissonance is caused by two or more inconsistent notions or by the discrepancy between individuals' behaviors and values, which was an important risk factor for mental health ( 15 , 16 ). Considering the importance of parental parenting style on children's and adolescents' cognitive development ( 17 , 18 ), we have enough reasons to believe the impact of parental parenting style disparities on children's and adolescents' mental health.…”

Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems

“…The active treatment was transdiagnostic CBT, according to the treatment manual Structured Material for Therapy (SMART) [ 42 ], delivered by the clinical staff at community child and adolescent mental health service clinics (CAMHS). The pre- to post-treatment short-term evaluation of the SMART treatment protocol for the present study sample is described in Lorentzen et al [ 43 ], including more detailed information about the SMART treatment protocol, clinical setting, training of therapists, randomization procedure, treatment integrity, user satisfaction, and therapeutic alliance.…”

“…Another promising transdiagnostic therapy protocol for emotional disorders is the Structured Material for Therapy (SMART) [ 42 ]. The short-term effectiveness of the SMART treatment was investigated in an RCT with a Norwegian sample of adolescents [ 43 ] and small to moderate effect sizes for the time by group interaction effect (ranging from 0.19 to 0.65) were observed for anxiety, emotional symptoms and general functioning, while the effect size for depressive symptoms did not reach significance directly after completion of treatment.…”

CORE-OM as a routine outcome measure for adolescents with emotional disorders: factor structure and psychometric properties

“…In the CAMHS sample (age 14–17, M = 15.72, SD = 1.15), there were 13 boys (9.3%) and 127 girls (90.7%). The adolescents in this sample were enrolled as participants in a psychotherapy research project, the SMART study [ 27 ] (‘Evaluation of short-term treatment for adolescents with emotional disorders in five children and adolescent CAMHS—A randomized controlled trial’ (ClinicalTrials.gov Identifier: NCT02150265); Regional Committee for Medical and Health Research Ethics (REC North); Reference number 2011/1937). Data for the present study were collected at enrolment, before treatment.…”