Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy.

Robbins, Michael S.; Liddle, Howard A.; Turner, C. W.; Dakof, Gayle A.; Alexander, James F.; Kogan, Steven M.

doi:10.1037/0893-3200.20.1.108

Cited by 145 publications

(124 citation statements)

References 33 publications

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“…Le sexe et l'ethnie du soignant ne semblent pas faire de différence dans le maintien en traitement des adolescents. Les cliniciens de sexe féminin ne comptent pas plus de décrocheurs que les thérapeutes masculins ou les cliniciens d'une ethnie en particulier (Robbins, Liddle, Turner, Dakof, Alexander, & Kogan, 2006 Wintersteen, Mensinger, & Diamond, 2005). L'affiliation professionnelle, par contre, ne fait pas consensus.…”

Section: Caractéristiques Du Soignantunclassified

“…La plupart concluent que l'alliance des parents avec le soignant est corrélée au maintien du suivi (Garcia & Weisz, 2002;Hawley & Weisz, 2005;Robbins et al, 2006;Robbins, Turner, Alexander, & Perez, 2003). L'étude de Garcia (2002) montre en fait que les problèmes de relation rencontrée par le parent avec le soignant contribuent davantage à la décision de cesser le traitement que les problèmes financiers.…”

Section: Relation Thérapeutiqueunclassified

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Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Desrosiers

Saint-Jean

Laporte

2016

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Malgré une vaste littérature sur l’abandon de traitement en pédopsychiatrie, les connaissances sur cette problématique chez l’adolescent avec trouble de personnalité limite (TPL) demeurent peu développées. Les conséquences d’un arrêt prématuré du traitement sont sérieuses considérant la récurrence de leurs conduites suicidaires. Afin de comprendre les processus associés à l’instabilité du mode de consultation de ces adolescents, une méthode de théorisation ancrée constructiviste avec un devis de cas multiples a été utilisée. Trente-quatre entrevues auprès de trois groupes d’informateurs (adolescent, parent et clinicien) ont été réalisées. Un modèle explicatif des facteurs de risque d’abandon, mais aussi des conditions susceptibles de favoriser la poursuite du traitement a été élaboré. Il identifie les déterminants de l’abandon qui sont spécifiques aux adolescents avec TPL et décrit les processus par lesquels ceux-ci interfèrent avec la poursuite du traitement. Deux moments critiques ont été mis en évidence. Le premier survient au moment de l’offre de traitement. Il est déterminé par les capacités du dispositif de soins à profiter de l’impulsion de la demande d’aide pour engager l’adolescent et le parent en tenant compte de leurs vulnérabilités à l’abandon. Le deuxième moment critique survient en cours de traitement. Il est marqué par les capacités du dispositif de soins à adopter des mesures correctives lorsqu’apparaissent des complications d’engagement. Ces résultats mettent en évidence l’importance des réponses du dispositif de soins et suggèrent que l’engagement des adolescents avec TPL devrait constituer un objectif thérapeutique au même titre que la réduction de la symptomatologie et des problèmes de vie.

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Section: Caractéristiques Du Soignantunclassified

Section: Relation Thérapeutiqueunclassified

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Desrosiers

Saint-Jean

Laporte

2016

smq

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“…18 We used attending three appointments as the cut off number to distinguish early and late dropouts, as the higher number of appointments to define late dropouts have been mainly used in studies where efficacy of a certain intervention was tested in strict approach. [19][20][21] Engagement with the service in the present study was therefore divided into three categories: (1) 'early dropout' (attended up to 3 appointments), (2) 'late dropout' (attended 4 or more appointments), (3) treatment 'attenders'.…”

Section: Methodsmentioning

confidence: 99%

Examination of risk factors for dropout in a child and adolescent psychiatry outpatient clinic

Örengül¹,

Görmez²

2017

Anadolu Psikiyatri Derg

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“…28 A strong therapeutic alliance in turn has also been highlighted as a crucial factor for engagement and retention. By preparing families for, and guiding them through, criminal and educational proceedings (e.g.…”

Section: Therapy Orientationmentioning

confidence: 99%

Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs – a randomised controlled feasibility trial

Watson

Toner

Day

et al. 2017

Health Technol Assess

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BackgroundFamily interventions appear to be effective at treating young people’s substance misuse. However, implementation of family approaches in UK services is low. This study aimed to demonstrate the feasibility of recruiting young people to an intervention based on an adaptation of adult social behaviour and network therapy. It also sought to involve young people with experience of using substance misuse services in the research process.ObjectivesTo demonstrate the feasibility of recruiting young people to family and social network therapy and to explore ways in which young people with experience of using substance misuse services could be involved in a study of this nature.DesignA pragmatic, two-armed, randomised controlled open feasibility trial.SettingTwo UK-based treatment services for young people with substance use problems, with recruitment taking place from May to November 2014.ParticipantsYoung people aged 12–18 years, newly referred and accepted for structured interventions for drug and/or alcohol problems.InterventionsA remote, web-based computer randomisation system allocated young people to adapted youth social behaviour and network therapy (Y-SBNT) or treatment as usual (TAU). Y-SBNT participants were intended to receive up to six 50-minute sessions over a maximum of 12 weeks. TAU participants continued to receive usual care delivered by their service.Main outcome measuresFeasibility was measured by recruitment rates, retention in treatment and follow-up completion rates. The main clinical outcome was the proportion of days on which the main problem substance was used in the preceding 90-day period as captured by the Timeline Follow-Back interview at 3 and 12 months.ResultsIn total, 53 young people were randomised (Y-SBNT,n = 26; TAU,n = 27) against a target of 60 (88.3%). Forty-two young people attended at least one treatment session [Y-SBNT 22/26 (84.6%); TAU 20/27 (74.1%)]; follow-up rates were 77.4% at month 3 and 73.6% at month 12. Data for nine young people were missing at both months 3 and 12, so the main clinical outcome analysis was based on 24 young people (92.3%) in the Y-SBNT group and 20 young people (74.1%) in the TAU group. At month 12, the average proportion of days that the main problem substance was used in the preceding 90 days was higher in the Y-SBNT group than in the TAU group (0.54 vs. 0.41; adjusted mean difference 0.13, 95% confidence interval –0.12 to 0.39;p = 0.30). No adverse events were reported. Seventeen young people with experience of substance misuse services were actively involved throughout the study. They informed key elements of the intervention and research process, ensuring that the intervention was acceptable and relevant to our target groups; contributing to the design of key trial documents, ideas for a new model of public involvement and this report. Two parents were also involved.ConclusionsThe adapted intervention could be delivered in young people’s services, and qualitative interviews found that Y-SBNT was acceptable to young people, family members and staff. Engagement of family and network members proved difficult within the intervention and research aspects. The study proved the feasibility of this work in routine services but outcome measurement based on narrow substance use variables may be limited and may fail to capture other important changes in wider areas of functioning for young people. Validation of the EuroQol-5 Dimensions for young people aged 12–18 years should be considered and flexible models for involvement of young people in research are required to achieve inclusive representation throughout all aspects of the research process. Although recommendation of a full trial of the Y-SBNT intervention compared with TAU is not supported, this study can inform future intervention development and UK research within routine addiction services.Trial registrationCurrent Controlled Trials ISRCTN93446265.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 15. See the NIHR Journals Library website for further project information.

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Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy.

Cited by 145 publications

References 33 publications

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Examination of risk factors for dropout in a child and adolescent psychiatry outpatient clinic

Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs – a randomised controlled feasibility trial

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