Review: Comprehensive treatments for youth comorbidity – evidence‐guided approaches to a complicated problem

Child and Adolescent Mental Health - Tập 20 Số 3 - Trang 131-141 - 2015
Sarah Kate Bearman1, John R. Weisz2
1Department of Educational Psychology, The University of Texas at Austin, 504 SZB, 1 University Station, D5800, Austin, TX, 78712-0383, USA.
2Department of Psychology; Harvard University; Boston MA USA

Tóm tắt

BackgroundEvidence‐based treatments (EBTs) with a single‐disorder focus have improved the potential for youth mental health care, yet may be an imperfect fit to clinical care settings where diagnostic comorbidity and co‐occurring problems are commonplace. Most EBTs were developed to treat one diagnosis or problem (or a small homogenous cluster), but most clinically referred youths present with multiple disorders and problems.FindingsThree emerging approaches may help address the comorbidity that is so common in treated youths. Conceptually unified treatments target presumed causal and maintaining factors that are shared among more than one disorder or problem area; preliminary open trials and case studies show promising results. Modular protocols combine the ‘practice elements’ that commonly appear in separate single‐disorder EBTs and repackage them into coordinated delivery systems; one modular protocol, MATCH, has produced positive findings in a randomized effectiveness trial. Monitoring and Feedback Systems (MFSs) provide real‐time data on client progress to inform clinical decision‐making, encompassing comorbid and co‐occurring problems; one study shows beneficial effects in everyday practice with diverse youth problems.ConclusionsAll three approaches – conceptually unified, modular, and MFS – can be strengthened by increased research attention to treatment integrity, clinician user‐appeal, design simplicity, and the infrastructure necessary for successful implementation.

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Tài liệu tham khảo

10.1016/j.beth.2013.03.003

10.1111/1469-7610.00424

10.1177/108705479700200301

10.1016/S0005-7894(04)80036-4

10.1093/med:psych/9780199772667.001.0001

10.1002/car.796

10.1016/j.beth.2012.12.004

10.1007/s10488-013-0485-5

10.1111/j.1468-2850.2009.01187.x

10.1097/CHI.0b013e3181825af8

10.1176/appi.ps.002052011

10.1016/j.beth.2012.04.007

10.1176/ps.2009.60.5.677

10.1002/cpp.315

10.1007/s10567-014-0172-4

10.1007/s11414-008-9139-x

Chorpita B.F., 2007, Modular cognitive‐behavioral therapy for childhood anxiety disorders

10.1111/j.1468-2850.2011.01247.x

10.1016/j.appsy.2005.05.002

Chorpita B.F., 2009, Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems (MATCH‐ADTC)

10.1037/a0034200

10.1016/j.cbpra.2010.10.005

10.1186/1753-2000-4-1

10.1001/archpsyc.60.8.837

10.1111/1469-7610.00332

10.1146/annurev-clinpsy-032210-104535

Ehrenreich J.T. Buzzela B.A. Trosper S.E. Bennett S.M. Wright L.A. &Barlow D.H.(2008).Unified protocol for the treatment of emotional disorders in youth (Unpublished treatment manual).University of Miami and Boston University.

10.1016/j.cbpra.2011.02.003

Fairburn C.G., 2008, Clinical handbook of psychological disorders: A step‐by‐step treatment manual, 578

10.1007/s10942-014-0178-3

Garland A.F., 2010, Mental health care for children with disruptive behavior problems: A view inside therapists’ offices, Psychiatric Services, 61, 788, 10.1176/ps.2010.61.8.788

10.1097/00004583-200104000-00009

10.1037/a0032517

10.1007/s10488-010-0323-y

10.1016/j.beth.2013.04.006

10.1177/1063426611407500

10.1037/0022-006X.76.4.544

10.1176/appi.ajp.2014.14020138

Institute of Medicine, 2001, Crossing the quality chasm: A new health system for the 21st Century

Institute of Medicine, 2007, The state of quality improvement and implementation research: Workshop summary

Jensen‐Doss A.J., 2005, Is comorbidity really a problem for the dissemination of evidence‐based treatments for youth?, The Behavior Therapist, 28, 160

10.1037/a0014690

10.1016/j.cbpra.2013.12.002

10.1207/s15374424jccp2201_1

10.1037/0735-7028.38.1.13

10.1097/00004583-200107000-00013

10.1016/j.janxdis.2010.01.009

10.1007/s10802-009-9303-7

10.1002/cpp.333

10.1037/a0018121

10.1111/cpsp.12020

10.1007/978-0-387-88639-8

10.1016/j.cbpra.2013.06.005

10.1007/s11414-007-9089-8

10.1111/j.1469-7610.2007.01733.x

NREPP. (2014)SAMHSA's National Registry of Evidence‐Based Programs and Practices. Available from:http://nrepp.samhsa.gov/Index.aspx. [last accessed 15 August 2014].

10.1016/j.cpr.2008.09.003

10.1007/s10488-012-0464-2

10.1007/s10488-014-0559-z

10.1080/15433714.2012.664062

10.1111/j.1475-3588.2011.00609.x

10.1016/j.cbpra.2011.06.006

10.1097/01.chi.0000121067.29744.41

10.1007/s10488-008-0181-z

10.1037/a0019247

10.1080/15374410701817725

10.1037/a0025694

10.1111/j.1467-8624.2004.00750.x

Terry R. Bailin A. Bearman S.K. &Weisz J.R.(2014 November).After the study ends: community mental health providers’ perspectives on the sustainability of a transdiagnostic cognitive behavioral treatment approach. Poster accepted for presentation at the Annual Convention of the Association for Cognitive and Behavioral Therapies Philadelphia PA.

10.1007/s10802-007-9104-9

10.1097/01.chi.0000145807.09027.82

10.1097/01.CHI.0000046839.90931.0D

10.1007/s10567-009-0043-6

10.1016/j.cbpra.2007.10.001

10.1016/j.cbpra.2011.06.002

Weisz J.R., 2012, Child and adolescent therapy: Cognitive‐behavioral procedures, 379

10.1037/a0023307

10.1001/archgenpsychiatry.2011.147

10.1016/j.chc.2004.05.006

10.1001/jamapsychiatry.2013.1176

Weisz J.R., 2013, Bergin and Garfield's handbook of psychotherapy and behavior change, 541

10.1037/0022-006X.69.6.875

10.1016/j.beth.2011.02.002

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Child and Adolescent Mental Health

Tập 20 Số 3

131-141

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