Predictors of treatment outcomes in group cognitive behavioural therapy for orphaned adolescents in sheltered homes

Research on predictors of group cognitive behaviour therapy (gCBT) outcomes in adolescents with depression and anxiety is limited. This study aims to analyse factors predicting outcomes of a gCBT intervention targeting depression and anxiety in orphaned adolescents living in sheltered homes in Selangor, Malaysia. It examines the predictive value of sociodemographics, intervention type (gCBT versus waitlist control), and pre-intervention scores of psychological variables for immediate post-intervention and pre-post intervention change scores.

Using cluster sampling, 17 sheltered homes were identified, and nine participated in the study. These homes were randomly assigned to either the gCBT or waitlist control group. Participants in the intervention group attended eight sessions of the gCBT (SAHABAT program) over one month. Data were collected at pre-intervention, mid-intervention, and immediate post-intervention using self-report questionnaires. Scores were analysed using a generalised linear mixed model.

Intervention type emerged as a significant predictor of outcomes for both depression and anxiety at immediate post-intervention, as well as for pre-post intervention change scores, indicating the gCBT was more effective than the waitlist control. At the immediate post-intervention, pre-intervention depression scores significantly predicted depression outcomes, while pre-intervention anxiety scores significantly predicted anxiety outcomes. Specifically, lower pre-intervention depression and anxiety scores, along with higher self-esteem scores, predicted better intervention outcomes. Pre-intervention scores of negative automatic thoughts predicted depression outcomes only. Additionally, pre-intervention anxiety scores influenced the pre-post change score for depression, whereas the pre-intervention depression scores did not affect the pre-post change score for anxiety. Age was also a significant predictor.

The results and implications of these findings are discussed.