对于注意力缺陷/多动障碍青少年的动机面试增强行为疗法的三年效果:基于社区的随机试验
Margaret H Sibley1, Paulo A Graziano2, Stefany Coxe3
1University of Washington School of Medicine and Seattle Children's Research Institute in Seattle, WA; Florida International University Herbert Wertheim College of Medicine in Miami, FL.
支持青少年的自主日常 (STAND) 干预措施显示,在被授权治疗师提供时,对青少年多动症有长期好处. 没有执照的治疗师需要进一步培训,以便在社区心理健康环境中获得最佳结果.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 行为治疗是一种行为疗法.
- 临床心理学 临床心理学
背景情况:
- 注意缺陷/多动症 (ADHD) 严重影响青少年.
- 父母-青少年认知/行为治疗旨在改善多动症症状和相关挑战.
- 整合到干预措施中的激励面试 (MI) 可能会提高治疗参与度和治疗结果.
研究的目的:
- 评估支持青少年自主日常 (STAND) 干预措施与青少年ADHD的常规护理 (UC) 相比的3年效果.
- 评估STAND对ADHD严重程度,父母与青少年冲突以及执行功能的影响.
- 检查治疗师执照对长期治疗结果的调节作用.
主要方法:
- 一项随机临床试验,涉及278名患有多动症的青少年和82名社区治疗师.
- 青少年和治疗师的双重随机化为STAND或UC.
- 在3年后评估的长期结果,包括ADHD的严重程度,父母与青少年之间的冲突,组织,时间管理,规划技能 (OTP),治疗/学校入学以及诊断的持续性.
主要成果:
- 在治疗意图分析中,没有发现STAND和UC之间的整体长期群体差异.
- 然而,STAND在减少多动性/冲动性,父母与青少年之间的冲突以及提高OTP技能方面,证明了获得许可的治疗师的优越长期结果.
- 之前观察到的治疗后对药物效应的影响在3年随访时没有显著.
结论:
- 虽然STAND并没有普遍优于UC,但治疗师许可证显著缓解了对ADHD症状,执行功能和父母与青少年冲突的长期影响.
- 这些发现表明,像STAND这样的辅助认知/行为治疗可以在社区环境中最大限度地提高ADHD青少年的长期结果.
- 需要进一步努力,以确保未经许可的临床医生有效地实施STAND,以实现持续的长期效益.
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