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Clinician factors related to the delivery of psychotherapy for autistic youth and youth with attention-deficit hyperactivity disorder / Flora ROUDBARANI in Autism, 27-2 (February 2023)
[article]
Titre : Clinician factors related to the delivery of psychotherapy for autistic youth and youth with attention-deficit hyperactivity disorder Type de document : Texte imprimé et/ou numérique Auteurs : Flora ROUDBARANI, Auteur ; Paula TABLON-MODICA, Auteur ; Brenna B. MADDOX, Auteur ; Yvonne BOHR, Auteur ; Jonathan A. WEISS, Auteur Article en page(s) : p.415-427 Langues : Anglais (eng) Mots-clés : ADHD autism children clinicians intention mental health psychotherapy theory of planned behaviour Index. décimale : PER Périodiques Résumé : Autistic children and adolescents are more likely than non-autistic youth to experience mental health problems, such as anxiety or depression, but less likely to receive psychotherapy to address these concerns. Recent research indicates that clinician factors, such as knowledge, attitudes, confidence and beliefs, can impact their decisions to provide care, though this work has primarily focused on adults or within the context of one kind of treatment (cognitive behaviour therapy). The current study examined psychological predictors (e.g. attitudes and confidence) of clinicians’ intention to deliver psychotherapy to autistic youth and those with attention-deficit hyperactivity disorder. Participants included 611 clinicians across publicly funded agencies in Ontario, Canada. Multiple mediation analyses revealed that clinician knowledge on mental health-related topics (e.g. core symptoms, developing treatment plans and identifying progress towards treatment goals) was associated with intention to treat autistic clients or clients with attention-deficit hyperactivity disorder, and normative pressures and attitudes partially mediated this association. Clinicians felt less likely to treat autistic clients than clients with attention-deficit hyperactivity disorder, partly because of differences in attitudes, normative pressures and knowledge. This research suggests that targeted training around autism and mental health care may be a useful initiative for agency staff. En ligne : http://dx.doi.org/10.1177/13623613221106400 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=493
in Autism > 27-2 (February 2023) . - p.415-427[article] Clinician factors related to the delivery of psychotherapy for autistic youth and youth with attention-deficit hyperactivity disorder [Texte imprimé et/ou numérique] / Flora ROUDBARANI, Auteur ; Paula TABLON-MODICA, Auteur ; Brenna B. MADDOX, Auteur ; Yvonne BOHR, Auteur ; Jonathan A. WEISS, Auteur . - p.415-427.
Langues : Anglais (eng)
in Autism > 27-2 (February 2023) . - p.415-427
Mots-clés : ADHD autism children clinicians intention mental health psychotherapy theory of planned behaviour Index. décimale : PER Périodiques Résumé : Autistic children and adolescents are more likely than non-autistic youth to experience mental health problems, such as anxiety or depression, but less likely to receive psychotherapy to address these concerns. Recent research indicates that clinician factors, such as knowledge, attitudes, confidence and beliefs, can impact their decisions to provide care, though this work has primarily focused on adults or within the context of one kind of treatment (cognitive behaviour therapy). The current study examined psychological predictors (e.g. attitudes and confidence) of clinicians’ intention to deliver psychotherapy to autistic youth and those with attention-deficit hyperactivity disorder. Participants included 611 clinicians across publicly funded agencies in Ontario, Canada. Multiple mediation analyses revealed that clinician knowledge on mental health-related topics (e.g. core symptoms, developing treatment plans and identifying progress towards treatment goals) was associated with intention to treat autistic clients or clients with attention-deficit hyperactivity disorder, and normative pressures and attitudes partially mediated this association. Clinicians felt less likely to treat autistic clients than clients with attention-deficit hyperactivity disorder, partly because of differences in attitudes, normative pressures and knowledge. This research suggests that targeted training around autism and mental health care may be a useful initiative for agency staff. En ligne : http://dx.doi.org/10.1177/13623613221106400 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=493 Practitioner Review: Empirical evolution of youth psychotherapy toward transdiagnostic approaches / Lauren Krumholz MARCHETTE in Journal of Child Psychology and Psychiatry, 58-9 (September 2017)
[article]
Titre : Practitioner Review: Empirical evolution of youth psychotherapy toward transdiagnostic approaches Type de document : Texte imprimé et/ou numérique Auteurs : Lauren Krumholz MARCHETTE, Auteur ; John R. WEISZ, Auteur Article en page(s) : p.970-984 Langues : Anglais (eng) Mots-clés : Adolescence comorbidity mental health psychotherapy Index. décimale : PER Périodiques Résumé : Background Psychotherapy for children and adolescents (herein, ‘youths’) has grown more precise and focused over the decades, shifting toward empirically supported treatments standardized via therapist manuals. The manuals have increasingly emphasized precise targeting of single disorders or problems, or homogenous clusters. These focal treatments represent a valuable advance, with intervention benefit documented in hundreds of studies. However, relatively few of these treatments are widely used in everyday clinical practice, and their level of benefit may not be ideal, particularly in practice contexts and when compared to usual clinical care. Thesis These limitations may be due, in part, to a mismatch between focal treatment design and the young people treated in real-world clinical care, who are diagnostically heterogeneous, and very frequently present with comorbidity. Improved fit may be achieved via transdiagnostic treatment approaches designed to address multiple disorders and problems, if these approaches can retain the benefits of manualization and the substantive clinical strength that has generated empirical support to date. Scope Here we review the evolution of empirically-based youth psychotherapy from focal treatment manuals toward transdiagnostic approaches, and we describe and illustrate three transdiagnostic treatment strategies: (a) a core dysfunction approach, (b) a common elements and modular design approach, and (c) a principle-guided approach. Clinical applications We complement research findings with a clinical perspective based on our use of manual-guided transdiagnostic intervention in clinical care settings, and we propose directions for research and practice. En ligne : http://dx.doi.org/10.1111/jcpp.12747 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=317
in Journal of Child Psychology and Psychiatry > 58-9 (September 2017) . - p.970-984[article] Practitioner Review: Empirical evolution of youth psychotherapy toward transdiagnostic approaches [Texte imprimé et/ou numérique] / Lauren Krumholz MARCHETTE, Auteur ; John R. WEISZ, Auteur . - p.970-984.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 58-9 (September 2017) . - p.970-984
Mots-clés : Adolescence comorbidity mental health psychotherapy Index. décimale : PER Périodiques Résumé : Background Psychotherapy for children and adolescents (herein, ‘youths’) has grown more precise and focused over the decades, shifting toward empirically supported treatments standardized via therapist manuals. The manuals have increasingly emphasized precise targeting of single disorders or problems, or homogenous clusters. These focal treatments represent a valuable advance, with intervention benefit documented in hundreds of studies. However, relatively few of these treatments are widely used in everyday clinical practice, and their level of benefit may not be ideal, particularly in practice contexts and when compared to usual clinical care. Thesis These limitations may be due, in part, to a mismatch between focal treatment design and the young people treated in real-world clinical care, who are diagnostically heterogeneous, and very frequently present with comorbidity. Improved fit may be achieved via transdiagnostic treatment approaches designed to address multiple disorders and problems, if these approaches can retain the benefits of manualization and the substantive clinical strength that has generated empirical support to date. Scope Here we review the evolution of empirically-based youth psychotherapy from focal treatment manuals toward transdiagnostic approaches, and we describe and illustrate three transdiagnostic treatment strategies: (a) a core dysfunction approach, (b) a common elements and modular design approach, and (c) a principle-guided approach. Clinical applications We complement research findings with a clinical perspective based on our use of manual-guided transdiagnostic intervention in clinical care settings, and we propose directions for research and practice. En ligne : http://dx.doi.org/10.1111/jcpp.12747 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=317 Randomized controlled trial of family-focused treatment for child depression compared to individual psychotherapy: one-year outcomes / Joan ASARNOW ROSENBAUM in Journal of Child Psychology and Psychiatry, 61-6 (June 2020)
[article]
Titre : Randomized controlled trial of family-focused treatment for child depression compared to individual psychotherapy: one-year outcomes Type de document : Texte imprimé et/ou numérique Auteurs : Joan ASARNOW ROSENBAUM, Auteur ; Martha C. TOMPSON, Auteur ; Alexandra M. KLOMHAUS, Auteur ; Kalina BABEVA, Auteur ; David A. LANGER, Auteur ; Catherine A. SUGAR, Auteur Article en page(s) : p.662-671 Langues : Anglais (eng) Mots-clés : Depression family therapy outcome psychotherapy treatment trials Index. décimale : PER Périodiques Résumé : OBJECTIVE: Childhood-onset depression is associated with increased risk of recurrent depression and high morbidity extending into adolescence and adulthood. This multisite randomized controlled trial evaluated two active psychosocial treatments for childhood depression: family-focused treatment for childhood depression (FFT-CD) and individual supportive psychotherapy (IP). Aims were to describe effects through 52 weeks postrandomization on measures of depression, functioning, nondepressive symptoms, and harm events. METHODS: Children meeting criteria for depressive disorders (N = 134) were randomly assigned to 15 sessions of FFT-CD or IP and evaluated at mid-treatment for depressive symptoms and fully at roughly 16 weeks (after acute treatment), 32 weeks, and 52 weeks/one year. See clinicaltrials.gov: NCT01159041. RESULTS: Analyses using generalized linear mixed models confirmed the previously reported FFT-CD advantage on rates of acute depression response (?50% Children's Depression Rating Scale reduction). Improvements in depression and other outcomes were most rapid during the acute treatment period, and leveled off between weeks 16 and 52, with a corresponding attenuation of observed group differences, although both groups showed improved depression and functioning over 52 weeks. Survival analyses indicated that most children recovered from their index depressive episodes by week 52: estimated 76% FFT-CD, 77% IP. However, by the week 52 assessment, one FFT-CD child and six IP children had suffered recurrent depressive episodes. Four children attempted suicide, all in the IP group. Other indicators of possible harm were relatively evenly distributed across groups. CONCLUSIONS: Results indicate a quicker depression response in FFT-CD and hint at greater protection from recurrence and suicide attempts. However, outcomes were similar for both active treatments by week 52/one year. Although community care received after acute treatment may have influenced results, findings suggest the value of a more extended/chronic disease model that includes monitoring and guidance regarding optimal interventions when signs of depression-risk emerge. En ligne : http://dx.doi.org/10.1111/jcpp.13162 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426
in Journal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.662-671[article] Randomized controlled trial of family-focused treatment for child depression compared to individual psychotherapy: one-year outcomes [Texte imprimé et/ou numérique] / Joan ASARNOW ROSENBAUM, Auteur ; Martha C. TOMPSON, Auteur ; Alexandra M. KLOMHAUS, Auteur ; Kalina BABEVA, Auteur ; David A. LANGER, Auteur ; Catherine A. SUGAR, Auteur . - p.662-671.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.662-671
Mots-clés : Depression family therapy outcome psychotherapy treatment trials Index. décimale : PER Périodiques Résumé : OBJECTIVE: Childhood-onset depression is associated with increased risk of recurrent depression and high morbidity extending into adolescence and adulthood. This multisite randomized controlled trial evaluated two active psychosocial treatments for childhood depression: family-focused treatment for childhood depression (FFT-CD) and individual supportive psychotherapy (IP). Aims were to describe effects through 52 weeks postrandomization on measures of depression, functioning, nondepressive symptoms, and harm events. METHODS: Children meeting criteria for depressive disorders (N = 134) were randomly assigned to 15 sessions of FFT-CD or IP and evaluated at mid-treatment for depressive symptoms and fully at roughly 16 weeks (after acute treatment), 32 weeks, and 52 weeks/one year. See clinicaltrials.gov: NCT01159041. RESULTS: Analyses using generalized linear mixed models confirmed the previously reported FFT-CD advantage on rates of acute depression response (?50% Children's Depression Rating Scale reduction). Improvements in depression and other outcomes were most rapid during the acute treatment period, and leveled off between weeks 16 and 52, with a corresponding attenuation of observed group differences, although both groups showed improved depression and functioning over 52 weeks. Survival analyses indicated that most children recovered from their index depressive episodes by week 52: estimated 76% FFT-CD, 77% IP. However, by the week 52 assessment, one FFT-CD child and six IP children had suffered recurrent depressive episodes. Four children attempted suicide, all in the IP group. Other indicators of possible harm were relatively evenly distributed across groups. CONCLUSIONS: Results indicate a quicker depression response in FFT-CD and hint at greater protection from recurrence and suicide attempts. However, outcomes were similar for both active treatments by week 52/one year. Although community care received after acute treatment may have influenced results, findings suggest the value of a more extended/chronic disease model that includes monitoring and guidance regarding optimal interventions when signs of depression-risk emerge. En ligne : http://dx.doi.org/10.1111/jcpp.13162 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426 Annual Research Review: Building a science of personalized intervention for youth mental health / Mei Yi NG in Journal of Child Psychology and Psychiatry, 57-3 (March 2016)
[article]
Titre : Annual Research Review: Building a science of personalized intervention for youth mental health Type de document : Texte imprimé et/ou numérique Auteurs : Mei Yi NG, Auteur ; John R. WEISZ, Auteur Article en page(s) : p.216-236 Langues : Anglais (eng) Mots-clés : Children adolescents psychotherapy personalized intervention tailoring treatments Index. décimale : PER Périodiques Résumé : Background Within the past decade, health care service and research priorities have shifted from evidence-based medicine to personalized medicine. In mental health care, a similar shift to personalized intervention may boost the effectiveness and clinical utility of empirically supported therapies (ESTs). The emerging science of personalized intervention will need to encompass evidence-based methods for determining which problems to target and in which order, selecting treatments and deciding whether and how to combine them, and informing ongoing clinical decision-making through monitoring of treatment response throughout episodes of care. We review efforts to develop these methods, drawing primarily from psychotherapy research with youths. Then we propose strategies for building a science of personalized intervention in youth mental health. Findings The growing evidence base for personalizing interventions includes research on therapies adapted for specific subgroups; treatments targeting youths’ environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta-analyses comparing treatments for specific patient characteristics; data-mining decision trees; and individualized metrics. Conclusion The science of personalized intervention presents questions that can be addressed in several ways. First, to evaluate and organize personalized interventions, we propose modifying the system used to evaluate and organize ESTs. Second, to help personalizing research keep pace with practice needs, we propose exploiting existing randomized trial data to inform personalizing approaches, prioritizing the personalizing approaches likely to have the greatest impact, conducting more idiographic research, and studying tailoring strategies in usual care. Third, to encourage clinicians’ use of personalized intervention research to inform their practice, we propose expanding outlets for research summaries and case studies, developing heuristic frameworks that incorporate personalizing approaches into practice, and integrating personalizing approaches into service delivery systems. Finally, to build a richer understanding of how and why treatments work for particular individuals, we propose accelerating research to identify mediators within and across RCTs, to isolate mechanisms of change, and to inform the shift from diagnoses to psychopathological processes. This ambitious agenda for personalized intervention science, although challenging, could markedly alter the nature of mental health care and the benefit provided to youths and families. En ligne : http://dx.doi.org/10.1111/jcpp.12470 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=282
in Journal of Child Psychology and Psychiatry > 57-3 (March 2016) . - p.216-236[article] Annual Research Review: Building a science of personalized intervention for youth mental health [Texte imprimé et/ou numérique] / Mei Yi NG, Auteur ; John R. WEISZ, Auteur . - p.216-236.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 57-3 (March 2016) . - p.216-236
Mots-clés : Children adolescents psychotherapy personalized intervention tailoring treatments Index. décimale : PER Périodiques Résumé : Background Within the past decade, health care service and research priorities have shifted from evidence-based medicine to personalized medicine. In mental health care, a similar shift to personalized intervention may boost the effectiveness and clinical utility of empirically supported therapies (ESTs). The emerging science of personalized intervention will need to encompass evidence-based methods for determining which problems to target and in which order, selecting treatments and deciding whether and how to combine them, and informing ongoing clinical decision-making through monitoring of treatment response throughout episodes of care. We review efforts to develop these methods, drawing primarily from psychotherapy research with youths. Then we propose strategies for building a science of personalized intervention in youth mental health. Findings The growing evidence base for personalizing interventions includes research on therapies adapted for specific subgroups; treatments targeting youths’ environments; modular therapies; sequential, multiple assignment, randomized trials; measurement feedback systems; meta-analyses comparing treatments for specific patient characteristics; data-mining decision trees; and individualized metrics. Conclusion The science of personalized intervention presents questions that can be addressed in several ways. First, to evaluate and organize personalized interventions, we propose modifying the system used to evaluate and organize ESTs. Second, to help personalizing research keep pace with practice needs, we propose exploiting existing randomized trial data to inform personalizing approaches, prioritizing the personalizing approaches likely to have the greatest impact, conducting more idiographic research, and studying tailoring strategies in usual care. Third, to encourage clinicians’ use of personalized intervention research to inform their practice, we propose expanding outlets for research summaries and case studies, developing heuristic frameworks that incorporate personalizing approaches into practice, and integrating personalizing approaches into service delivery systems. Finally, to build a richer understanding of how and why treatments work for particular individuals, we propose accelerating research to identify mediators within and across RCTs, to isolate mechanisms of change, and to inform the shift from diagnoses to psychopathological processes. This ambitious agenda for personalized intervention science, although challenging, could markedly alter the nature of mental health care and the benefit provided to youths and families. En ligne : http://dx.doi.org/10.1111/jcpp.12470 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=282 Annual Research Review: Defining and treating pediatric treatment-resistant depression / Jennifer B. DWYER in Journal of Child Psychology and Psychiatry, 61-3 (March 2020)
[article]
Titre : Annual Research Review: Defining and treating pediatric treatment-resistant depression Type de document : Texte imprimé et/ou numérique Auteurs : Jennifer B. DWYER, Auteur ; Argyris STRINGARIS, Auteur ; David A. BRENT, Auteur ; Michael H. BLOCH, Auteur Article en page(s) : p.312-332 Langues : Anglais (eng) Mots-clés : Depression major depressive disorder psychopharmacology psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Adolescent major depressive disorder (MDD) is a significant health problem, associated with substantial morbidity, cost, and mortality. Depression is a significant risk factor for suicide, which is now the second leading cause of death in young people. Up to twenty per cent of adolescents will experience MDD before adulthood, and while a substantial proportion will improve with standard-of-care treatments (psychotherapy and medication), roughly one third will not. METHODS: Here, we have reviewed the literature in order to discuss the concept of treatment-resistant depression (TRD) in adolescence, examine risk factors, diagnostic difficulties, and challenges in evaluating symptom improvement, and providing guidance on how to define adequate medication and psychotherapy treatment trials. RESULTS: We propose a staging model for adolescent TRD and review the treatment literature. The evidence base for first- and second-line treatments primarily derives from four large pediatric clinical trials (TADS, TORDIA, ADAPT, and IMPACT). After two medications and a trial of evidence-based psychotherapy have failed to alleviate depressive symptoms, the evidence becomes quite thin for subsequent treatments. Here, we review the evidence for the effectiveness of medication switches, medication augmentation, psychotherapy augmentation, and interventional treatments (i.e., transcranial magnetic stimulation, electroconvulsive therapy, and ketamine) for adolescent TRD. Comparisons are drawn to the adult TRD literature, and areas for future pediatric depression research are highlighted. CONCLUSIONS: As evidence is limited for treatments in this population, a careful consideration of the known risks and side effects of escalated treatments (e.g., mood stabilizers and atypical antipsychotics) is warranted and weighed against potential, but often untested, benefits. En ligne : http://dx.doi.org/10.1111/jcpp.13202 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=420
in Journal of Child Psychology and Psychiatry > 61-3 (March 2020) . - p.312-332[article] Annual Research Review: Defining and treating pediatric treatment-resistant depression [Texte imprimé et/ou numérique] / Jennifer B. DWYER, Auteur ; Argyris STRINGARIS, Auteur ; David A. BRENT, Auteur ; Michael H. BLOCH, Auteur . - p.312-332.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 61-3 (March 2020) . - p.312-332
Mots-clés : Depression major depressive disorder psychopharmacology psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: Adolescent major depressive disorder (MDD) is a significant health problem, associated with substantial morbidity, cost, and mortality. Depression is a significant risk factor for suicide, which is now the second leading cause of death in young people. Up to twenty per cent of adolescents will experience MDD before adulthood, and while a substantial proportion will improve with standard-of-care treatments (psychotherapy and medication), roughly one third will not. METHODS: Here, we have reviewed the literature in order to discuss the concept of treatment-resistant depression (TRD) in adolescence, examine risk factors, diagnostic difficulties, and challenges in evaluating symptom improvement, and providing guidance on how to define adequate medication and psychotherapy treatment trials. RESULTS: We propose a staging model for adolescent TRD and review the treatment literature. The evidence base for first- and second-line treatments primarily derives from four large pediatric clinical trials (TADS, TORDIA, ADAPT, and IMPACT). After two medications and a trial of evidence-based psychotherapy have failed to alleviate depressive symptoms, the evidence becomes quite thin for subsequent treatments. Here, we review the evidence for the effectiveness of medication switches, medication augmentation, psychotherapy augmentation, and interventional treatments (i.e., transcranial magnetic stimulation, electroconvulsive therapy, and ketamine) for adolescent TRD. Comparisons are drawn to the adult TRD literature, and areas for future pediatric depression research are highlighted. CONCLUSIONS: As evidence is limited for treatments in this population, a careful consideration of the known risks and side effects of escalated treatments (e.g., mood stabilizers and atypical antipsychotics) is warranted and weighed against potential, but often untested, benefits. En ligne : http://dx.doi.org/10.1111/jcpp.13202 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=420 Omega-3 supplementation associated with improved parent-rated executive function in youth with mood disorders: secondary analyses of the omega 3 and therapy (OATS) trials / A. T. VESCO in Journal of Child Psychology and Psychiatry, 59-6 (June 2018)
PermalinkToward precision therapeutics: general and specific factors differentiate symptom change in depressed adolescents / Madison AITKEN in Journal of Child Psychology and Psychiatry, 61-9 (September 2020)
PermalinkEditorial: Common factors in the art of healing / B. S. PETERSON in Journal of Child Psychology and Psychiatry, 60-9 (September 2019)
PermalinkEfficacy of a computer-assisted cognitive-behavior therapy program for treating youth with anxiety and co-occurring autism spectrum disorder: Camp Cope-A-Lot / Felicia CRUZ PRYOR in Research in Autism Spectrum Disorders, 83 (May 2021)
PermalinkHow can psychologists meet the needs of autistic adults? / Rebecca L. FLOWER in Autism, 28-2 (February 2024)
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