Therapy For Young People Research Articles

Depth of emotional experiencing and outcome in therapy with young people.

To analyse the relationship between depth of emotional experiencing and outcomes in young people. We also wanted to understand whether 'early' or 'working' depth of emotional experiencing was most predictive of outcomes, and how these compared against alliance effects. Hierarchical linear regression analysis of data from a study of school-based humanistic counselling (SBHC). Data from 60 young people were used for the study across 15 schools: mean age 13.7 years old (range: 13-16); 67% female; 52% from Black, mixed or non-white ethnicities. Depth of emotional experiencing was rated using the Client Experiencing Scale at session 1 (early EXP) and session 6 (working EXP). The dependent variable was changes in psychological distress from baseline to 12-week follow-up, as assessed by the Young Person's CORE. In our final model, working EXP accounted for 11.6% of the variance in YP-CORE change scores after baseline YP-CORE scores were taken into account. Early EXP and working alliance were not predictive of benefit. Sensitivity analyses indicated that working EXP was associated with benefits across a range of indicators. Our findings show, for the first time, that depth of emotional experiencing has a significant and sizeable association with outcomes in therapy for young people. This is consistent with emerging evidence from the adult field. It suggests that practitioners working with young people should monitor the depth of emotional experiencing and foster methods for supporting its development.

Enabling successful life engagement in young people with ADHD: new components beyond adult models of recovery

Purpose To examine the lived experiences of young people successfully managing life with ADHD and investigate the applicability of adult models of Recovery to these individuals. Methods Twenty-seven young people aged 15–31 years participated in qualitative interviews. Participants’ success was indicated by employment, school attendance, absence of acute mental health episodes, or absence of chronic alcohol or drug use. Thematic analysis identified specific components of their life successes and challenges. Results The emergent framework comprised four elements: (i) Recovernance (RE) (a portmanteau merging ‘Recovery’ and ‘Maintenance’; ongoing adjustment to maintain one’s personal best without an end point); (ii) Personal Optimization (PO) (continuously striving to maximize function and adjust one’s goals given fluctuating impairments and internal resources); (iii) Self (S) (facing internal challenges and developing internal resilience); and (iv) Environment (E) (facing external challenges and fostering external resilience). These four elements yielded the acronym ‘REPOSE’. Conclusions Recovery in young people with ADHD was not a linear journey, with many missteps leading to greater self-knowledge, life skills and mastery. Progress was leveraged on securely anchored internal and external resilience factors against the prospect of setbacks. Findings provide new concepts and novel lexicons to extend existing concepts in Recovery. Implications for rehabilitation Counselling and therapy for young people with ADHD should foster self-understanding, goal setting and self-vigilance as an ongoing process to build their capacity to tackle setbacks and adversities. Counselling and therapy for young people with ADHD focus on a strengths-based approach building internal and external resources, such as developing skills and establishing social connections that build infrastructure in the environment for meaningful participation.

Approbation of the program of physical occupational therapy of young men who specialize in Greco-Roman wrestling after treatment of coronavirus disease

According to the results of the analysis of scientific-methodical, special and reference literature, the members of the research group established, that the issue of development (testing) of modern pedagogical technologies of physical occupational therapy, therapy of boys and girls who specialize in wrestling after the treatment of coronavirus disease is devoted to an insufficient number of scientific and methodological works, which requires further research and emphasizes the relevance and practical component of the chosen field of study.
 The main purpose of the study is to test the program of physical occupational therapy for young people aged 14-15, who specialize in Greco-Roman wrestling after treatment of coronavirus disease. The following methods were used in the process of research and analytical work: analysis and synthesis (abstraction), induction (deduction), modeling, mathematical and statistical (correlation analysis, factor analysis), etc.
 As a result of empirical research, members of the research group tested the program of physical occupational therapy for 14-15 year olds who specialize in Greco-Roman wrestling after treatment of coronavirus disease. Analyzing the results obtained, we found that the above experimental program provided accelerated recovery, as well as physical (special physical), psychological, technical and tactical training of young people aged 14-15, who specialize in Greco-Roman wrestling. In addition, the experimental program of physical occupational therapy for young people of the studied category, adapted to today's requirements, provided qualitative changes in their state of health, which was confirmed: activation of resorption of the inflammatory pneumonic center; intensification of bronchial drainage function; leveling of existing adhesions in the lungs; normalization of pulmonary hemodynamics; increasing the stimulation of immunological and nonspecific resistance of athletes; accelerating the regenerative processes of the broncho-pulmonary system, improving the function of the external respiratory system, etc.

Particularities of the Development of Creativeness in Students Through Art Therapy

In the following article, the students will have an idea of the selection of theoretical problems of the formation of creativeness attributes through means of Art therapy in young people. In addition, this article presents a theoretical analysis of different views on the issue of creativeness and attitudes.

<b>G</b>ROUPS <b>4</b> <b>H</b>EALTH versus Cognitive Behaviour Therapy in Young People with Depression and Loneliness: A Randomized, Phase 3, Non-Inferiority Trial with 12 Month Follow-Up

Background: Depression treatments are typically less effective for young people than for adults. However, extant treatments rarely target loneliness, which is a key risk factor in the onset, maintenance, and development of depression. This study evaluated the efficacy of a novel loneliness intervention, GROUPS 4 HEALTH (G4H), relative to best-practice treatment Cognitive Behaviour Therapy (CBT) in reducing loneliness and depression over a 12 month follow-up. Methods: The study was a phase 3, randomised non-inferiority trial comparing G4H to dose-controlled group CBT. Participants were 174 young people aged 15-25 years experiencing loneliness and clinically significant symptoms of depression, who were not in receipt of adjunct treatment. Participants were recruited from mental health services in Southeast Queensland, Australia. Randomisation was conducted using computer software. Follow-up assessments and statistical analyses were blind to allocation. Both interventions consisted of 5 x 75 min group-based psychotherapy sessions. The primary outcomes were depression and loneliness, with a non-inferiority margin of 2.20 for depression. Outcomes: 174 participants were enrolled between 24 April 2018 and 25 May 2019, with 84 in the G4H condition and 90 in the CBT condition. All randomised participants were included in the intention-to-treat analyses (N=174). The pre-post effect sizes for loneliness were d =-1.07G4H and d=-0.89CBT. For depression, they were d=-.71G4H and d=-.91CBT. At 12 month follow-up, the absolute difference between groups in loneliness was -0.679 (95%CI: -.1.43, .07) and in depression was 1.176 (95%CI: -1.94, 4.29). No adverse effects were observed. Interpretation: G4H was non-inferior to CBT for depression and showed a slight advantage over CBT for loneliness that emerged after treatment completion. Trial Registration: The trial was prospectively registered on the Australian New Zealand Clinical Trial Registry (ACTRN12618000440224) on 27 March 2018 and is closed to new participants. Funding Statement: Australian Rotary Health and the National Health and Medical Research Council (#1173270). Declaration of Interests: The authors TC, CH and AH are the developers of the GROUPS 4 HEALTH program, and The University of Queensland holds its associated Intellectual Property. These authors have an academic, rather than commercial, interest in the program, with training offered at cost and additional funds directed to ongoing program development and evaluation. All other authors have nothing to declare. Ethics Approval Statement: All participants provided informed and voluntary consent in writing. For young people aged under 16 who wished to participate, parental consent was also sought in accordance with the organizational policy of the healthcare services where the group was taking place. The trial received ethics approval (Brisbane Metro South HREC/18/QPAH/54, ratified by the University of Queensland #2018000420).

Multi-Family Therapy for Young People With Anorexia Nervosa: Clinicians' and Carers' Perspectives on Systemic Changes

Multi-Family Therapy for Young People With Anorexia Nervosa: Clinicians' and Carers' Perspectives on Systemic Changes

Carlo Acerini - raging against the dying of the light.

Carlo Acerini - raging against the dying of the light.

The connecting adolescents to reduce relapse (CARR) trial: study protocol for a randomized controlled trial comparing the efficacy of Groups 4 Health and cognitive behaviour therapy in young people

BackgroundDepression is the leading cause of disability in young people (aged 15–25) globally. Loneliness is a major factor in the development and relapse of depression in young people, yet few interventions directly address loneliness. Groups 4 Health (G4H) – a novel, theoretically derived group psychotherapy intervention – may address this disconnect. Previous trials (Phase I and Phase II) have found G4H to be efficacious in reducing symptoms of depression. However, the efficacy of G4H compared to current evidence-based treatments (Phase III) has not been investigated. This protocol details the design and methodology of the Connecting Adolescents to Reduce Relapse (CARR) trial, a randomised control trial assessing the efficacy of G4H in young people relative to cognitive behavioural therapy (CBT).MethodsThe CARR trial is a two-arm non-inferiority randomised controlled trial that will compare the efficacy of G4H to the most widely used evidence-based treatment for depression, CBT, at program completion and 6- and 12-month follow up. Participants will be 200 young people (aged 15–25) with symptoms of depression and/or loneliness recruited from community and university mental health services. We hypothesise that the interventions will be comparable in reducing depression symptoms, but that G4H will be superior in reducing loneliness. Because loneliness is a primary risk factor for depression relapse in young people, we therefore expect the benefits of Groups 4 Health to be particularly apparent at 12-month follow up.DiscussionThis trial will be the first to evaluate an intervention that targets loneliness, in comparison to the current gold standard treatment approach – CBT. If found to be effective, this program offers a new approach to treatment and relapse prevention of depression among young people.Trial registrationTrial prospectively registered on ANZCTR (ACTRN12618000440224), registered on 27/03/2018.

Adherence to Aerosol Therapy in Young People With Cystic Fibrosis: Patient and Parent Perspectives Following Electronic Data Capture.

The benefits of improved treatments for cystic fibrosis (CF) depend on optimal adherence, which remains problematic, particularly to aerosol therapy. In this study, we explored the process of adhering to aerosol therapy from the perspective of both adolescents with CF and their parents. Interviews were conducted individually with six adolescents and six parents, informed by accurate adherence data from an electronically chipped, aerosol device. Interview transcripts from audio-recordings were analyzed using grounded theory method (GTM). Major themes revealed differences in perspective between parent and adolescent, with this relationship mediating the cognitive and emotional processes that play a significant role in adherence behavior. These processes are further influenced by interactions with the aerosol therapy treatment regimen, device characteristics, and the context in which adherence is taking place. Parents and adolescents have different views of treatment and how to manage it. Both need to be addressed if optimal adherence is to be achieved.

Mindfulness-Based Cognitive Therapy for Young People and Their Carers: a Mixed-Method Feasibility Study

We aimed to evaluate whether mindfulness-based cognitive therapy (MBCT) was feasible and acceptable for young people, their parents and the clinicians working with them; whether a parallel course for parents was a useful addition; and whether attendance at MBCT was associated with improved outcomes. The design was a mixed-method service evaluation of an eight-session MBCT programme for young people who were recovering from depression. The course was a manualised eight-session group intervention. Both young people (n = 18) and parents (n = 21) completed validated measures before and after the course. Semi-structured interviews were completed with some group participants and clinical staff working in the service. Care records were searched for additional contact following the intervention. Qualitative data from young people, parents and clinicians suggested that MBCT was acceptable and feasible and provided strategies to cope. The parent course was reported to provide personal support to parents and helped them cope with their child’s depression whilst also impacting the family, promoted shared understanding of depression and strategies to combat it and addressed intergenerational aspects of depression. Eighty-four per cent of participants attended at least 6/8 sessions, and 48% required no further intervention within the following year. Young people had statistically significant improvements across all outcome measures, whilst parents had statistically significant improvements in rumination, self-compassion and decentring.

Electrocardiographic Markers of Appropriate Implantable Cardioverter-Defibrillator Therapy in Young People with Congenital Heart Diseases.

Implantable cardioverter-defibrillators (ICDs) are increasingly utilized in patients with congenital heart disease (CHD). Prediction of the occurrence of shocks is important if improved patient selection is desired. The electrocardiogram (ECG) has been the first-line tool predicting the risk of sudden death, but data in CHD patients are lacking. We aim to evaluate the predictive value of electrocardiographic markers of appropriate therapy of ICD in young people with CHD. We conducted a prospective, longitudinal study, in twenty-six CHD patients (mean age 24.7±5.3years) who underwent first ICD implantation. Forty-two age- and diagnosis-matched controls were recruited. Twelve-lead ECG and 24h Holter analysis were performed during a mean follow-up of 38.9months. Data included heart rate, heart rate variability, QRS duration (QRSd), QTc interval and its dispersion, Tpeak-Tend (Tp-Te) interval and its dispersion, presence of fragmented QRS (fQRS), T wave alternans, atrial arrhythmias, and non-sustained ventricular tachycardia. Implant indication was primary prevention in ten cases (38.5%) and secondary prevention in 16 (61.5%). Overall, 17 subjects (65.3%) received at least one appropriate and effective ICD discharge. fQRS was present in 64.7% of cases with ICD therapy compared with patients without events or controls (p<0.0001). Tp-e and Tp-e dispersion were significantly prolonged in patients with recurrences (113.5 and 37.2ms) versus patients without ICD discharge (89.6 and 24.1ms) or controls (72.4 and 19.3ms) (p<0.0001 and p<0.0001, respectively). On univariate Cox regression analysis QRSd (hazard ratio: 1.19 per ms, p=0.003), QTc dispersion (hazard ratio: 1.57 per ms, p=0.002), fQRS (hazard ratio: 3.58 p<0.0001), Tp-e (hazard ratio: 2.27 per ms, p<0.0001), and Tp-e dispersion (hazard ratio: 4.15 per ms, p<0.0001), emerged as strong predictors of outcome. On multivariate Cox analysis fQRS, Tp-e and Tp-e dispersion remained in the model. The presence of fQRS, and both Tp-e and Tp-e dispersion are useful ECG tools in daily clinical practice to identify CHD patients at risk for appropriate ICD therapy.

Emotion awareness and cognitive behavioural therapy in young people with autism spectrum disorder.

Young people with autism spectrum disorder experience high levels of emotional problems, including anxiety and depression. Adapted cognitive behavioural therapy is recommended for such difficulties. However, no evidence suggests whether emotion awareness is important in treatment outcome for young people on the autism spectrum. This study aimed to investigate the potential differences in emotion awareness between (1) young people on the autism spectrum and typically developing youth and (2) young people on the autism spectrum with and without experience of cognitive behavioural therapy. Three groups (aged 11-20 years) participated: (1) typically developing young people ( n = 56); (2) young people on the autism spectrum with no experience of cognitive behavioural therapy ( n = 23); and (3) young people on the autism spectrum who had attended cognitive behavioural therapy ( n = 33). All participants completed the Emotion Awareness Questionnaire-30 item version. Young people on the autism spectrum differed significantly from typically developing young people on the emotional awareness measure. Young people on the autism spectrum who had attended cognitive behavioural therapy scored significantly lower on the Differentiating Emotions subscale, and significantly higher on the Attending to Others' Emotions subscale, compared to young people on the autism spectrum who had not attended cognitive behavioural therapy. This study highlights the importance of psycho-educational components of cognitive behavioural therapy when adapting for young people on the autism spectrum.

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta-analysis of the Literature.

Cognitive remediation therapy (CRT) for eating disorders has demonstrated promising findings in adult age groups, with randomised treatment trials and systematic reviews demonstrating medium to large effect sizes in improved cognitive performance. In recent years, several case series have been conducted for young people with anorexia nervosa, but these findings have not been synthesised in the form of a systematic review. This systematic review aimed to evaluate the evidence for the efficacy of CRT in child and adolescent age groups. Nine studies were identified, with a subsequent meta-analysis suggesting improvements in cognitive performance with small effect sizes. Patient feedback was positive, with low dropout rates. These findings suggest that CRT has potential as a supplementary treatment for young people with anorexia nervosa, warranting further investigation using randomised treatment trials. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Family therapy for autism spectrum disorders.

Autism spectrum disorders (ASDs) are characterised by impairments in communication and reciprocal social interaction. These impairments can impact on relationships with family members, augment stress and frustration, and contribute to behaviours that can be described as challenging. Family members of individuals with ASD can experience high rates of carer stress and burden, and poor parental efficacy. While there is evidence to suggest that individuals with ASD and family members derive benefit from psychological interventions designed to reduce stress and mental health morbidity, and enhance coping, most studies to date have targeted the needs of either individuals with ASD, or family members. We wanted to examine whether family (systemic) therapy, aimed at enhancing communication, relationships or coping, is effective for individuals with ASD and their wider family network. To evaluate the clinical effectiveness and acceptability of family therapy as a treatment to enhance communication or coping for individuals with ASD and their family members. If possible, we will also seek to establish the economic costs associated with family therapy for this clinical population. On 16 January 2017 we searched CENTRAL, MEDLINE, Embase, 10 other databases and three trials registers. We also handsearched reference lists of existing systematic reviews and contacted study authors in the field. Randomised controlled trials (RCTs) and quasi-RCTs investigating the effectiveness of family therapy for young people or adults with ASD or family members, or both, delivered via any modality and for an unspecified duration, compared with either standard care, a wait-list control, or an active intervention such as an alternative type of psychological therapy. Two authors independently screened each title and abstract and all full-text reports retrieved. To enhance rigour, 25% of these were independently screened by a third author. The search yielded 4809 records. Of these, we retrieved 37 full-text reports for further scrutiny, which we subsequently excluded as they did not meet the review inclusion criteria, and identified one study awaiting classification. Few studies have examined the effectiveness of family therapy for ASD, and none of these are RCTs. Further research studies employing methodologically robust trial designs are needed to establish whether family therapy interventions are clinically beneficial for enhancing communication, strengthening relationships, augmenting coping and reducing mental health morbidity for individuals with ASD and family members.

Transition to adult rheumatology care is necessary to maintain DMARD therapy in young people with juvenile idiopathic arthritis.

To evaluate the outpatient health service utilisation of young people (YP) with juvenile idiopathic arthritis (JIA) during transfer from paediatric to adult care in Germany. Based on claims data of a large German statutory health fund (BARMER GEK) we conducted a cohort study of 2008-2014. Insured YP with diagnosis of JIA (ICD: M08 or M09.0) in two quarters at the age of 16 and continuous insurance until the age of 20 were included. Outpatient health care utilisation, prescribed antirheumatic drugs and diagnosis maintenance were analysed over four consecutive years for all YP with JIA and for the subgroup on disease-modifying antirheumatic drugs (DMARDs) at the age of 16. A total of 256 YP with JIA (67% female) were followed during the transfer period, 115 of them received (DMARDs) at the age of 16. At the age of 20, 30% of all 256 YP utilised adult specialty care, 59% still had a JIA diagnosis and 30% were treated with DMARDs. Of those 115 YP, treated with DMARDs at the age of 16 and in need of follow-up, 49% had visited an adult rheumatologist at the age of 20, 75% had a JIA diagnosis and 56% were on DMARDs. Those 49% YP with successful transfer to adult specialty care had a JIA diagnosis in 93% and were treated with DMARDs in 80%. YP, who were only seen by general practitioners, had a JIA diagnosis in 54% and received DMARDs in 27%. One in two YP with JIA and a clear need for ongoing follow-up do not utilise adult rheumatologic care. The maintenance of JIA diagnosis and DMARD therapy depend on the utilisation of specialised care services.

Use of nicotine replacement therapy in young people entering custody in New South Wales, Australia.

To describe the prevalence of nicotine dependence and acceptance of nicotine replacement therapy (NRT) in young people entering custody, where smoking is not allowed. Cross-sectional study in 2013. All New South Wales Juvenile Justice Centres. Incarcerated youth, aged 12-21 years. gender, age, ethnicity, cannabis use. rates of smoking, cannabis use, nicotine dependence, NRT acceptance. Data were collected from 252 Initial Reception Assessments (90.1% male, 56.3% Aboriginal, mean age 16.6 years ± 1.2 standard deviation). According to Fagerstrom screening, 207 (82.1%) young people smoked cigarettes immediately prior to their current incarceration, and of the smokers, 78 (38.4%) were nicotine dependent. Most young people (76.4%) were also daily cannabis users, with 85.6% of cigarette smokers also using cannabis daily. NRT (as 24-h nicotine patches prescribed for 2 weeks) was offered to 54 nicotine dependent and 7 non-dependent young people. Only 13 (21.3%) young people accepted NRT (all daily cannabis-using males), and only 2 young people completed the full prescription. Reasons for refusing or not completing NRT were a fear of 'weird dreams', sleeping issues or that it was no longer needed. Many young people entering custody are nicotine-dependent cigarette smokers and daily cannabis users, and are at high risk of nicotine withdrawal on abstinence. NRT as patch therapy has poor acceptance in this group, except in young men who are daily cannabis users. Screening for nicotine dependence in high-risk young people should include questions about cannabis use, and alternatives to patch therapy deserve further research.

Dring, G. (2015). Finding a voice: Family therapy for young people with anorexia. London, England: Karnac Books, 352 pp., $44.56.

Dring, G. (2015). Finding a voice: Family therapy for young people with anorexia. London, England: Karnac Books, 352 pp., $44.56.

Cognitive–Behavioral Therapies for Young People in Outpatient Treatment for Nonopioid Drug Use

Objectives: This review evaluates the evidence on the effects of cognitive–behavioral therapy (CBT) on drug use reduction for young people in treatment for nonopioid drug use. Method: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized trials. Meta-analytic methods were used to quantitatively synthesize study results. Results: The search yielded seven studies that met inclusion criteria. Each of the seven studies compared CBT to another intervention. Authors’ Conclusions: The review found that there was no evidence that CBT interventions perform better or worse than the comparison interventions and additional research is needed. The number of studies included in this review was limited, and therefore should the overall results be interpreted with caution.

Functional Family Therapy for Young People in Treatment for Nonopioid Drug Use

Objectives: This review evaluates the evidence on the effects of functional family therapy (FFT) on drug abuse reduction for young people in treatment for nonopioid drug use. Data and Analysis: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized trials. Results: The search yielded two studies that met inclusion criteria. Only one study provided numerical results on the effect of FFT on drug use reduction. Conclusions: There is insufficient evidence to allow any conclusion to be drawn on the effect of FFT for young people in treatment for nonopioid drug use. There is a need for more research and particularly for more methodologically rigorous studies in the field of treatment for young drug users.

The Experience of Depression

There is a lack of research in health psychology on the subjective experience of adolescents with mental health disorders. The aim of this study was to explore the experience of depression and the journey into therapy of young people (YP) diagnosed with depression. Semi-structured interviews were carried out with six YP (5 female, aged 15–19). Interviews were analyzed using Interpretative Phenomenological Analysis. The following four key themes were identified: “Suffering is experienced as overwhelming,” “An experience of loneliness and isolation,” “Struggling to understand the suffering,” and “Therapy as a last resort.” Reasons for a delay in accessing treatment were not knowing what is “normal,” the feeling that they have to deal with it by themselves, and/or the lack of a caring adult who supports the YP in getting help. The findings suggest the ongoing importance of reducing stigma and promoting mental health education for YP as well as parents, school staff, and health professionals.