Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course.

BACKGROUND: The group-based CBT intervention, the Adolescent Coping with Depression Course (ACDC), has previously been evaluated within a quasi-experimental design, showing reduction in depressive symptoms compared to a benchmark of similar studies. The aim of our study was to investigate the effectiveness of ACDC within a randomized controlled (RCT) design. METHOD: Thirty-five course/control leaders randomly assigned to provide ACDC or usual care (UC) recruited 133 adolescents allocated to ACDC and 95 to UC. ACDC participants received eight weekly sessions and two follow-up sessions about 3 and 6 weeks after the last session. UC participants received usual care as implemented at the different sites. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale for adolescents (CES-D), perfectionism with the revised version of the Dysfunctional Attitude Scale (DAS), and rumination with the revised version of the Ruminative Responses Scale (RRS). Attrition was considered missing at random (MAR) and handled with a full information maximum likelihood (FIML) procedure. RESULTS: Intention to treat analysis (ITT), including baseline scores and predictors of missing data as control or auxiliary variables, showed a small to medium reduction in depressive symptoms for the ACDC group compared to UC (d = -.31). Changes in perfectionism and rumination in favor of the intervention were also significant. Sensitivity analyses confirmed the findings from the ITT analyses. CONCLUSIONS: The current study supports the effectiveness of this group-based CBT intervention. The intervention can hopefully result in clinically significant reductions in symptoms associated with depression among adolescents. TRIAL REGISTRATION: ISRCTN registry ISRCTN19700389 . Registered 6 October 2015.

Behavioral Trajectories During Middle Childhood: Differential Effects of the School-Wide Positive Behavior Support Model.

The aims of this study were to assess the longitudinal trajectories of externalizing problem behavior during middle childhood among typically developing children and to examine subgroup differences in the effectiveness of the School-Wide Positive Behavior Support (SWPBS) model, called N-PALS in Norway. Participants were approximately 3000 students, and behavioral assessments were performed by class head teachers at four time points from the 4th or 5th grade through the 7th grade. Using a combination of latent class growth analyses (LCGA) and growth mixture modeling (GMM), four distinct trajectory classes were identified, i.e., persistent low (84.4%), persistent high (2.5%), decreasing (7.9%), and increasing (5.3%). An indication of a significant positive effect of the N-PALS model was found for students with a persistently high-risk trajectory. The current study adds to the evidence that this school-wide prevention model can moderate the development of externalizing behavior problems among children and youth.

The longitudinal association between internalizing symptoms and academic achievement among immigrant and non-immigrant children in Norway.

The aim of this study was to explore the longitudinal relation between internalizing symptoms and academic achievement, as two processes of children and youth development, among children in Norway, and whether having an immigrant background moderated this association. Data collected from 4,458 students in Norway in four waves over three years were analyzed with multi-group latent growth curve modeling (LGM). Results showed that internalizing symptoms level remained unchanged over time both for immigrant and non-immigrant children, while levels of academic achievement increased only for children of immigrants with both parents born outside of Norway. Further analyses supported a reciprocal relation between internalizing symptoms and academic achievement and revealed that the initial level of academic achievement predicted the rate of change in internalizing symptoms over time, but not vice versa. Moreover, immigrant background did not moderate the associations in the model, however, children of immigrants with both parents born abroad initially had lower levels of academic achievement, but showed an increase in academic achievement, compared to their non-immigrant peers as well as to peers with one native-born parent after controlling for gender and their grade at the first observation. The implications for policy and practice were discussed.

Functional family therapy for adolescent disruptive behavior in Norway: Results from a randomized controlled trial.

Disruptive behavior during adolescence is linked to severe problems for the youths later in life and poses challenges to the families, schools, and treatment systems these youths meet. This randomized controlled trial was conducted to examine the short- and long-term effectiveness of functional family therapy (FFT) for adolescents aged 11-17 referred for disruptive behavior to Child Welfare Services in Norway. One hundred sixty-one youths (Mage = 14.7, 45.9% female) were randomly assigned to FFT (n = 88) or treatment as usual (TAU, n = 73). Primary outcomes were parent- and teacher-reported youth aggressive behavior, rule-breaking behavior, internalizing problems, and social skills; youth self-reported delinquency (SRD) and negative peer involvement; and teacher-reported academic performance and adaptive functioning. Outcomes were collected before treatment (pretest), 6 months after pretest (posttest), and 18 months after pretest (follow-up). The results showed no intervention effect for FFT compared to TAU between pretest and posttest (p > .05). Significant improvements between pretest and posttest were found for youth receiving both FFT and TAU on parent-reported aggressive and rule-breaking behavior, internalizing problems, and social skills (ranging from d = 0.56 to -0.45) and youth SRD (d = 0.29). Between posttest and follow-up, however, a significant intervention effect in favor of TAU was found for parent-reported youth internalizing (d = 0.27). Significant improvements between posttest and follow-up were also found for youth receiving both FFT and TAU on parent- and teacher-reported aggressive behavior. Findings did not support the hypothesized superiority of FFT over TAU. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating Modular Approach to Therapy for Children with Anxiety, Depression, Trauma and Conduct Problems (MATCH-ADCT) in Norwegian child and adolescent outpatient clinics: Study protocol for a randomized controlled trial.

BACKGROUND: Norwegian health, care, and welfare services are experiencing increased demands to deliver services that are safe, effective, of high quality, and that ensure user involvement. Yet, evidence-based treatment for common disorders such as depression, anxiety, trauma, and behavioral problems in children are not regularly used in clinical practice in Norway. Possible explanations for this are that many standard, evidence-based treatments may have difficulty addressing the complexity and comorbidity of referred children and the fact that children's treatment needs often shift during treatment. The Modular Approach to Therapy for children with Anxiety, Depression, Trauma and Conduct problems (MATCH-ADTC) was designed to address these challenges and reduce some of the barriers to therapists' use of evidence-based treatment in their practice. METHODS/DESIGN: Participants will include 280 children (aged 6-14.5 years at intake) who receive treatment in child and adolescent mental health outpatient clinics in Norway, and their families. Families are randomly assigned to either the experimental group receiving treatment from therapists trained in MATCH, or to the comparison group receiving treatment from therapists delivering treatment as usual (TAU). Data on children's symptomology, child and family functioning, demographics, background information, and mental health outcomes are collected as well as frequent feedback on treatment response, plus video-recordings of treatment sessions and implementation quality scores from each participating clinic. Questionnaires are administered in six waves. DISCUSSION: MATCH has been tested in the US with promising results, but we do not know whether this treatment approach will produce similar results in Norway. The implications of this study are 1. Possibly better treatment outcomes and/or more efficient improvements for children and families treated in mental health outpatient clinics in Norway 2. Clinicians learning to use more evidence-based practices in their treatment 3. Implementation of standard procedures for obtaining feedback from children and families and sharing the feedback with clinicians 4. Increased understanding, at the end of the trial, of whether introducing MATCH improves outcomes for children and families treated in mental health outpatient clinics TRIAL REGISTRATION: ISRCTN, registration number: ISRCTN24029895 . Registered on 8 August 2016.