scholarly journals Efficacy of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2020 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Community Mental Health ◽  
Post Treatment ◽  
Treatment As Usual ◽  
Mental Health Clinics ◽  
Health Clinics ◽  
Remission Rates ◽  
Community Mental Health Clinics

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. Objective: To study the efficacy of ABFT compared with Treatment as Usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD. Method: Sixty adolescents, aged 13-18 years, with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were clinician-rated (Hamilton Depression Scale, HAMD) and self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles. Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups ( X 2 [2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority of adolescents were still in the clinical range after 16 weeks of treatment. Conclusion: In this sample of adolescents treated for MDD in community mental health clinics, ABFT was not associated with more favorable outcomes than TAU in terms of remission rates on clinician rated and self-reported depressive symptoms. Remission and response rates were low in both groups, suggesting a need for continued improvement of the treatment methods. Trial Registration: Clinicaltrials.gov identifier: NCT01830088 https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013 Keywords: Depression, Adolescents, Attachment Based Family Therapy, Efficacy trial

scholarly journals Efficacy of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2020 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Community Mental Health ◽  
Post Treatment ◽  
Treatment As Usual ◽  
Mental Health Clinics ◽  
Health Clinics ◽  
Remission Rates ◽  
Community Mental Health Clinics

Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the efficacy of ABFT compared with Treatment as Usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents, aged 13-18 years, with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were clinician-rated (Hamilton Depression Scale, HAMD) and self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority of adolescents were still in the clinical range after 16 weeks of treatment.Conclusion: In this sample of adolescents treated for MDD in community mental health clinics, ABFT was not associated with more favorable outcomes than TAU in terms of remission rates on clinician rated and self-reported depressive symptoms. Remission and response rates were low in both groups, suggesting a need for continued improvement of the treatment methods.

scholarly journals Effectiveness of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2021 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Depression Scale ◽  
Small Sample ◽  
Post Treatment ◽  
Treatment Manual ◽  
Future Research ◽  
Hamilton Depression Scale ◽  
Treatment As Usual

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles. Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment. Conclusion: ABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s small sample size, missing data, and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted . Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings. Trial Registration: Clinicaltrials.gov identifier: NCT01830088 https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

scholarly journals Community treatment orders and antipsychotic long-acting injections

2009 ◽  
Vol 195 (S52) ◽  
pp. s57-s62 ◽  
Author(s):  
Tim J. Lambert ◽  
Bruce S. Singh ◽  
Maxine X. Patel
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Legal Framework ◽  
Community Treatment ◽  
Mental Health Clinics ◽  
Health Clinics ◽  
Community Mental Health Clinics ◽  
Long Acting ◽  
The Relationship ◽  
Treatment Order

BackgroundThe community treatment order (CTO) is the legal framework by which people in the community are compelled to accept treatment. Both antipsychotic long-acting injections (LAIs) and CTOs are used to address treatment non-adherence.AimsTo investigate the relationship between CTOs and LAI use in patients with schizophrenia.MethodPrescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002.ResultsAgainst a background of increasing use of oral second-generation antipsychotic (SGA) medication and decreasing use of LAIs, the rates of CTO implementation doubled from 13% to 26% of patients with schizophrenia between 1998 and 2002. Proportionally more patients with a CTO are prescribed LAIs rather than oral SGAs.ConclusionsThe relationship between receiving an LAI and being subject to a CTO is significant, and reflects the consideration given to enhancing adherence in a community mental health setting.

Sign in / Sign up

Export Citation Format

Share Document