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Cognitive Behavioral Treatment: A Quasi-Experimental Study comparing CBT Effectiveness with Children and Adolescents Ac

Statement of the Problem. Globally, youth experience mental health problems at a surprisingly similar rateData not be comparable with one another, largely due to the differences in how disorders are measured country to countryNumbers all signify the world's children are experiencing mental healt

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Cognitive Behavioral Treatment: A Quasi-Experimental Study comparing CBT Effectiveness with Children and Adolescents Ac

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    1. Cognitive Behavioral Treatment: A Quasi-Experimental Study comparing CBT Effectiveness with Children and Adolescents Across Programs World Congress on Behavioral Therapies Barcelona Spain 13 July 2007 Kirstin Painter, LCSW, Project Manager, Doctoral Candidate Maria Scannapieco, Ph.D. Professor and Director\ University of Texas at Arlington School of Social Work Center for Child Welfare

    2. Statement of the Problem Globally, youth experience mental health problems at a surprisingly similar rate Data not be comparable with one another, largely due to the differences in how disorders are measured country to country Numbers all signify the world’s children are experiencing mental health problems at an alarming rate.

    3. Global Prevalence Canada reports 15% and Australia reports 14% of youth had mental or behavioral problems Both the United States of America and Great Britain report 1 in 10 children has a mental disorder China recently reported up to 22% of children suffered emotional problems

    4. Global Prevalence India the rate of psychiatric disorders of children has been reported to be between 7 – 20% Approximately 10% to 20% of youth worldwide are experiencing a mental disorder.

    5. Treatment Unlike the prevalence of mental disorders being similar among countries worldwide, there is tremendous disparity in the availability of mental health services globally Given the tremendous challenges children and families face in all countries it makes it imperative the mental health treatments utilized be based on empirical verification supporting its effectiveness.

    6. Cognitive Behavioral Therapy Cognitive Behavioral Therapy (CBT) most extensively tested psychosocial treatments for depression (DeRubeis & Crits-Christoph, 1998) CBT found to be strongly correlated with an individuals’ changed cognitions and their improved depression (DeRubeis, Evans, Hollon, Garvey, Grove, & Tuason, 1990; DeRubeis, & Feeley, 1990, Oei & Free, 1995; Oei & Sullivan, 1999)

    7. Cognitive Behavioral Therapy CBT as effective in alleviating patients depressive symptoms as well-administered pharmacotherapy (Segal, Whitney, Lam, & CANMAT Depression Work Group, 2001)

    8. Purpose of Study To evaluate the use of CBT with seriously emotionally disturbed youth in a community mental health setting and compare it to usual services (counseling).

    9. Hypotheses Youth who receive CBT will experience more improved mental health symptoms than those receiving usual counseling services. Youth who receive CBT will experience more improved functioning than those receiving usual counseling services. Youth who receive CBT will experience more improved school achievement than those receiving usual community services. Youth who receive CBT will experience a decreased risk of self harm than those receiving usual community services. Youth who receive CBT will experience more decreased disruptive and aggressive behavior than those receiving usual community services.

    10. Methodology Secondary data analysis Pretest-post-test Quasi-experimental design

    11. Criteria for Inclusion in the Study Youth with a severe emotional disturbance in community mental health treatment Diagnosed with Major Depressive Disorder Ages 10 to 17

    12. Eligibility for CBT at MHMR Eligibility Diagnosed with diagnosis classified as “Internalizing Disorder” Not actively psychotic Authorized for 12 60-minute units in 90 days, can authorize up to 8 additional units

    13. Therapists 3 Caucasian Females 2 Licensed Master’s Level Social Worker 1 Licensed Professional Counselor 1 Caucasian Male Licensed Professional Counselor

    14. Time Frames of Study September 2003 to November 2004 Counseling as usual September 2005 to November 2006 Cognitive Behavioral Therapy No data collected from Nov 2004 to Aug. 2005 to allow therapists time to gain expertise in models.

    15. Training in CBT Same therapists provided regular counseling and the CBT models Received a week long training in CBT to include: Theoretical background of CBT Research on CBT Indicators for use of CBT Training on each manual

    16. CBT Treatment Models Depression Taking Action Treating Depressed Children: Therapist Manual for “Taking ACTION” (Stark & Kendall, 1996) Adolescent Coping with Depression Adolescent Coping with Depression Course Manual & Student Workbook (Clark, Lewinsohn, & Hops 1984)

    17. Indicated for unipolar disorders, dysthymia or depressed mood Program comprised of 16-18 sessions Designed for treatment of children ages 9-13 years old Contraindicated for youth with strong indications for Suicidality as they may require a more protective setting Taking Action

    18. Adolescent Coping with Depression Youth ages 14 to 18 Suffering from depressive disorders 16 sessions Individuals with mania or hypomania should be stabilized psychiatrically to have the best chance of benefiting from the treatment

    19. Fidelity Components System Support Credentials Training Supervision

    20. Cognitive-Behavioral Strategies Structured and Goal-Oriented Sessions In-Session Practice Homework Reward System Parent/Caregiver Involvement

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