Transdiagnostic Treatment for Early Stage Mental Health Problems in Youth
Condition: Mental Disorders
MeSH terms: Mental Disorders
Study type: Interventional

Summary: 
      The aim of this pilot study is to examine a brief manualized treatment, Emotional Regulation
      Group Skills Training (ERG ST), which has shown promise with high-risk youth presenting with
      a range of mental health concerns. The investigators will examine the effectiveness of a ERG
      ST group, as well as two additional components to which clients will be randomized: a
      motivational enhancement (ME) pre-treatment, and family skills treatment (FAM). This project
      will be the first to combine and test these modules as a transdiagnostic early intervention
      for youth in the early stages on mental illness. This pilot trial will answer the following
      questions: 1) What is the response rate to ERG ST compared to ERG ST plus FAM, and who
      benefits? 2) What is the response rate to a ME pre-treatment, and who benefits? 3) What is
      the acceptability of this treatment?

      The ME pre-treatment will consist of four weekly one and a half hour sessions. The 12-week
      ERG ST will consist of 12 weekly two-hour sessions with 4-12 youths per group. The 12-week
      FAM will consist of 12 weekly two-hour sessions, with 16-20 caregivers per group. This study
      will use a two-stage randomization design to allow for balanced groups if there is
      differential attrition after pre-treatment. The following are the four treatment
      combinations: ERG ST; ERG ST+FAM; ME+ERG ST; ME+ERG ST+FAM. Four subjects will be enrolled in
      the study and randomized. The primary outcome is to improve emotion dysregulation in
      participants. Emotion dysregulation will be measured using the Difficulties in Emotion
      Regulation Scales (DERS).
    

Detailed description: 
      The goal of this pilot study was to carry out a randomized controlled trial to investigate
      whether motivational enhancement therapy (MET) improved the treatment effects of a 12-week
      psychological intervention, Dialectical Behaviour Therapy Skills Training (DBT-ST), for EA
      presenting in the early stages of mental health difficulties. Participants were recruited
      from the Youth Wellness Centre at St. Joseph's Healthcare Hamilton and McMaster University's
      Student Wellness Centre in Hamilton, Canada.

      Methods: Seventy-five participants were randomized to receive MET followed by DBT-ST or to
      DBT-ST alone. We assessed psychological distress, emotion dysregulation, and depression and
      anxiety symptoms as outcomes. Results: We found that both treatment groups had significant
      reductions in emotional dysregulation, psychological distress, depression, and anxiety at
      post- treatment and at the 3-month follow-up. Participants assigned to MET pre-treatment
      experienced greater improvement in psychological distress at the end of treatment.
      Conclusion: This pilot study provides preliminary evidence of the potential augmentation of
      DBT-ST using MET in a real-world setting. Future studies should examine whether MET uniquely
      augments DBT-ST through the use of a comparable pre-treatment control group.
    

Intervention name(s): ERG Skills Training; Motivational Enhancement; Family Skills Training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Group-based Dialectical Behavior Therapy Skills Training for 12 weeks; Three week Motivational Enhancement group; 12-week group-based family skills training using Family Connections model
Other intervention name(s): Family Connections
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Emotional Dysregulation; Early Intervention; Youth Mental Health; Staging; Motivational Enhancement; Family Connections; Family Skills Training