Multi-family Therapy and School Refusal: an Exploratory Study With Adolescents and Their Families

Study Overview
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Brief Summary
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The purpose of this study is to determine whether multi-family therapy is effective in the treatment of school refusal with anxiety in adolescence.

Detailed Description
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Anxious school refusal in adolescence is a major public health problem. The involvement of families is essential and multi-family therapy has shown its effectiveness for many mental disorders. This study aims to explore the benefit of multi-family therapy in the care of anxious school refusal in adolescence. The method will be qualitative with phenomenological analysis of semi-structured interviews with adolescents and their parents and quantitative with a SCED design to assess the evolution of the level of anxiety of adolescents and parents, as well as personalized objectives. The objective is therefore to improve the care of adolescents with anxious school refusal.

Official Title
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Multi-family Therapy and School Refusal: an Exploratory Study With Adolescents and Their Families

Conditions
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School Phobia

Intervention / Treatment
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* Behavioral: Multi-family therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Families with an adolescent Aged 12 to 18 Totally out of school for more than 2 consecutive weeks and less than 18 months Follow-up at the Maison de Solenn-Maison des Adolescents (Cochin Hospital AP-HP) for a school refusal Having agreed to participate in a multi-family therapy Domiciliation in Ile de France Agreement of the parents and the adolescent to participate in the study: Collection of the non-opposition of non-emancipated minors and their legal representatives Exclusion Criteria: any family situation that makes it impossible to bring parents and children together in family therapy patient under curatorship or tutorship patient with AME (french State Medical Aid)

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adolescents<br> | Behavioral: Multi-family therapy<br>* 8 sessions of Multi-family therapy of 3 hours each during 24 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale (VAS) | Visual Analogue Scale for anxiety (adolescents and parents) / 0 = no anxiety at all, 10 = maximum anxiety imaginable / Weekly measurement between inclusion and the end of the Single Case Experimental Design (SCED) follow-up (13 to 15 months) | 13 to 15 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Goal Attainment Scale (GAS) | School attendance (adolescent) / 3-terminal GAS are 5-level GAS, i.e. with a possible rating ranging from -2 to +2. Level -2 corresponds to the initial state at the time of inclusion. Levels -2, 0 and +2 are precisely described, level -1 corresponds to a rating between -2 and 0 and level +1 to a rating between 0 and +2 / Weekly measurements, parents and adolescent, once a week from inclusion to the end of the SCED follow-up (13 to 15 months) | 13 to 15 months | 
| Adolescent Depression Rating Scale (ADRS) | Depression (adolescent) / 10 questions / Monthly measurements, adolescent and referring psychiatrist once a month from inclusion to the end of the SCED follow-up (13 to 15 months) | 13 to 15 months | 
| Family Assessment Device General Functioning (FAD-GF) | Family functioning / 12 questions, minimum = 12, maximum = 48 / Monthly measurements, parents and adolescent, once a month from inclusion to the end of the SCED follow-up (13 to 15 months) | 13 to 15 months | 
| Global Assessment of Functioning Scale (GAF) | Global Functioning of the adolescent / From 0 = inadequate information, to 100 = higher level of functioning in a wide variety of activities - V-axis of the DSM 5 / Monthly measurements, referring psychiatrist, once a month from inclusion to the end of the SCED follow-up (13 to15 months) | 13 to 15 months | 
| CSQ 8 (Client Satisfaction Questionnaire) | Satisfaction of the patients and the parents with multi-family therapy / 8 questions, minimum score = 8, maximum = 32 / At the end of the multifamily therapy, parents and teenager | 7 to 9 months | 
| Semi-structured interview | Semi-structured interview with qualitative phenomenological analysis (patients and parents) At the end of multi-family therapy | 7 to 9 months | 
| Semi-structured interview | Semi-structured interview with qualitative phenomenological analysis (patients and parents) 12 months after the end of multi-family therapy | 19 to 21 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adolescence, School Phobia, Multi-family therapy, Anxiety disorder