Effectiveness of Six Sessions CBT for Adolescents With Emotional Problems in Community Clinics

Study Overview
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Brief Summary
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Background: There is need for more effectiveness studies concerning treatment of emotional symptom problems indicating anxiety and depression in adolescents. SMART is the only treatment manual for combined emotional disorders developed in Norwegian. Purpose: To find the best individualized treatment for adolescents with emotional difficulties by: Finding criteria for the selection of appropriate patients for treatment with cognitive-behavior therapy program SMART in an outpatient population (14-18 years). Finding predictors of completion of treatment program SMART. Examining the effects of treatment with the SMART program at 6 months follow-up. Design: A randomized controlled study in six outpatient clinics in the north of Norway. N= 160 referred adolescents (14-18 years) with score above 6 on the Emotional Problems scale of the Strength and Difficulties Questionnaire (SDQ). Two thirds are treated according to the SMART-manual immediately, while the waiting list control group is treated with SMART after six weeks. Hypothesis: The SMART treatment is an effective treatment for emotional symptom problems. Publication: The results sought published internationally and nationally and will be communicated to clinicians.

Official Title
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Effectiveness of Cognitive Behavioral Short-term Treatment for Adolescents With Emotional Symptom Problems in Community Clinics in Norway. A Randomized Controlled Study

Conditions
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Depression, Generalized Anxiety Disorder, Social Phobia, Agoraphobia, Panic Disorder

Intervention / Treatment
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* Behavioral: SMART manual cognitive behavioral therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 14 to 18 years Referred to Community Mental Health Clinic for Children and Adolescents Score above 6 on Emotional symptoms scale on the SDQ Fluent Norwegian language Exclusion Criteria: Indicators for Pervasive Developmental Disorder (PDD) Acute suicidal symptoms Psycho-active drug treatment start coinciding with start of intervention Symptoms indicating psychotic disorder

Ages Eligible for Study
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Minimum Age: 14 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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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Waiting list control group<br>6 week waiting list | |
| Experimental: Individual cognitive behavioral therapy with SMART<br>SMART manual cognitive behavioral therapy individual weekly sessions for 6 weeks | Behavioral: SMART manual cognitive behavioral therapy<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Status of primary emotional disorder based on theDevelopment and Well-Being Assessment (DAWBA) interview schedule with parents and youths | Diagnostic interview | At recruitment, before treatment start and at 6 months follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SDQ Strengths and Difficulties Questionnaire | Measure of general emotional and behavioral symptoms and strengths | At recruitment, before treatment start and at 6 months follow up | 
| Anxiety symptom score on the Multi-Dimensional Anxiety Scale for Children (MASC) | Measure of anxiety symptoms | At recruitment, before treatment start and at 6 months follow up | 
| Depression symptom status as measured by the self-rating instrument Beck Depression Inventory (BDI-II) | Measure of depressive symptoms | At recruitment, before treatment start and at 6 months follow up | 
| Life functioning as measured by the rating scale C-GAS rated by clinicians | Measure of functioning | At recruitment, before treatment start and at 6 months follow up | 
| General outcome measured by Clinical Outcomes in Routine Evaluations Outcome Measure (CORE-OM) | Measure of symptoms, risk, functioning and total burden of disorder | At recruitment, before treatment start and at 6 months follow up. The short version (CORE 10) mid-therapy: 3 weeks after starting treatment |