Effectiveness of outpatient cognitive-behavioral therapy for adolescents under routine care conditions on behavioral and emotional problems rated by parents and patients: an observational study

  • Daniel Walter
  • Lydia Dachs
  • Martin Faber
  • Hildegard Goletz
  • Anja Goertz-Dorten
  • Christopher Hautmann
  • Claudia Kinnen
  • Christiane Rademacher
  • Stephanie Schuermann
  • Tanja Wolff Metternich-Kaizman
  • Manfred Doepfner
Original Contribution
  • 55 Downloads

Abstract

Few studies have examined the effectiveness of outpatient cognitive-behavioral therapy (CBT) delivered in routine care settings for children and adolescents with mental disorders. This observational study examined changes in behavioral and emotional problems of adolescents with mental disorders during routine outpatient CBT delivered at a university outpatient clinic and compared them with a historical control group of youths who received academic tutoring of comparable length and intensity. Assessments were made at the start and end of treatment (pre- and post-assessment) using parent ratings of the German versions of the Child Behavior Checklist (CBCL) and self-ratings of the Youth Self-Report (YSR) scale. For the main analysis, 677 adolescents aged 11‒21 years had complete data. Changes from pre- to post-assessment showed significant reductions in mental health problems on both parent- and self-ratings. Pre- to post-effect sizes (Cohen’s d) were small-to-medium for the total sample (d = 0.23 to d = 0.62) and medium-to-large for those adolescents rated in the clinical range on each (sub)scale at the start of treatment (d = 0.65 to d = 1.48). We obtained medium net effect sizes (d = 0.69) for the CBCL and YSR total scores when patients in the clinical range were compared to historical controls. However, a substantial part of the sample remained in the clinical range at treatment end. The results suggest that CBT is effective for adolescents with mental disorders when administered under routine care conditions but must be interpreted conservatively due to the lack of a direct control condition.

Keywords

Adolescents Mental disorders Routine treatment Cognitive-behavioral therapy Outpatient treatment Effectiveness 

Supplementary material

787_2017_1021_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 26 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Daniel Walter
    • 1
    • 2
  • Lydia Dachs
    • 2
  • Martin Faber
    • 2
  • Hildegard Goletz
    • 2
  • Anja Goertz-Dorten
    • 2
  • Christopher Hautmann
    • 2
  • Claudia Kinnen
    • 2
  • Christiane Rademacher
    • 1
  • Stephanie Schuermann
    • 1
  • Tanja Wolff Metternich-Kaizman
    • 1
    • 2
  • Manfred Doepfner
    • 1
    • 2
  1. 1.Department for Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyMedical Faculty of the University of CologneCologneGermany
  2. 2.School for Child and Adolescent Cognitive Behavior Therapy (AKiP)Medical Faculty of the University of CologneCologneGermany

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