Parent Participation in Cognitive Behavioral Therapy for Children and Adolescents: A Scoping Review

Abstract

This research aims to evaluate the psycho-education and therapy programs prepared for children and adolescents with the Cognitive Behavioral Therapy approach and implemented between 2001-2021 in terms of parental involvement. This research, which was carried out in the descriptive model, is a review study. The articles covered in the research were accessed through Web of Science, ERIC, PubMed, Google Scholar, and ScienceDirect academic databases and were determined to be by the inclusion and exclusion criteria determined by the researchers, 10 of which were quasi-experimental with a control group and 7 in a randomized controlled study design. 17 articles were reviewed. Fifteen of the studies included child and adolescent sessions, while 2 included only children's sessions. According to the findings, it was determined that parent participation was used in all of the studies, the number of therapy sessions was between 8-30, and the session durations varied between 20 minutes and 1.5 hours in total, including the child/adolescent and parents It was stated that children and adolescents included in the treatment experienced various psychological disorders such as anxiety disorder, depression, obsessive-compulsive disorder, anger control disorder, attention deficit, and hyperactivity disorder, and eating disorder. These findings show that Cognitive Behavioral Therapy practices for different psychological disorders for children and adolescents benefit from parental involvement in 82% of the studies. The fact that the types of parental involvement and the presence of parental pathologies are not detailed in the studies constitute the shortcomings of parent involvement studies..

Keywords

• Adolescent
• child
• parent involvement
• cognitive behavioral therapy
• psychoeducation
• family

Çocuk ve Ergenlerle Bilişsel Davranışçı Terapide Ebeveyn Katılımı: Bir Gözden Geçirme Çalışması

Öz

Bu araştırmanın amacı Bilişsel Davranışçı Terapi yaklaşımıyla çocuklara ve ergenlere yönelik hazırlanan ve 2001-2021 yılları arasında uygulanan psiko-eğitim ve terapi programlarını ebeveyn katılımı yönünden değerlendirmektir. Betimsel modelde gerçekleştirilen bu araştırma bir gözden geçirme çalışmasıdır. Araştırmada ele alınan makalelere Web of Science, ERIC, PubMed, Google Scholar, ScienceDirect akademik veri tabanları aracılığıyla ulaşılmış ve araştırmacılar tarafından belirlenen içerleme ve dışarlama kriterlerine uygun olduğu belirlenen, 10’u kontrol gruplu yarı deneysel, 7’si randomize kontrollü araştırma deseninde olmak üzere 17 makale incelenmiştir. Çalışmaların 15 tanesi çocuk ve ergen oturumlarını içerirken, 2 çalışma sadece çocuk oturumlarını içermektedir. Bulgulara göre çalışmaların tamamında ebeveyn katılımını kullandığı, terapi oturum sayılarının 8-30 arasında olduğu, oturum sürelerinin çocuk/ergen ve ebeveynler dahil toplam 20 dakika ile 1.5 saat arasında değiştiği belirlenmiştir. Tedaviye dahil edilen çocuk ve ergenlerin kaygı bozukluğu, depresyon, obsesif kompulsif bozukluk, öfke kontrol bozukluğu, dikkat eksikliği ve hiperaktivite bozukluğu, yeme bozukluğu gibi çeşitli psikolojik bozukluklar yaşadığı belirtilmiştir. Bu bulgular, çocuk ve ergenlere yönelik farklı psikolojik bozukluklara ilişkin Bilişsel Davranışçı Terapi uygulamalarının ebeveyn katılımından yararlandığını ve çalışmaların %82’sinde ebeveyn katılımının terapinin faydasını arttırdığını ortaya koymaktadır. Ebeveyn katılımının türlerinin ve ebeveyn patolojilerinin varlığının çalışmalarda detaylandırılmamış olması, ebeveyn katılımı çalışmalarının eksikliklerini oluşturmaktadır.

Anahtar Kelimeler

• ergen
• çocuk
• ebeveyn katılımı
• BDT
• psikoeğitim
• aile

Kaynakça

1. Amel AK, Amel SK, Erfan A (2018) Effectiveness of parents-focused cognitive-behavioral therapy on attention deficit hyperactivity disorder symptoms, obesity and self-esteem of overweight children with attention deficit hyperactivity disorder. Adv Biomed Res, 7:73.
2. Arıcı-Özcan N, Arslan R (2018) Ergen annelerine uygulanan ebeveyn stresini yönetme programı’nın etkililiği. Sakarya University Journal of Education, 8:40-59.
3. Barrett PM, Dadds MR, Rapee RM (1996) Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol, 64:333.
4. Berger R, Pat-Horenczyk R, Gelkopf M (2007) School-based intervention for prevention and treatment of elementary students terror-related distress in Israel: A quasi-randomized controlled trial. J Trauma Stress, 20:541-551.
5. Berman SL, Weems CF, Silverman WK, Kurtines WM (2000) Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic and anxiety disorders in children. Behav Ther, 31:713-731.
6. Breinholst S, Esbjørn BH, Reinholdt-Dunne ML, & Stallard P (2012) CBT for the treatment of child anxiety disorders: A review of why parental involvement has not enhanced outcomes. J Anxiety Disord, 26:416-424.
7. Bögels SM, Brechman-Toussaint ML (2006) Family issues in child anxiety: Attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev, 26:834-856.
8. Börekçi B (2017) Okul öncesi çocuklarda dikkat eksikliği hiperaktivite bozukluğu belirtilerinin, davranışsal, sosyal problemler, aile işlevselliği ve ebeveyn tutumları ile ilişkilerinin değerlendirilmesi (Uzmanlık tezi). İstanbul, Işık Üniversitesi.

9. Cardy JL, Waite P, Cocks F, Creswell C (2020) A systematic review of parental involvement in cognitive behavioral therapy for adolescent anxiety disorders. Clin Child Fam Psychol Rev, 23:483-509.
10. Creswell C, Cartwright-Hatton S (2007) Family treatment of child anxiety: outcomes, limitations, and future directions. Clin Child Fam Psychol Rev, 10:232-252.
11. Connolly SD, Bernstein GA (2007) Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry, 46:267-283.
12. Cohen JA, Mannarino AP (1996) A treatment outcome study for sexually abused preschool children: Initial findings. J Am Acad Child Adolesc Psychiatry, 35:42-50.
13. Couturier J, Kimber M, Szatmari P (2013) Efficacy of family-based treatment for adolescents with eating disorders: A systematic review and meta-analysis. Int J Eat Disord, 46:3-11.
14. Çekiç A, Akbaş T, Hamamcı Z (2016) Akılcı duygusal aile eğitim programının anne babaların akılcı olmayan inançlarına ve anne babalık streslerine etkisi. International Journal of Human Science, 13:2398-2417.
15. De Miguel-Etayo P, Muro C, Santabárbara J, López-Antón R, Morandé G, Martín-Matillas M et al. (2016) Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study. Int J Obes (Lond), 40:84-87.
16. Douglas J (1998) Therapy for parents of difficult pre-school children. In Cognitive Behavior Therapy For Children and Families (Ed P Graham). Cambridge, Cambridge University Press.
17. Egger M, Smith GD, O'Rourke K (2001) Systematic Reviews in Health Care: Meta‐Analysis in Context. London, UK, BMJ Publishing.
18. Elkins RM, Gallo KP, Pincus, DB, Comer JS (2016) Moderators of intensive cognitive behavioral therapy for adolescent panic disorder: The roles of fear and avoidance. Child Adolesc Ment Health, 21:30-36.
19. Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R (2001) Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obesity Res, 9:171-178.
20. Erermiş S, Bellibaş E, Özbaran B, Nagehan-Büküşoğlu D, Altıntoprak E, Bildik T et al. (2009) Ayrılma anksiyetesi bozukluğu olan okul öncesi yaş grubu çocukların annelerinin mizaç özellikleri. Turk Psikiyatri Derg, 20:14-21.
21. Ginsburg GS, Schlossberg MC (2002) Family-based treatment of childhood anxiety disorders. Int Rev Psychiatry, 14:143-154.
22. Golan M, Crow S (2004) Targeting parents exclusively in the treatment of childhood obesity: Long-term results. Obesity Res, 12:357-361.
23. Grant MJ, Booth A (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Info Libr J, 26:91-108.
24. Grasso DJ, Joselow B, Marquez, Y, Webb C (2011) Trauma-focused cognitive behavioral therapy of a child with posttraumatic stress disorder. Psychotherapy, 48:188-197.
25. Green S, Higgins JP, Alderson P, Clarke M, Mulrow CD, Oxman AD (2008) What is a systematic review? In Cochrane Handbook of Systematic Reviews of Interventions (Eds JPT Higgins, S Green):1-9. Chichester, Wiley.
26. Hudson JL, Rapee RM (2001) Parent-child interactions and the anxiety disorders: An observational analysis. Behav Res Ther, 39:1411-1427.
27. Hudson JL, Rapee RM (2002) Parent-child interactions in clinically anxious children and their siblings. J Am Acad Child Adolesc Psychiatry, 31:548-555.
28. Hudson JL, Rapee RM, Deveney C, Schniering CA, Lyneham HJ, Bovopoulos N (2009) Cognitive-behavioral treatment versus active control for children and adolescents with anxiety disorders: A randomized trial. J Am Acad Child Adolesc Psychiatry, 48:533-544.
29. Hughes AA, Furr JM, Sood ED, Barmish AJ, Kendall PC (2009) Anxiety, mood and substance use disorders in parents of children with anxiety disorders. Child Psychiat Hum Dev, 40:405-419.
30. In-Albon T, Schneider S (2007) Psychotherapy of childhood anxiety disorders: A meta-analysis. Psychother Psychosom, 76:15-24.
31. James AC, Reardon T, Soler A, James G, Creswell C (2020) Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev, 11(11):CD013162.
32. Jelalian E, Hart CN, Mehlenbeck RS, Lloyd-Richardson EE, Tiger JD, Flynn‐O'Brien KT et al. (2008) Predictors of attrition and weight loss in an adolescent weight control program. Obesity (Silver Spring), 16:1318-1323.
33. Karaman D, Durukan İ, Erdem M (2011) Çocukluk çağı başlangıçlı obsesif kompulsif bozukluk. Psikiyatride Güncel Yaklaşımlar, 3:278-295.
34. Kendall PC, Gosch E, Furr JM, Sood E (2008) Flexibility within fidelity. J Am Acad Child Adolesc Psychiatry, 47:987-993.
35. Kendall PC (2011) Child and Adolescent Therapy: Cognitive-Behavioral Procedures. New York, NY, Guilford Press.
36. Khan KS, Kunz R, Kleijnen J, Antes G (2003) Five steps to conducting a systematic review. J R Soc Med, 96:118-121.
37. King NJ, Tange BJ, Mullen P, Myerson N, Hayne D, Rollings S et al. (2000) Treating sexually abused children with posttraumatic stress symptoms: a randomized clinical trial. J Am Acad Child Adolesc Psychiatry, 39:1347-1355.
38. Leyfer O, Carpenter A, Pincus D (2018) N-methyl-d-aspartate partial agonist enhanced intensive cognitive-behavioral therapy of panic disorder in adolescents. Child Psychiatry Hum Dev, 50:268-277.
39. Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B (2010) Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry, 67:1025-1032.
40. Mega F (2019) Çatışmalı ailelerde yaşayan çocuklara yönelik "Ailelere Alternatif Bilişsel Davranışçı Terapi" modeli. Bosphorus Medical Journal, 6:67-73.
41. Murray L, Creswell C, Cooper PJ (2009) The development of anxiety disorders in childhood: an integrative review. Psychol Med, 39:1413-1423.
42. Nauta MH, Scholing A, Emmelkamp PM, Minderaa RB (2001) Cognitive‐behavioural therapy for anxiety disordered children in a clinical setting: Does additional cognitive parent training enhance treatment effectiveness? Clin Psychol Psychother, 8:330-340.
43. Nauta MH, Scholing A, Emmelkamp PM, Minderaa RB (2003) Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: No additional effect of a cognitive parent training. J Am Acad Child Adolesc Psychiatry, 42:1270-1278.
44. Öngider N, Baykara B (2015) Anksiyete tanısı almış çocuklarda bilişsel davranışçı grup terapisinin etkililiği. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi, 1:26-37.
45. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. (2021) The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. J Clin Epidemiol, 134:178-189.
46. Scheeringa MS, Weems CF, Cohen JA (2011) Trauma-focused cognitive behavioral therapy for post-traumatic stress disorder in three through six year old children: A randomized clinical trial. J Child Psychol Psychiatry, 52:853-860.
47. Siqueland L, Rynn M, Diamond GS (2005) Cognitive-behavioral and attachment based family therapy for anxious adolescents: Phase I and II studies. J Anxiety Disord, 19:361-381.
48. Skuladottir A, Thome M, Ramel A (2004) Improving day and night sleep problems in infants by changing day time sleep rhythm: A single group before and after study. Int J Nurs Stud, 42:843-850.
49. Stallard P (2005) A Clinician's Guide to Think Good-Feel Good: Using CBT with Children and Young People. Honoken, NJ, Wiley.
50. Stallard P (2014) Anxiety: Cognitive Behaviour Therapy with Children and Young People. New York, NY, Routledge.
51. Stjerneklar S, Hougaard E, Nielsen AD, Gaardsvig MM, Thastum, M (2018) Internet-based cognitive behavioral therapy for adolescents with anxiety disorders: A feasibility study. Internet Interv, 11:30-40.
52. Taylor L, Creswell C, Pearcey S, Brooks E, Leigh E, Stallard P et al. (2021) Delivering cognitive therapy for adolescent social anxiety disorder in NHS camhs: A qualitative analysis of the experiences of young people, their parents and clinicians-in-training. Behav Cogn Psychother, 49:398-412.
53. Tekinsav-Sütcü GS (2006) Ergenlerde öfke ve saldırganlığı azaltmaya yönelik bilişsel davranışçı bir müdahale programının etkililiğinin değerlendirilmesi (Doktora tezi). İzmir, Ege Üniversitesi.
54. Tricco AC, Tetzlaff J, Moher D (2011) The art and science of knowledge synthesis. J Clin Epidemiol, 64:11-20.
55. Türkbay T, Söhmen T (2001) Ayrılık kaygısı bozukluğunda bireysel ve ailesel etmenler. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 8:77-84.
56. Uysal Toraman A, Dağhan Ş, Kısa Ö (2021) Akran zorbalığını önlemede okul tabanlı müdahale programları: Sistematik derleme. Humanistic Perspective, 3:359-399.
57. Ünver H (2017) Obsesif kompulsif bozukluk tanılı ergene bilişsel davranışçı yaklaşım: Olgu sunumu. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 25:77-81.
58. Waite P, Marshall T, Creswell C (2019) A randomized controlled trial of internet-delivered cognitive behaviour therapy for adolescent anxiety disorders in a routine clinical care setting with and without parent sessions. Child Adolesc Ment Health, 24:242-250.
59. Zeller M, Kirk S, Claytor R, Khoury P, Grieme J, Santangelo M et al. (2004) Predictors of attrition from a pediatric weight management program. J Pediatr, 144:466-470.