Проведение когнитивно-поведенческой терапии с детьми и подростками с тревожными расстройствами

597

Аннотация

В этой статье представлены введение и обзор когнитивно-поведенческого подхода к лечению тревожных расстройств у детей и подростков. Сначала мы представляем введение в когнитивно-поведенческую концептуализацию тревоги, выделяя тройственную модель эмоций: когниции, физиологическое возбуждение и избегание. Затем мы представляем обзор основных принципов когнитивно-поведенческой терапии тревожных расстройств у детей и подростков, включая генерализованное тревожное расстройство, социальную тревожность, страх разлуки, а также специфические фобии. Затем мы приводим структуру и цели лечения, включая три этапа лечения: психообразование, практическое применение навыков и предотвращение рецидивов. В контексте практического применения мы фокусируемся в первую очередь на стратегиях поведенческой экспозиции (exposure) и когнитивной перестройки. В заключение мы приводим краткое описание различных форматов, в которых может быть реализована когнитивно-поведенческая терапия, включая индивидуальную работу с ребенком, групповой формат, терапию с участием родителей и телемедицину.

Общая информация

Ключевые слова: тревожные расстройства, дети, подростки, когнитивно-поведенческая терапия

Рубрика издания: Прикладные исследования

Тип материала: научная статья

DOI: https://doi.org/10.17759/cpse.2022110207

Финансирование. Данное исследование было поддержано грантом Национального института психического здоровья (NIMH), грант R01MH119299-01 предоставлен Уэнди К. Сильверман и Джереми В. Петтит.

Получена: 10.08.2021

Принята в печать:

Для цитаты: Патриарка Г.С., Петтит Д.В., Сильверман У.К. Проведение когнитивно-поведенческой терапии с детьми и подростками с тревожными расстройствами [Электронный ресурс] // Клиническая и специальная психология. 2022. Том 11. № 2. С. 108–122. DOI: 10.17759/cpse.2022110207

Литература

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: Author, 2013. 947 p.
  2. Asnaani A., Hofmann S.G. Collaboration in multicultural therapy: Establishing a strong therapeutic alliance across cultural lines. Journal of Clinical Psychology, 2012, vol. 68 (2), pp. 187–197. DOI: 10.1002/jclp.21829
  3. Badin E., Alvarez E., Chu B.C. Cognitive behavioral therapy for child and adolescent anxiety: CBT in a nutshell. In R. Friedberg, B. Nakamura (eds.), Cognitive Behavioral Therapy in Youth: Tradition and Innovation. Neuromethods, vol. 156. New York, NY: Humana, 2020, pp. 41–71. DOI: 10.1007/978-1-0716-0700-8_3
  4. Beidas R.S., Mychailyszyn M.P., Podell J.L. et al. Brief cognitive-behavioral therapy for anxious youth: The inner workings. Cognitive and Behavioral Practice, 2013, vol. 20 (2), pp. 134–146. DOI: 10.1016/j.cbpra.2012.07.004
  5. Berman S.L., Weems C.F., Silverman W.K. et al. Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic and anxiety disorders in children. Behavior Therapy, 2000, vol. 31. pp. 713–731. DOI: 10.1016/S0005-7894(00)80040-4
  6. Breinholst S., Esbjørn B.H., Reinholdt-Dunne M.L. et al. CBT for the treatment of child anxiety disorders: A review of why parental involvement has not enhanced outcomes. Journal of Anxiety Disorders, 2012, vol. 26 (3), pp. 416–424. DOI: 10.1016/j.janxdis. 2011.12.014
  7. Carpenter A.L., Pincus D.B., Furr J.M. et al. Working from home: An initial pilot examination of videoconferencing-based cognitive behavioral therapy for anxious youth delivered to the home setting. Behavior Therapy, 2018, vol. 49 (6), pp. 917–930. DOI: 10.1016/j.beth.2018.01.007
  8. Chiu A.W., McLeod B.D., Har K. et al. Child–therapist alliance and clinical outcomes in cognitive behavioral therapy for child anxiety disorders. Journal of Child Psychology and Psychiatry, 2009, vol. 50 (6), pp. 751–758. DOI: 10.1111/j.1469-7610.2008.01996.x
  9. Compton S.N., Peris T.S., Almirall D. et al. Predictors and moderators of treatment response in childhood anxiety disorders: results from the CAMS trial. Journal of Consulting and Clinical Psychology, 2014, vol. 82 (2), pp. 212–224. DOI: 10.1037/a0035458
  10. Craske M.G., Kircanski K., Zelikowsky M. et al. Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 2008, vol. 46 (1), pp. 5–27. DOI: 10.1016/j.brat.2007.10.003
  11. Craske M.G., Treanor M., Conway C.C. et al. Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 2014, vol. 58, pp. 10–23. DOI: 10.1016/j.brat.2014.04.006
  12. Creswell C., Waite P., Hudson J. et al. Practitioner Review: Anxiety disorders in children and young people–assessment and treatment. Journal of Child Psychology and Psychiatry, 2020, vol. 61 (6), pp. 628–643. DOI: 10.1111/jcpp.13186
  13. Cunningham M.J., Rapee R.M., Lyneham H.J. et al. The cool teens CD-ROM — An anxiety management program for young people. Sydney: Centre for Emotional Health, Macquarie University, 2006.
  14. Essau C.A., Gabbidon J. Epidemiology, comorbidity, and mental health services utilization. In C.A. Essau, T.H. Ollendick (eds.), The Wiley-Blackwell Handbook of the Treatment of Childhood and Adolescent Anxiety. Chichester, UK: John Wiley & Sons Ltd, 2013, pp. 23–41. DOI: 10.1002/9781118315088.ch2
  15. Field A., Purkis H.M. The role of learning in the etiology of child and adolescent fear and anxiety. In W.K. Silverman, A.P. Field (eds.), Anxiety Disorders in Children and Adolescents, 2nd ed. Cambridge University Press, 2013, pp. 187–211.
  16. Gosch E.A., Flannery-Schroeder E., Mauro C.F. et al. Principles of cognitive-behavioral therapy for anxiety disorders in children. Journal of Cognitive Psychotherapy, 2006, vol. 20 (3), pp. 247–262. DOI: 10.1891/088983906780643966
  17. Harmon H., Langley A., Ginsburg G.S. The role of gender and culture in treating youth with anxiety disorders. Journal of Cognitive Psychotherapy, 2006, vol. 20 (3), pp. 30–310. DOI: 10.1891/088983906780644000
  18. Higa-McMillan C.K., Francis S.E., Rith-Najarian L. et al. Evidence base update: 50 years of research on treatment for child and adolescent anxiety. Journal of Clinical Child & Adolescent Psychology, 2016, vol. 45 (2), pp. 91–113. DOI: 10.1080/15374416.2015. 1046177
  19. Hill C., Waite P., Creswell C. Anxiety disorders in children and adolescents. Pediatrics and Child Health, 2016, vol. 26 (12), pp. 548–553. DOI: 10.1016/j.paed. 2016.08.007
  20. Hudson J.L., Keers R., Roberts S. et al. Clinical predictors of response to cognitive-behavioral therapy in pediatric anxiety disorders: The Genes for Treatment (GxT) study. Journal of the American Academy of Child & Adolescent Psychiatry, 2015, vol. 54 (6), pp. 454–463. DOI: 10.1016/j.jaac.2015.03.018
  21. Kendall P.C., Hedtke K. Cognitive behavioral therapy for anxious children: Therapist manual. Ardmore, PA: Workbook, 2006. 104 p.
  22. Khan A.N., Bilek E., Tomlinson R.C. et al. Treating social anxiety in an era of social distancing: Adapting exposure therapy for youth during COVID-19. Cognitive and Behavioral Practice, 2021, vol. 28 (4), pp. 669–678. DOI: 10.1016/j.cbpra.2020.12.002
  23. Kieling C., Baker-Henningham H., Belfer M. et al. Child and adolescent mental health worldwide: evidence for action. The Lancet, 2011, vol. 378 (9801), pp. 1515–1525. DOI: 10.1016/S0140-6736(11)60827-1
  24. Lang P.J. Fear reduction and fear behavior: problems in treating a construct. In J.M. Shlien (ed.), Research in Psychotherapy. American Psychological Association, 1967, pp. 332–368.
  25. Lang P.J., Levin D.N., Miller G.A. et al. Fear behavior, fear imagery, and the psychophysiology of emotion: The problem of affective response integration. Journal of Abnormal Psychology, 1983, vol. 92 (3), pp. 276–306. DOI: 10.1037//0021-843x.92.3.276
  26. Lebowitz E.R., Marin C., Martino A. et al. Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized non-inferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 2020, vol. 59 (3), pp. 362–372. DOI: 10.1016/j.jaac. 2019.02.014
  27. Lebowitz E.R., Omer H., Hermes H. et al. Parent training for childhood anxiety disorders: the SPACE program. Cognitive and Behavioral Practice, 2014, vol. 21 (4), pp. 456–469. DOI: 10.1016/j.cbpra.2013.10.004
  28. McLeod B.D., Islam N.Y., Chiu A.W. et al. The relationship between alliance and client involvement in CBT for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 2014, vol. 43 (5), pp. 735–741. DOI: 10.1080/15374416.2013.850699
  29. Nauphal M., Swetlitz C., Smith L. et al. A preliminary examination of the acceptability, feasibility, and effectiveness of a telehealth cognitive-behavioral therapy group for social anxiety disorder. Cognitive and Behavioral Practice, 2021, vol. 28 (4), pp. 730–742. DOI: 10.1016/J.CBPRA.2021.04.011
  30. Naz S., Gregory R., Bahu M. Addressing issues of race, ethnicity and culture in CBT to support therapists and service managers to deliver culturally competent therapy and reduce inequalities in mental health provision for BAME service users. The Cognitive Behaviour Therapist, 2019, vol. 12, e22. DOI:10.1017/S1754470X19000060
  31. Ollendick T., Allen B., Benoit K. et al. The tripartite model of fear in children with specific phobias: Assessing concordance and discordance using the behavioral approach test. Behaviour Research and Therapy, 2011, vol. 49 (8), pp. 459–465. DOI: 10.1016/j.brat. 2011.04.003
  32. Pettit J.W., Bechor M., Rey Y. et al. A randomized controlled trial of attention bias modification treatment in youth with treatment-resistant anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 2020, vol. 59 (1), pp. 157–165. DOI: 10.1016/j.jaac.2019.02.018
  33. Pettit J.W., Silverman W.K., Rey Y. et al. Moving to second stage treatments faster: Identifying midtreatment tailoring variables for youth with anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 2016, vol. 45 (4), pp. 457–468. DOI: 10.1080/15374416.2015.1038824
  34. Rachman S. Anxiety disorders: Some emerging theories. Journal of Behavioral Assessment, 1984, vol. 6 (4), pp. 281–299. DOI: 10.1007/BF01321322
  35. Rachman S., Hodgson R. I. Synchrony and desynchrony in fear and avoidance. Behaviour Research and Therapy, 1974, vol. 12 (4), pp. 311–318. DOI: 10.1016/0005-7967(74)90005-9
  36. Rey Y., Marin C.E., Silverman W.K. Failures in cognitive‐behavior therapy for children. Journal of Clinical Psychology, 2011, vol. 67 (11), pp. 1140–1150. DOI: 10.1002/jclp.20848
  37. Rogers C.R. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 1957, vol. 21, pp. 95–103.
  38. Saavedra L.M., Silverman W.K., Morgan‐Lopez A.A. et al. Cognitive behavioral treatment for childhood anxiety disorders: long‐term effects on anxiety and secondary disorders in young adulthood. Journal of Child Psychology and Psychiatry, 2010, vol. 51 (8), pp. 924–934. DOI: 10.1111/j.1469-7610.2010.02242.x
  39. Sanchez A.L., Comer J.S., LaRoche M. Enhancing the responsiveness of family-based CBT through culturally informed case conceptualization and treatment planning. Cognitive and Behavioral Practice, 2021. DOI: 10.1016/j.cbpra.2021.04.003
  40. Silk J.S., Pramana G., Sequeira S.L. et al. Using a smartphone app and clinician portal to enhance brief cognitive behavioral therapy for childhood anxiety disorders. Behavior Therapy, 2020, vol. 51 (1), pp. 69–84. DOI: 10.1016/J.BETH.2019.05.002
  41. Silverman W.K., Kurtines W.M. Anxiety and phobic disorders: A pragmatic approach. Springer US, 1996. 158 p.
  42. Silverman W.K., Kurtines W.M., Ginsburg G.S. Contingency management, self-control, and education support in the treatment of childhood phobic disorders:
    a randomized clinical trial. Journal of Consulting and Clinical Psychology, 1999, vol. 67 (5), pp. 675–687. DOI: 10.1037//0022-006x.67.5.675
  43. Silverman W.K., Kurtines W.M., Ginsburg G.S. et al. Treating anxiety disorders in children with group cognitive-behavioral therapy: A randomized clinical trial. Journal of Consulting and Clinical Psychology,1999, vol. 67 (6), pp. 995–1003. DOI: 10.1037//0022-006x.67.6.995
  44. Silverman W.K., Kurtines W.M. Treating anxiety disorders in children. In J. Hughes, J. Conoley, A.M. La Greca (eds.), Handbook of Psychological Services for Children and Adolescents. London: Oxford University Press, 2001, pp. 313–334. DOI: 10.1037/0022-006x.67.6.995
  45. Silverman W.K., Marin C.E., Rey Y. et al. Group-versus parent-involvement CBT for childhood anxiety disorders: Treatment specificity and long-term recovery mediation. Clinical Psychological Science, 2019, vol. 7 (4), pp. 840–855. DOI: 10.1177/ 216770261983040
  46. Silverman W.K., Pina A.A., Viswesvaran C. Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 2008, vol. 37 (1), pp. 105–130. DOI: 10.1080/15374410701817907
  47. Silverman W.K., Rey Y., Marin C.E. et al. Does training parents in reinforcement skills or relationship skills enhance individual youths’ cognitive behavioral therapy for anxiety? Outcome, specificity, and mediation. Clinical Psychological Science, 2022, vol. 10 (2), pp. 355–373. DOI: 10.1177/21677026211016402
  48. Silverman W.K., van Schalkwyk G.I. What is anxiety? In S.N. Compton, M.A. Villabo, H. Kristensen (eds.), Pediatric Anxiety Disorders. Academic Press, 2019, pp. 7–16.
  49. Weineland S., Ribbegårdh R., Kivi M. et al. Transitioning from face-to-face treatment to iCBT for youths in primary care–therapists' attitudes and experiences. Internet Interventions, 2020, vol. 22, 100356. DOI: 10.1016/j.invent.2020.100356
  50. Wergeland G.J.H., Fjermestad K.W., Marin C.E. An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 2014, vol. 57C (1), pp. 1–12. DOI: 10.1016/j.brat.2014.03.007
  51. Whiteside S.P.H., Sim L.A., Morrow A.S. et al. A meta-analysis to guide the enhancement of CBT for childhood anxiety: Exposure over anxiety management. Clinical Child and Family Psychology Review, 2020, vol. 23, pp. 102–121. DOI: 10.1007/s10567-019-00303-2

Информация об авторах

Патриарка Гуадалупе С., бакалавр (психология), аспирант департамента психологии, Международный университет Флориды, Майами, США, ORCID: https://orcid.org/0000-0001-7282-2407, e-mail: gpatriar@fiu.edu

Петтит Джереми В., PhD, профессор, руководитель департамента психологии, Международный университет Флориды, Майами, США, ORCID: https://orcid.org/0000-0002-7426-9411, e-mail: jpettit@fiu.edu

Сильверман Уэнди К., PhD, Центр изучения ребенка, Медицинская школа Йельского университета, e-mail: wendy.silverman@yale.edu, Нью-Хейвен, США, ORCID: https://orcid.org/0000-0003-4415-4098, e-mail: wendy.silverman@yale.edu

Метрики

Просмотров

Всего: 1448
В прошлом месяце: 47
В текущем месяце: 32

Скачиваний

Всего: 597
В прошлом месяце: 23
В текущем месяце: 21