Category: Treatment - CBT

PS4- #A24 - Mind My Mind! A Feasibility Randomized Clinical Trial of a New Modular Therapy for School-Age Children in Diverse Municipalities in Denmark

Friday, Nov 17
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Child Anxiety | Child Depression | Child Externalizing

Emotional and behavioral disorders are common in youths, and large-scale implementation of evidence-based treatments lack behind the needs of the population. The Mind My Mind (MMM) feasibility RCT in Denmark is a multidisciplinary collaborative effort to adapt current evidence-based treatment strategies for implementation with school children in diverse municipalities in Denmark. The modular and flexible cognitive and behavioural therapy (MMM) is compared with treatment as usual (TAU) for children aged 6-16 years with subclinical or clinical levels of emotional and behavioural difficulties. Educational psychologists in four municipalities received one-week intensive training and on-going weekly supervision in the MMM manual. The manual comprises problem-specific and generic modules and flowcharts to guide the dosing and sequencing of the modules in accordance with the principal problem and the current needs of the child. Altogether, 150 help-seeking children (93% ethnic Danes) were included and randomized (3:1) to MMM (n=113, 52.2 % boys, mean age 10.5 (SD=2.6) years) or TAU (n=37, 35.1% boys, mean age 10.6 (SD=2.6) years). The mean duration of the MMM intervention was 11 sessions (range 1-20) in 13 weeks (range 1-22). Only 9 (8.0 %) of 113 children in MMM ended treatment prematurely, mostly due to referral to other more specialized services. The TAU treatment varied from no treatment to other evidence-based practice in the municipality. The attrition rate from the follow-up with web-based standardized questionnaires was approximately 25% and highest in the TAU group. Preliminary results of interim intention-to-treat analyses using a linear regression with multiple imputations indicated superiority of MMM compared with TAU across several domains and informants at end of treatment, including reduced parent-reported impact of problems (Strengths and Difficulties Questionnaire (SDQ)-Impact scale, difference in means (MD) = -1.33 (-2.22; -0.44), P= 0.004), anxiety (Spence Children’s Anxiety Scale, MD = -12.1 (-18.0; -6.1), P=0.001), depressive symptoms (Mood and Feelings Questionnaire, MD =-5.9 (-10.2; -1.5), P=0.009), daily functioning (Weiss Functional Impairment Rating Scale, MD = -8.1 (-15.7; -0.6), P=0.03), and self-reported general health (KIDSCREEN subscale, MD = 3.4 (1.1; 5,8), P=0.004). The mean level of behavioral problems was low, and significant effects were found only in the subgroup with problems at entry. The modular manual, the centralized education and weekly supervision, and the web-based data collection with feedback in real time to therapists and researchers paved the way for a successful implementation of an explanatory RCT and future dissemination. The poster will present the final results and experiences from the feasibility RCT. 

Pia Jeppesen

Associate professor, senior researcher
Child and Adolescent Mental Health Centre, Mental Health Services - Capital Region Denmark & Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
Glostrup, Hovedstaden, Denmark

Kerstin Plessen

Professor, Head of Research
Child and Adolescent Mental Health Centre, Mental Health Services - Capital Region Denmark & Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
Copenhagen, Hovedstaden, Denmark

Niels Bilenberg

Professor, Head of Research
Department for Child and Adolescent Psychiatry, Psychiatry in Southern Denmark and University of Southern Denmark

Per Hove Thomsen

Professor and Director
Research Center at the Psychiatric Hospital for Children and Adolescents, Aarhus University Hospital, Denmark.

Mikael Thastum

Professor
Department of Psychology, Aarhus University, Denmark
AArhus, Denmark

Simon-Peter Neumer

Senior researcher
Centre for Child and Adolescent Mental Health, Oslo, Norway.

Christoph U. Correll

Professor of Psychiatry and Medical Director
Hofstra Northwell School of Medicine Hempstead, New York, USA & Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA & The Zucker Hillside Hospital, Department of Psychiatry

Wendy Silverman

Alfred A. Messer Professor of Child Psychiatry, Professor of Psychology and Director
Yale University and Child Study Center Program for Anxiety Disorders, USA
New Haven, Connecticut