Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders

Background: Our study addressed the gap in research on the effectiveness of cognitive behavioral therapy (CBT) in treating children with mixed psychiatric disorders. We examined the immediate and long-term effects of group CBT (GCBT), delivered in naturalistic clinical settings, on reducing internal...

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Main Authors: Sarianna Barron-Linnankoski, Hanna Raaska, Paula Bergman, Eija Närvänen, Marko Elovainio, Marja Laasonen
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/9/11/1602
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author Sarianna Barron-Linnankoski
Hanna Raaska
Paula Bergman
Eija Närvänen
Marko Elovainio
Marja Laasonen
author_facet Sarianna Barron-Linnankoski
Hanna Raaska
Paula Bergman
Eija Närvänen
Marko Elovainio
Marja Laasonen
author_sort Sarianna Barron-Linnankoski
collection DOAJ
description Background: Our study addressed the gap in research on the effectiveness of cognitive behavioral therapy (CBT) in treating children with mixed psychiatric disorders. We examined the immediate and long-term effects of group CBT (GCBT), delivered in naturalistic clinical settings, on reducing internalizing and externalizing symptoms in children with mixed psychiatric disorders. Further, we compared the effectiveness of cost-effective, manualized GCBT to treatment as usual (TAU) consisting of individually tailored psychiatric outpatient services delivered by mental health care specialists. Methods: Children aged 6–12 years (<i>n</i> = 103) diagnosed with psychiatric disorders, more than 70% with psychiatric comorbidity, were assigned either directly to GCBT (GCBT group; <i>n</i> = 52) or TAU for approximately 3 months, after which they received GCBT (TAU + GCBT group; <i>n</i> = 51). Internalizing and externalizing symptoms were assessed using parent- and teacher-report questionnaires (Child Behavior Checklist and Teacher Report Form) at referral to treatment, pre-treatment, post-treatment, and six-month follow-up. Results: Parent- and teacher-rated internalizing symptoms and parent-rated externalizing symptoms were reduced immediately after GCBT. Long-term GCBT gains were prominent for parent-rated externalizing symptoms. No differences were observed between the effectiveness of GCBT and TAU. Conclusions: Our results suggest that GCBT and TAU services are equally effective in treating internalizing and externalizing symptoms in children with mixed psychiatric disorders, providing support for the broader use of cost-effective manualized GCBT. Manualized GCBT, which requires relatively short training, can also be delivered at primary healthcare levels. Our results are of relevance to cost-effectiveness and global mental health staff shortages.
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spelling doaj.art-3aa680b45ac5490787c81c2acec4aded2023-11-24T04:10:48ZengMDPI AGChildren2227-90672022-10-01911160210.3390/children9111602Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric DisordersSarianna Barron-Linnankoski0Hanna Raaska1Paula Bergman2Eija Närvänen3Marko Elovainio4Marja Laasonen5Department of Child Psychiatry, Helsinki University Hospital and University of Helsinki, P.O. Box 827, 00029 Helsinki, FinlandDepartment of Child Psychiatry, Helsinki University Hospital and University of Helsinki, P.O. Box 827, 00029 Helsinki, FinlandBiostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, FinlandDepartment of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, FinlandDepartment of Psychology and Logopedics/Research Program Unit, University of Helsinki, 00014 Helsinki, FinlandLogopedics, Philosophical Faculty, School of Humanities, University of Eastern Finland, 80100 Joensuu, FinlandBackground: Our study addressed the gap in research on the effectiveness of cognitive behavioral therapy (CBT) in treating children with mixed psychiatric disorders. We examined the immediate and long-term effects of group CBT (GCBT), delivered in naturalistic clinical settings, on reducing internalizing and externalizing symptoms in children with mixed psychiatric disorders. Further, we compared the effectiveness of cost-effective, manualized GCBT to treatment as usual (TAU) consisting of individually tailored psychiatric outpatient services delivered by mental health care specialists. Methods: Children aged 6–12 years (<i>n</i> = 103) diagnosed with psychiatric disorders, more than 70% with psychiatric comorbidity, were assigned either directly to GCBT (GCBT group; <i>n</i> = 52) or TAU for approximately 3 months, after which they received GCBT (TAU + GCBT group; <i>n</i> = 51). Internalizing and externalizing symptoms were assessed using parent- and teacher-report questionnaires (Child Behavior Checklist and Teacher Report Form) at referral to treatment, pre-treatment, post-treatment, and six-month follow-up. Results: Parent- and teacher-rated internalizing symptoms and parent-rated externalizing symptoms were reduced immediately after GCBT. Long-term GCBT gains were prominent for parent-rated externalizing symptoms. No differences were observed between the effectiveness of GCBT and TAU. Conclusions: Our results suggest that GCBT and TAU services are equally effective in treating internalizing and externalizing symptoms in children with mixed psychiatric disorders, providing support for the broader use of cost-effective manualized GCBT. Manualized GCBT, which requires relatively short training, can also be delivered at primary healthcare levels. Our results are of relevance to cost-effectiveness and global mental health staff shortages.https://www.mdpi.com/2227-9067/9/11/1602cognitive behavioral therapygroup cognitive behavioral therapyinternalizing symptomsexternalizing symptomschildren
spellingShingle Sarianna Barron-Linnankoski
Hanna Raaska
Paula Bergman
Eija Närvänen
Marko Elovainio
Marja Laasonen
Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
Children
cognitive behavioral therapy
group cognitive behavioral therapy
internalizing symptoms
externalizing symptoms
children
title Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
title_full Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
title_fullStr Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
title_full_unstemmed Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
title_short Effectiveness of Group CBT on Internalizing and Externalizing Symptoms in Children with Mixed Psychiatric Disorders
title_sort effectiveness of group cbt on internalizing and externalizing symptoms in children with mixed psychiatric disorders
topic cognitive behavioral therapy
group cognitive behavioral therapy
internalizing symptoms
externalizing symptoms
children
url https://www.mdpi.com/2227-9067/9/11/1602
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