Document analyse richtlijnen

Analyse van 13 richtlijnen die gaan over psychosociale problematiek met betrekking tot gespreksvoering

Document analyse richtlijnen

Analyse van 13 richtlijnen die gaan over psychosociale problematiek met betrekking tot gespreksvoering

Effectiviteit van Triple P in Nederland: stand van zaken en controverse

Objective: The Triple P – Positive Parenting Program is available in over 50% of the Dutch municipalities. In this article we summarize the effects of Triple P as found in international meta-analyses and Dutch research. We also discuss the controversy surrounding Triple P. Method: We systematically discuss international meta-analyses and Dutch studies with a control group. Results: According to international research, the effect of Triple P on child behavioural problems and parenting skills is greater than that of care-as-usual. In the Netherlands, Triple P levels 3 and 4 are not more effective than care-as-usual; other levels of Triple P have not been studied. Discussion: Conflict of interest among the developers of Triple P appears to influence the results of international research on Triple P in which they are often involved. Dutch research is performed independently of Triple P developers except for one study) and finds that Triple P is not more effective than care-as-usual

Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis

Background: Cognitive-behavioral therapy (CBT) is first choice of treatment for depressive symptoms and disorders in adolescents, however improvements are necessary because overall efficacy is low. Insights on CBT components and contextual and structural characteristics might increase the efficacy. The aim of our approach is to evaluate the efficacy of CBT for youth with depression and investigate the influence of specific components, contextual and structural factors that could improve effects. Methods: A systematic review of randomized controlled trials was conducted, searches were undertaken in CINAHL, CENTRAL, EMBASE, MEDLINE/PubMed and PsycINFO. Outcomes were meta-analyzed and confidence in results was assessed using the GRADE-method. Meta-regression was used to pinpoint components or other factors that were associated with an in- or decrease of effects of CBT. Results: We included 31 trials with 4335 participants. Moderate-quality evidence was found for CBT reducing depressive symptoms at the end of treatment and at follow-up, and CBT as indicated prevention resulted in 63% less risk of being depressed at follow-up. CBT containing a combination of behavioral activation and challenging thoughts component (as part of cognitive restructuring) or the involvement of caregiver(s) in intervention were associated with better outcomes for youth on the long term. Conclusions: There is evidence that CBT is effective for youth with a (subclinical) depression. Our analyses show that effects might improve when CBT contains the components behavioral activation and challenging thoughts and also when the caregiver(s) are involved. However, the influential effects of these three moderators should be further tested in RCTs

Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis

Background: Cognitive-behavioral therapy (CBT) is first choice of treatment for depressive symptoms and disorders in adolescents, however improvements are necessary because overall efficacy is low. Insights on CBT components and contextual and structural characteristics might increase the efficacy. The aim of our approach is to evaluate the efficacy of CBT for youth with depression and investigate the influence of specific components, contextual and structural factors that could improve effects. Methods: A systematic review of randomized controlled trials was conducted, searches were undertaken in CINAHL, CENTRAL, EMBASE, MEDLINE/PubMed and PsycINFO. Outcomes were meta-analyzed and confidence in results was assessed using the GRADE-method. Meta-regression was used to pinpoint components or other factors that were associated with an in- or decrease of effects of CBT. Results: We included 31 trials with 4335 participants. Moderate-quality evidence was found for CBT reducing depressive symptoms at the end of treatment and at follow-up, and CBT as indicated prevention resulted in 63% less risk of being depressed at follow-up. CBT containing a combination of behavioral activation and challenging thoughts component (as part of cognitive restructuring) or the involvement of caregiver(s) in intervention were associated with better outcomes for youth on the long term. Conclusions: There is evidence that CBT is effective for youth with a (subclinical) depression. Our analyses show that effects might improve when CBT contains the components behavioral activation and challenging thoughts and also when the caregiver(s) are involved. However, the influential effects of these three moderators should be further tested in RCTs