Les Trucs de Dominique : regard sur un programme d’apprentissage des techniques de gestion de l’anxiété destiné aux enfants

Si de nombreuses études démontrent les effets positifs de l’apprentissage des techniques cognitives behaviorales de gestion de l’anxiété (ex. identification des signes physiques d’anxiété, modification du discours intérieur, résolution de problème, exposition graduelle), leur enseignement à des jeunes n’est pas sans présenter un défi. Afin de faciliter l’intégration des apprentissages transmis en atelier, le programme Les trucs de Dominique adopte une approche différente de celle dans les autres programmes du genre (ex. Friends, Coping Cat, Super L’Écureuil) : des histoires réalistes mettant en scène des jeunes aux prises avec des situations de stress significatives pour les préadolescents appuient les activités d’information et d’enseignement des techniques de gestion de l’anxiété. En plus de normaliser l’anxiété reliée à ces situations, les comportements des personnages illustrent les stratégies les plus (et les moins) productives pour les affronter. Les enfants réalisent ensuite des exercices pour consolider ces apprentissages. Après avoir justifié l’importance de développer des interventions de prévention des troubles anxieux accessible en contexte non clinique et avoir exposé les fondements théoriques du programme, les auteurs expliquent la séquence et la nature des apprentissages proposés. Finalement, ils mettent en lumière les avantages et les difficultés rencontrées lors de son application au cours d’une expérimentation antérieure. Cet article, destiné aux intervenants, fait suite à une première publication décrivant l’étude empirique qui accompagna cette expérimentation en milieu scolaire (Bouchard, Gervais, & Gagnier, sous presse). Le programme Les trucs de Dominique destiné originalement aux préadolescents est utilisé en milieu clinique scolaire et communautaire.Research has shown that learning cognitive behavior skills to cope with anxiety is effective, including the use of techniques such as detecting the physiological signs of anxiety, challenging dysfunctional beliefs, problem solving and gradual exposure. However, teaching those skills to children is not easy. The program Dominique’s Handy Tricks was developed to provide a different approach to learn and master the techniques addressed in other primary prevention program such as Friends, Coping Cat or Super l’Écureuil. The program is based on realistic stories describing preadolescent characters facing various stressors that can be experienced at this age. The storybooks illustrate how the characters are applying effective and ineffective coping strategies and normalize the emotional reactions to these stressors. Based on the stories, the children learn and practice coping skills, first applying them to the characters in the storybooks, and then to their own personal daily stressors. In this article, the authors first document the need for primary prevention interventions delivered in school and community settings and the theoretical bases of the program. Second, they describe the content of the program. Finally, the assets and challenges faced when implementing the program are discussed. This article focuses on clinical issues relevant for professionals and complements the presentation of the outcome results in another publication (Bouchard, Gervais & Gagné, in press)

Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP

Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind–Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms

Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada

Associations between HIV-related stigma and reduced antiretroviral therapy (ART) adherence are widely established, yet the mechanisms accounting for this relationship are underexplored. There has been less attention to HIV-related stigma and its associations with ART initiation and current ART use. We examined pathways from HIV-related stigma to ART initiation, current ART use, and ART adherence among women living with HIV in Canada