EVAADO: Qualitative Evaluation of Therapeutic Alliance in Adolescent Psychiatry
Study Details
Study Description
Brief Summary
Context: Psychiatric disorders (anorexia nervosa, depression, anxiety based school refusal) are a major public health concern in adolescence. Their treatment is a challenge for the families, the health care system and society. The treatment is complex and non-standardized. In clinical practice, the relational dimension between the stakeholders is recognized by all. Nevertheless no study has ever crossed their perspectives about therapeutic alliance in adolescent psychiatry.
Objective: to explore, within a qualitative approach, how a therapeutic alliance is established in three different clinical situations according to the adolescents, their parents and their physicians by crossing their perspectives.
Methods: This is a national (France) multi-center qualitative study based on 180 semi-structured interviews. Participants (purposively selected until data saturation) came from three different sub-samples: (i) adolescents with anorexia nervosa (N =20) plus their parents (N=20) and their physicians (N=20), (ii) adolescents with depressions (N=20) plus their parents (N=20) and their physicians (N=20), and (iii) adolescents with anxiety-based school refusal (N=20) plus their parents (N=20) and their physicians (N=20). Data are collected through open ended semi structured interviews and independently analyzed with NVivo V.11 software by three researchers according to the principles of Interpretative Phenomenological Analysis.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Anorexia nervosa adolescents with anorexia nervosa (N=20 ?), their parents (N=20), their physicians (N=20) |
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| Anxiety based school refusal adolescents with anxiety based school refusal (N=20 ?), their parents (N=20), their physicians (N=20) |
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| Depression adolescents with depression (N=20 ?), their parents (N=20), their physicians (N=20) |
Outcome Measures
Primary Outcome Measures
- to describe the facilitators of therapeutic alliance within adolescent psychiatry using a qualitative approach [2 years]
qualitative methodology using verbal data analysis of semi-structured interviex
Eligibility Criteria
Criteria
Inclusion Criteria:
- adolescents, boys and girls, aged 12 to 18 years, speaking fluent French, with (i) anorexia nervosa according to DSM 5 criteria (ii) depressive disorders (dysthymia, depressive episode) according to DSM 5 criteria (iii) anxiety-based school refusal according to four criteria:
- refusal to attend school (to operationalize this first criterion, adolescents were included if they had not attended school at all for at least one month before starting treatment); (2) presence of a DSM-5 anxiety disorder (except obsessive-compulsive or post-traumatic stress disorders) with emotional upset at the prospect of attending school; (3) absence of a DSM-5 conduct disorder; and (4) parental knowledge of the adolescent's whereabouts during the period of non-attendance.
that led to treatment that had begun at least six months earlier and clinically determined to be well enough to participate in a research interview.
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receiving treatment for at least 6 months
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one parent at least agrees to participate
Exclusion Criteria:
- acute symptoms and serious somatic and/or psychiatric co-morbidities
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | CHVictorDupouy | Argenteuil | France | 95100 | |
| 2 | CHU Rouen | Rouen | France | 76000 |
Sponsors and Collaborators
- Centre Hospitalier Victor Dupouy
Investigators
- Principal Investigator: Anne Revah-Levy, MD PhD, Paris diderot University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 20140600001072