Short- and Long-Term Effects of Inpatient Cognitive-Behavioral Treatment of Adolescents With Anxious-Depressed School Absenteeism: A Within-Subject Comparison of Changes

Abstract

The effects of inpatient treatment, including manual-guided cognitive-behavioral treatment (CBT), were examined for 36 adolescents (12–18 years) with chronic school absenteeism and mental health problems. Using a within-subject control group design, no changes were noted during the untreated waiting period, whereas there was a strong, statistically significant reduction in school absence rates and mental health problems from the start to the end of inpatient treatment. At discharge, 88.9% of adolescents attended school regularly or were employed (86.1 and 63.9% at 2- and 9-months follow-up, respectively). Self- and parent-reported mental health problems were significantly reduced during treatment and remained stable during follow-up.

KEYWORDS:

• adolescents
• anxious-depressed
• cognitive-behavioral therapy
• inpatient treatment
• school absenteeism

Notes

*b _treat , β _treat  = growth rate during treatment period reaching from PRE2 to POST; b_follow-up, β _follow-up  = growth rate from POST to FU2.

Note. SCL-MDD = Symptom Checklist for Major Depressive Disorders (A-Adolescent/P-Parent rating); SCL-APD = Symptom Checklist for Anxiety/Phobic Disorders (A-Adolescent/P-Parent rating); SELBST-TO = SELBST Questionnaire Total Score (A-Adolescent/P-Parent rating).

PRE1 = assessment 11–31 days before start of inpatient treatment; PRE2 = assessment on 1st day of inpatient treatment; POST = assessment on day of discharge; FU1 = assessment at 2 months after end of inpatient treatment; FU2 = assessment at 9 months after end of inpatient treatment.

Note. SCL-MDD = Symptom Checklist for Major Depressive Disorders (A-Adolescent/P-Parent rating); SCL-APD = Symptom Checklist for Anxiety/Phobic Disorders (A-Adolescent/P-Parent rating); SELBST-TO = SELBST Questionnaire Total Score (A-Adolescent/P-Parent rating).

PRE1 = assessment 11–31 days before start of inpatient treatment; PRE2 = assessment on 1st day of inpatient treatment; POST = assessment on day of discharge; FU1 = assessment at 2 months after end of inpatient treatment; FU2 = assessment at 9 months after end of inpatient treatment.

b _wait  = growth rate during waiting period from PRE 1 to PRE 2; b _treat  = growth rate during treatment period from PRE2 to POST (SCL-MDD-P, SCL-APD-P = PRE2 to FU1); b _follow-up  = growth rate during follow-up period from POST to FU1 (SELBST-TO-A = POST to FU2; SELBST-TO-P = FU1 to FU2).

^* p < .05; ^** p < .001; n.s. = not significant.