Clinical Case Studies最新文献

Comprehensive Virtual Treatment for Severe Anxiety in Youth: A Case Report 青少年严重焦虑症的综合虚拟治疗：病例报告

Clinical Case Studies Pub Date : 2024-05-16 DOI: 10.1177/15346501241253845

D. G. Gittins Stone, Mona P. Potter, Hannah Doucette, Brianna Weissel, K. Boger

{"title":"Comprehensive Virtual Treatment for Severe Anxiety in Youth: A Case Report","authors":"D. G. Gittins Stone, Mona P. Potter, Hannah Doucette, Brianna Weissel, K. Boger","doi":"10.1177/15346501241253845","DOIUrl":"https://doi.org/10.1177/15346501241253845","url":null,"abstract":"Anxiety disorders and obsessive-compulsive disorder (OCD) are among the most common mental health conditions in children and adolescents and are associated with various impairments and long-term consequences. Evidence-based treatments exist but are often lacking in elements needed to effectively treat youth with more severe presentations. This case report illustrates a patient’s treatment course in an innovative program for children, adolescents, and young adults with severe anxiety. The program offers a continuum of outpatient, evidence-based care tailored to the severity of the patient’s condition. The case study focuses on “Jane,” an adolescent female with anxiety as well as obsessive-compulsive spectrum disorders, who had previously received extensive treatment without sustained improvement. Through the program’s three treatment phases, Jane and her parents demonstrated consistent engagement and adherence to treatment. Jane showed significant progress, with rapid reduction in symptoms and functional impairment. This case report underscores key elements of this treatment that address gaps in traditional approaches to care, particularly for patients with severe presentations, including the coordinated, team-based approach; the continuum of evidence-based, phased treatment titrated to need; the utilization of virtual individual, group and parent-focused care and between-session coaching to enhance learning generalization; and the use of measurement-based care. Further research is warranted to evaluate the generalizability and long-term outcomes of this program and its potential to transform the treatment landscape for pediatric anxiety and OCD.","PeriodicalId":508912,"journal":{"name":"Clinical Case Studies","volume":"11 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Promoting Safety While Addressing Dangerous Behavior via Telehealth: A Clinical Case Investigation Serving the Family of an Autistic Adolescent Living in India 通过远程医疗在解决危险行为的同时促进安全：服务于印度自闭症青少年家庭的临床案例调查

Clinical Case Studies Pub Date : 2024-03-29 DOI: 10.1177/15346501241243103

A. Rajaraman, Cory J. Whelan, Joshua Jessel, Holly C. Gover

{"title":"Promoting Safety While Addressing Dangerous Behavior via Telehealth: A Clinical Case Investigation Serving the Family of an Autistic Adolescent Living in India","authors":"A. Rajaraman, Cory J. Whelan, Joshua Jessel, Holly C. Gover","doi":"10.1177/15346501241243103","DOIUrl":"https://doi.org/10.1177/15346501241243103","url":null,"abstract":"When clinicians address dangerous behavior via remote telehealth consultation, it may be especially important to ensure remote implementers can apply behavioral interventions in a manner that keeps recipients and implementers safe while still achieving effective outcomes. We present the case of a 13-year-old autistic adolescent with limited communication skills, living in South India, whose dangerous behavior was escalating and becoming more pervasive during the pandemic quarantine, putting himself and his family at risk. In this study, we evaluated the effects of an enhanced choice model of skill-based treatment—informed by a practical functional assessment of dangerous behavior. We systematically replicated and extended procedures that have been shown to address dangerous behavior while avoiding difficult situations that place the individual and others at risk. The intervention yielded elimination of dangerous and associated non-dangerous behavior and socially valid acquisition of multiple alternative behaviors. We report multiple strategies to overcome barriers unique to remotely addressing dangerous behavior and discuss implications for the safe, telehealth application of behavior analysis in research and practice.","PeriodicalId":508912,"journal":{"name":"Clinical Case Studies","volume":"42 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140366684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment for Anxiety, Depression, and Family Conflict in Adolescence via Telehealth during the COVID-19 Pandemic 在 COVID-19 大流行期间通过远程保健治疗青少年的焦虑、抑郁和家庭冲突

Clinical Case Studies Pub Date : 2024-02-06 DOI: 10.1177/15346501241231830

William C. Kelner, Jennifer B. Bush, L. Elledge

{"title":"Treatment for Anxiety, Depression, and Family Conflict in Adolescence via Telehealth during the COVID-19 Pandemic","authors":"William C. Kelner, Jennifer B. Bush, L. Elledge","doi":"10.1177/15346501241231830","DOIUrl":"https://doi.org/10.1177/15346501241231830","url":null,"abstract":"Anxiety and depression are two of the most common mental health disorders diagnosed in adolescents. While either disorder individually creates impairments in psychological, emotional, and social functioning, these disorders often co-occur and reciprocally influence one another which can lead to continual worsening in functioning over time. Specifically with adolescents, anxiety and depression are associated with interpersonal conflicts with family and friends, which can further contribute to disruptions in functioning. This case study explores the effectiveness of using cognitive behavioral therapy (CBT) with a 14-year-old white male with generalized anxiety disorder (GAD) and persistent depressive disorder (PDD) via telehealth during the COVID-19 pandemic. Treatment was divided into two phases, with the first phase occurring over 20 sessions and the second phase occurring over nine sessions for a total of 29 sessions. In the first phase, the Unified Protocol for Adolescents (UP-A) was flexibly implemented to target emotion regulation, behavioral skills, and cognitive restructuring. The second phase focused on family dynamics and targeted effective communication and collaborative problem-solving. Outcome data showed significant reductions in anxiety symptoms and slight reductions in depressive symptoms as well moderate improvements in peer relationships. These results provide support for using the UP-A to target internalizing symptoms in adolescents but also highlight the importance of addressing the family system in treatments. Treatment implications and recommendations for clinicians are discussed.","PeriodicalId":508912,"journal":{"name":"Clinical Case Studies","volume":"73 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139861121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment for Anxiety, Depression, and Family Conflict in Adolescence via Telehealth during the COVID-19 Pandemic 在 COVID-19 大流行期间通过远程保健治疗青少年的焦虑、抑郁和家庭冲突

Clinical Case Studies Pub Date : 2024-02-06 DOI: 10.1177/15346501241231830

William C. Kelner, Jennifer B. Bush, L. Elledge

{"title":"Treatment for Anxiety, Depression, and Family Conflict in Adolescence via Telehealth during the COVID-19 Pandemic","authors":"William C. Kelner, Jennifer B. Bush, L. Elledge","doi":"10.1177/15346501241231830","DOIUrl":"https://doi.org/10.1177/15346501241231830","url":null,"abstract":"Anxiety and depression are two of the most common mental health disorders diagnosed in adolescents. While either disorder individually creates impairments in psychological, emotional, and social functioning, these disorders often co-occur and reciprocally influence one another which can lead to continual worsening in functioning over time. Specifically with adolescents, anxiety and depression are associated with interpersonal conflicts with family and friends, which can further contribute to disruptions in functioning. This case study explores the effectiveness of using cognitive behavioral therapy (CBT) with a 14-year-old white male with generalized anxiety disorder (GAD) and persistent depressive disorder (PDD) via telehealth during the COVID-19 pandemic. Treatment was divided into two phases, with the first phase occurring over 20 sessions and the second phase occurring over nine sessions for a total of 29 sessions. In the first phase, the Unified Protocol for Adolescents (UP-A) was flexibly implemented to target emotion regulation, behavioral skills, and cognitive restructuring. The second phase focused on family dynamics and targeted effective communication and collaborative problem-solving. Outcome data showed significant reductions in anxiety symptoms and slight reductions in depressive symptoms as well moderate improvements in peer relationships. These results provide support for using the UP-A to target internalizing symptoms in adolescents but also highlight the importance of addressing the family system in treatments. Treatment implications and recommendations for clinicians are discussed.","PeriodicalId":508912,"journal":{"name":"Clinical Case Studies","volume":"102 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0