Qualitative Evaluation of Therapeutic Alliance in Adolescent Psychiatry

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.

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Key information

Conditions

Anorexia Nervosa Anxiety Disorders Behavior Behavioral Symptoms Depression Feeding and Eating Disorders Mental Disorders Phobia, School Phobic Disorders School Phobia

Age range

12 year–18 year

Sex eligibility

All sexes

Study type

Observational

Primary location

CHVictorDupouy, Argenteuil, France

Who can participate

Only the study team can determine whether someone qualifies for participation.

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.

receiving treatment for at least 6 months
one parent at least agrees to participate

Exclusion criteria

acute symptoms and serious somatic and/or psychiatric co-morbidities

Treatment and study plan

Primary outcomes

to describe the facilitators of therapeutic alliance within adolescent psychiatry using a qualitative approach

Time frame: 2 years

qualitative methodology using verbal data analysis of semi-structured interviex

Sponsors and collaborators

Lead sponsor

Centre Hospitalier Victor Dupouy

Other

Registry information

Official study title

Qualitative Evaluation of Therapeutic Alliance in Adolescent Psychiatry: Crossing Perspectives of Adolescents, Parents and Physicians

Acronym: EVAADO

Important dates

Study start: 2016
Primary completion: 2019
Study completion: 2021
First posted: Sep 20, 2017
Registry last updated: Aug 23, 2024

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed