Transdiagnostic Approach to Mental Illness Effective in Teen
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Behavioral therapy and cognitive-behavioral therapy (CBT) programs targeting a single class of problems have not been widely implemented. The population of youths with common mental health problems is markedly undertreated.

A Study was conducted to determine the effectiveness of a new transdiagnostic CBT program (Mind My Mind [MMM]) compared with management as usual (MAU) in youths with emotional and behavioral problems below the threshold for referral to mental health care.

This pragmatic, multisite, randomized clinical trial of MMM vs MAU was conducted including 8 weeks of postintervention follow-up. Consecutive help-seeking youths were randomized (1:1) to the MMM or the MAU group. Main inclusion criteria were: patients with age 6 to 16 years and anxiety, depressive symptoms, and/or behavioral disturbances as a primary problem.

The MMM intervention consisted of 9 to 13 weekly, individually adapted sessions of manualized CBT delivered by local psychologists. The MAU group received 2 care coordination visits to enhance usual care.

The primary outcome was change in mental health problems reported by parents at week 18, using the Strengths and Difficulties Questionnaire (SDQ) Impact scale (range,0-10 points, with higher scores indicating greater severity of distress and impairment). Primary and secondary outcomes were assessed in the intention-to-treat population at week 18. Maintenance effects were assessed at week 26.

A total of 396 youths were randomized to MMM (n=197) or MAU (n=199), with primary outcome data available in 177 and 167, respectively at 18 weeks.
--The SDQ Impact score decreased by 2.34 points with MMM and 1.23 with MAU, from initial scores of 4.12 and 4.21, respectively.
--Number of responders was greater with MMM than with MAU (144 of 197 vs 93 of 199; number needed to treat,4.
--Secondary outcomes indicated statistically significant benefits in parent-reported changes of anxiety, depressive symptoms, daily functioning, school attendance, and the principal problem. All benefits were maintained at week 26 except for school attendance.

Conclusively, in this randomized clinical trial, the scalable transdiagnostic cognitive-behavioral intervention MMM outperformed MAU in a community setting on multiple, clinically relevant domains in youth with emotional and behavioral problems.