The purpose of this study is to examine various behavioral, social, and emotional changes that result from engaging in an OBH and CBT treatment program designed for adolescents.
After being informed about the study and potential risks, all study participants, including minors and parent/guardians, giving written informed consent will complete a screening survey. The screening survey will support research staff in determining whether participants meet the inclusionary and exclusionary data, including meeting scores on the Youth Outcome Questionnaire and the Revised Children's Anxiety and Depression Scale. If participants are eligible based on preliminary criteria, they undergo a screening interview. If participants are eligible following the screening interview and complete a second informed consent, minors and parents/guardians, they will be randomized in a partially-blind, parallel-group study conducted in the United States (7 Outdoor Behavioral Healthcare programs and up to 42 CBT-licensed therapists).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
10
Participants in this intervention will participate in one of 7 programs that have been accredited by the Outdoor Behavioral Healthcare Council that specializes in 13-17 year old adolescents experiencing behavioral healthcare issues. Each program works in a unique wilderness setting in various United States National Forests and Parks (e.g., Washington, Oregon, New Mexico, Wisconsin, Utah). The average length of stay in an OBH wilderness program is 90 days, which is a total standard care time of 1,056 hours. All of the OBH programs have been accredited by the Association for Experiential Education Accreditation for Outdoor Behavioral Healthcare programs.
The 12-week treatment period will consist of 15 90-minute sessions that will be administered individually. Homework (including reading assignments) are given to encourage your child to practice the techniques learned during the weekly sessions. The total standard of care time for CBT is 22.5 hours of direct treatment hours not including time spent on homework over these twelve weeks. Those therapists that are selected to deliver treatment for the CBT group will be certified by a nationally recognized CBT organization and licensed to work as a therapist in the state where they are providing treatment. Therapy will be delivered in an outpatient setting or through Telehealth.
University of New Hampshire
Durham, New Hampshire, United States
Change from Baseline in statistical and clinical measures on the Youth Outcomes Questionnaire Self-Report (YoQ-SR) at Week 12
The Y-OQ 2.0 has both a parent report global measure of adolescent functioning and an adolescent self-report measure (Y-OQ SR). Both surveys are designed to measure treatment progress for children and adolescents receiving psychological treatment from a parent or caregiver's perspective. Clinical significance is measured by (1) a gain in seven or more points during the clinical trials or (2) a score under 47. The instrument measures overall youth participant functioning that includes six subscales: (a) Intrapersonal Distress, (b) Somatic Symptoms, (c) Interpersonal Relationships, (d) Social Problems, (e) Behavioral Dysfunction, and (f) Critical Items. It is a 64-item parent/guardian report survey designed to assess youth aged 4 to 17 years (Burlingame et al., 2001). Scores for the YoQ-SR range from -16 to +240. The clinical cut-off score is 46. 47 or above represents clinically acute needs.
Time frame: Baseline and Week 12
Change from Baseline in statistical and clinical measures on the Revised Child Anxiety and Depression Scale (RCADS) at Week 12
The Revised Child Anxiety and Depression Scale (RCADS) is a 47-item, youth self-report survey with subscales including: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and low mood (major depressive disorder). It also yields a Total Anxiety Scale (sum of the 5 anxiety subscales) and a Total Internalizing Scale (sum of all 6 subscales). Additionally, The Revised Child Anxiety and Depression Scale - Parent Version (RCADS-P) similarly assesses parent report of youth's symptoms of anxiety and depression across the same six subscales. Scores for the RCADS range from 0 to 141 (47 items on a Likert scale from 0-3). Higher scores signify a worse outcome.
Time frame: Baseline and Week 12
Change from Baseline in statistical and clinical measures on the Family Assessment Device (FAD) at Week 12
The Family Assessment Device (FAD) is a self-report measure that adolescents complete the 10 times (baseline, admission, 5 times during treatment, discharge, 6-months and 12-months post-discharge) and parents complete 5 times (baseline, admission, discharge, 6-months and 12-months post-discharge). The measure consists of seven scales including a General Functioning scale which incorporates items from each of the other scales. The remaining six scales assess the six dimensions of the McMaster Model of Family Functioning which include: (1) Problem Solving, (2) Communication, (3) Roles, (4) Affective Responsiveness, (5) Affective Involvement, and (6) Behavior Control. The FAD has 12 questions scored on a Likert scale from 1-4, resulting in a range of scores from 12 to 48. Higher scores indicate a worse outcome. The clinical cut-off score is 2.0. Scores below 2.0 are normal and scores above 2.0 are clinical.
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Time frame: Baseline and Week 12
Change from Baseline in statistical and clinical measures on the Adolescent Alcohol Relapse Coping Questionnaire (ARCQ) at Week 12
The ARCQ is a measure designed to assess temptation coping responses among adolescents with a history of alcohol and drug abuse. The instrument has three factors that represent coping strategies that adolescents utilize when placed in situations that require resisting substance use: (1) cognitive and behavioral problem-solving strategies, (2) self-critical thinking items, \& (3) abstinence focused cognitive and behavioral coping items that focus on situational demands of a temptation and the negative consequences of alcohol and drug use. The Adolescent Relapse Coping Questionnaire (ARCQ) has a range of scores from 34 to 250. Higher scores indicate stronger endorsement of the particular construct measured.
Time frame: Baseline and Week 12
Change from Baseline in statistical and clinical measures on the Youth Outcomes Questionnaire Self-Report (YoQ-SR) at Week 36
The Y-OQ 2.0 has both a parent report global measure of adolescent functioning and an adolescent self-report measure (Y-OQ SR). Both surveys are designed to measure treatment progress for children and adolescents receiving psychological treatment from a parent or caregiver's perspective. Clinical significance is measured by (1) a gain in seven or more points during the clinical trials or (2) a score under 47. The instrument measures overall youth participant functioning that includes six subscales: (a) Intrapersonal Distress, (b) Somatic Symptoms, (c) Interpersonal Relationships, (d) Social Problems, (e) Behavioral Dysfunction, and (f) Critical Items. It is a 64-item parent/guardian report survey designed to assess youth aged 4 to 17 years (Burlingame et al., 2001). Scores for the YoQ-SR range from -16 to +240. The clinical cut-off score is 46. 47 or above represents clinically acute needs.
Time frame: Baseline and Week 36
Change from Baseline in statistical and clinical measures on the Youth Outcomes Questionnaire Self-Report (YoQ-SR) at Week 60
The Y-OQ 2.0 has both a parent report global measure of adolescent functioning and an adolescent self-report measure (Y-OQ SR). Both surveys are designed to measure treatment progress for children and adolescents receiving psychological treatment from a parent or caregiver's perspective. Clinical significance is measured by (1) a gain in seven or more points during the clinical trials or (2) a score under 47. The instrument measures overall youth participant functioning that includes six subscales: (a) Intrapersonal Distress, (b) Somatic Symptoms, (c) Interpersonal Relationships, (d) Social Problems, (e) Behavioral Dysfunction, and (f) Critical Items. It is a 64-item parent/guardian report survey designed to assess youth aged 4 to 17 years (Burlingame et al., 2001). Scores for the YoQ-SR range from -16 to +240. The clinical cut-off score is 46. 47 or above represents clinically acute needs.
Time frame: Baseline and Week 60
Change from Baseline in statistical and clinical measures on the Revised Child Anxiety and Depression Scale (RCADS) at Week 36
The Revised Child Anxiety and Depression Scale (RCADS) is a 47-item, youth self-report survey with subscales including: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and low mood (major depressive disorder). It also yields a Total Anxiety Scale (sum of the 5 anxiety subscales) and a Total Internalizing Scale (sum of all 6 subscales). Additionally, The Revised Child Anxiety and Depression Scale - Parent Version (RCADS-P) similarly assesses parent report of youth's symptoms of anxiety and depression across the same six subscales. Scores for the RCADS range from 0 to 141 (47 items on a Likert scale from 0-3). Higher scores signify a worse outcome.
Time frame: Baseline and Week 36
Change from Baseline in statistical and clinical measures on the Revised Child Anxiety and Depression Scale (RCADS) at Week 60
The Revised Child Anxiety and Depression Scale (RCADS) is a 47-item, youth self-report survey with subscales including: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and low mood (major depressive disorder). It also yields a Total Anxiety Scale (sum of the 5 anxiety subscales) and a Total Internalizing Scale (sum of all 6 subscales). Additionally, The Revised Child Anxiety and Depression Scale - Parent Version (RCADS-P) similarly assesses parent report of youth's symptoms of anxiety and depression across the same six subscales. Scores for the RCADS range from 0 to 141 (47 items on a Likert scale from 0-3). Higher scores signify a worse outcome.
Time frame: Baseline and Week 60
Change from Baseline in statistical and clinical measures on the Family Assessment Device (FAD) at Week 36
The Family Assessment Device (FAD) is a self-report measure that adolescents complete the 10 times (baseline, admission, 5 times during treatment, discharge, 6-months and 12-months post-discharge) and parents complete 5 times (baseline, admission, discharge, 6-months and 12-months post-discharge). The measure consists of seven scales including a General Functioning scale which incorporates items from each of the other scales. The remaining six scales assess the six dimensions of the McMaster Model of Family Functioning which include: (1) Problem Solving, (2) Communication, (3) Roles, (4) Affective Responsiveness, (5) Affective Involvement, and (6) Behavior Control. The FAD has 12 questions scored on a Likert scale from 1-4, resulting in a range of scores from 12 to 48. Higher scores indicate a worse outcome. The clinical cut-off score is 2.0. Scores below 2.0 are normal and scores above 2.0 are clinical.
Time frame: Baseline and Week 36
Change from Baseline in statistical and clinical measures on the Family Assessment Device (FAD) at Week 60
The Family Assessment Device (FAD) is a self-report measure that adolescents complete the 10 times (baseline, admission, 5 times during treatment, discharge, 6-months and 12-months post-discharge) and parents complete 5 times (baseline, admission, discharge, 6-months and 12-months post-discharge). The measure consists of seven scales including a General Functioning scale which incorporates items from each of the other scales. The remaining six scales assess the six dimensions of the McMaster Model of Family Functioning which include: (1) Problem Solving, (2) Communication, (3) Roles, (4) Affective Responsiveness, (5) Affective Involvement, and (6) Behavior Control. The FAD has 12 questions scored on a Likert scale from 1-4, resulting in a range of scores from 12 to 48. Higher scores indicate a worse outcome. The clinical cut-off score is 2.0. Scores below 2.0 are normal and scores above 2.0 are clinical.
Time frame: Baseline and Week 60
Change from Baseline in statistical and clinical measures on the Adolescent Alcohol Relapse Coping Questionnaire (ARCQ) at Week 36
The ARCQ is a measure designed to assess temptation coping responses among adolescents with a history of alcohol and drug abuse. The instrument has three factors that represent coping strategies that adolescents utilize when placed in situations that require resisting substance use: (1) cognitive and behavioral problem-solving strategies, (2) self-critical thinking items, \& (3) abstinence focused cognitive and behavioral coping items that focus on situational demands of a temptation and the negative consequences of alcohol and drug use. The Adolescent Relapse Coping Questionnaire (ARCQ) has a range of scores from 34 to 250. Higher scores indicate stronger endorsement of the particular construct measured.
Time frame: Baseline and Week 36
Change from Baseline in statistical and clinical measures on the Adolescent Alcohol Relapse Coping Questionnaire (ARCQ) at Week 60
The ARCQ is a measure designed to assess temptation coping responses among adolescents with a history of alcohol and drug abuse. The instrument has three factors that represent coping strategies that adolescents utilize when placed in situations that require resisting substance use: (1) cognitive and behavioral problem-solving strategies, (2) self-critical thinking items, \& (3) abstinence focused cognitive and behavioral coping items that focus on situational demands of a temptation and the negative consequences of alcohol and drug use. The Adolescent Relapse Coping Questionnaire (ARCQ) has a range of scores from 34 to 250. Higher scores indicate stronger endorsement of the particular construct measured.
Time frame: Baseline and Week 60