First months of psychotherapy are most effective in treatment of adolescents

University of Helsinki

The first six months are crucial to the success of psychotherapeutic interventions for adolescents. According to a recently completed doctoral thesis, the frequency of intervention should be high at the initial stages of treatment.

According to Vera Gergov’s doctoral thesis, the prognosis for psychotherapeutic interventions is good if the adolescent considers their relationship with their therapist to function well. (Image: Veikko Somerpuro)

Psychotherapeutic interventions are effective in treating adolescents with mental disorders. They reduce the psychological symptoms of adolescents and improve their functioning. The biggest change occurs in the first six months of treatment. The more frequently the patient and the therapist meet, the more likely that improvement is seen in the adolescent’s psychological well-being and functioning. This is demonstrated by a doctoral thesis in the field of psychology by Vera Gergov, Licentiate of Psychology.

In addition to psychotherapy, psychotherapeutic interventions refer to forms of therapy that include functional elements, such as music, art and riding therapy as well as psychiatric occupational therapy.

In her doctoral thesis, Gergov assessed the psychological symptoms and functioning of patients between 13 and 15 years of age with a range of self-assessment measures before beginning therapy. A total of 58 adolescents took part in the study. Assessments were repeated three, six and 12 months after the beginning of treatment. The adolescents also completed self-assessments pertaining their own expectations and the therapeutic alliance. Therapists also assessed the alliance.

Externalizing symptoms and treatment expectations predicted premature termination of treatment

According to the doctoral thesis, the prognosis for the intervention was good if the adolescent considered their relationship with the therapist to function well.

Gergov also investigated which factors contributed to the premature termination of treatment. The greatest risk of discontinuation was among adolescents with behavioural problems or hyperactivity and attention-associated challenges, as well as low expectations for their own active role in the intervention. The risk of premature termination was also high in the case of adolescents who felt that the therapeutic alliance was weak or weakened during the treatment.

According to Gergov, it is important for therapists to be aware of the potential behavioural symptoms in adolescents and their expectations for treatment.

“Therapy should focus on strengthening the active role of adolescents during therapy. This increases their commitment to psychotherapy and helps them benefit from it.”

An effectiveness measure for the treatment of adolescents

As part of her doctoral thesis, Gergov translated the YP-CORE treatment outcome measure targeted at adolescents from English into Finnish, investigating the feasibility of the measure in a dataset comprising 104 adolescents. The measure proved to be suitable for assessing the effectiveness psychotherapeutic interventions for adolescents.

“In Finland, assessment methods developed specifically for young people are needed, as measures targeted at adults are currently usually used in the assessment of treatment. They are not necessarily suited to adolescents that well,” Gergov says.

According to Gergov, the effectiveness of psychotherapeutic interventions for adolescents should be investigated regularly to increase the knowledge on the topic. Predictors related to the effectiveness of treatment should also be further examined to be able to make more personalised treatment recommendations.

“Future studies should consider young people’s experiences of treatment and its benefits. To make treatments increasingly effective, it’s also important to take into consideration the reasons for the premature termination of treatment.”

Public examination

Vera Gergov, Licentiate of Psychology, will defend her doctoral thesis entitled ‘Psychotherapeutic Interventions for Adolescents With Mental Disorders: Effectiveness and Predictors of Treatment Outcome’ on Friday, 2 December 2022 at 13.00 at the Faculty of Medicine, University of Helsinki. The public examination will take place on the City Centre Campus (room 132 of the Psychologicum building, Siltavuorenpenger 1). Henrik Enckell will serve as the opponent and Jari Lahti as the custos.

The doctoral thesis is already available online in the Helda repository.

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