Qualitative Evaluation of Therapeutic Alliance in Adolescent Psychiatry

Completed

• Conditions: School Phobia; Anorexia Nervosa; Depression

• Registration Number: NCT03288649
• Lead Sponsor: Centre Hospitalier Victor Dupouy

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-01-01
• Study First Submitted: 2017-09-13
• Study First Submitted QC: 2017-09-19
• Study First Posted: 2017-09-20
• Primary Completion: 2019-12-31
• Study Completion: 2021-06-30
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-22
• Last Update Posted: 2024-08-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 129

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:

  1. 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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
to describe the facilitators of therapeutic alliance within adolescent psychiatry using a qualitative approach	2 years	qualitative methodology using verbal data analysis of semi-structured interviex

Trial Locations

Locations (2)

CHVictorDupouy; 🇫🇷 Argenteuil, France

CHU Rouen; 🇫🇷 Rouen, France