Cognitive-behavioral treatment for antisocial behavior in youth in residential treatment
Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group
Published Online: 17 OCT 2007
Assessed as up-to-date: 14 JUN 2005
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Armelius BÅ, Andreassen TH. Cognitive-behavioral treatment for antisocial behavior in youth in residential treatment. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005650. DOI: 10.1002/14651858.CD005650.pub2.
- Publication Status: Edited (no change to conclusions)
- Published Online: 17 OCT 2007
Cognitive-behavioral therapy (CBT) appears to be effective in the treatment of antisocial behavior both in adolescents and adults. Treatment of antisocial behavior in youth in residential settings is a challenge since it usually involves more serious behavioral problems and takes place in a closed setting. The motivation for change is usually low and there is little possibility to address the maintenance of any behavioral changes following release.
To investigate the effectiveness of CBT in reducing recidivism of adolescents placed in secure or non-secure residential settings. A secondary objective was to see if interventions that focus particularly on criminogenic needs are more effective than those with a more general focus on cognitions and behavior.
We searched a number of databases including: CENTRAL 2005 (Issue 2), MEDLINE 1966 to May 2005, Sociological Abstracts 1963 to May 2005, ERIC 1966 to November 2004, Dissertation Abstracts International 1960s to 2005. We contacted experts in the field concerning current research.
Both randomised controlled trials and studies with non-randomized comparison groups were included. Participants had to be young people aged 12-22 and placed in a residential setting for reasons of antisocial behavior.
Data collection and analysis
Two reviewers independently reviewed 93 titles and abstracts; 35 full-text reports were retrieved and data from 12 trials eligible for inclusion were extracted and entered into RevMan. Results were synthesized using a random effects model, due to the significant heterogeneity across included studies. Results are reported at 6, 12 and 24 months post-treatment, and presented in graphical (forest plots) form. Odds ratios are used throughout and intention-to-treat analyses were made with drop-outs imputed proportionally. Pooled estimates were weighted with inverse variance methods and 95% confidence intervals were used.
The results for 12 months follow-up show that although single studies generally show no significant effects, the results for pooled data are clearly significant in favor of CBT compared to standard treatment with an odds ratio of 0,69. The reduction in recidivism is about 10% on the average. There is no evidence of effects after 6 or 24 months or when CBT is compared to alternative treatments.
CBT seems to be a little more effective than standard treatment for youth in residential settings. The effects appear about one year after release, but there is no evidence of more long-term effects or that CBT is any better than alternative treatments.
Plain language summary
Cognitive-behavioral treatment for antisocial youth in residential care
Results of twelve studies, five RCTs and seven non-RCTs including a control group, conducted in the USA, Canada and Great Britain suggest that Cognitive Behavioral Treatment (CBT) in residential settings is more effective than standard treatment in reducing criminal behavior in adolescents twelve months after release from the institution. The results are consistent across studies although the studies vary in quality. There is no evidence that the results of CBT are better than those of alternative treatments, i.e. treatments other than CBT.
針對接受機構治療 (residential treatemnt) 的青年的反社會行為之認知行為治療 (Cognitivebehavioral therapy, CBT) Armelius BA, Andreassen TH
欲研究對於居住在有保全或無保全系統之機構環境中的青少年，認知行為治療降低重複犯罪行為的效果。次要目的是想看看以致使犯罪需求 (criminogenic needs) 為焦點的介入，是否比更廣泛地以認知和行為為重點的介入還有效。
我們搜尋了以下的資料庫，包括: CENTRAL 2005年第2期, MEDLINE (1966年至2005年5月), Sociological Abstracts (1963年至2005年5月), ERIC (1966年至2004年10月), Dissertation Abstracts International (1960年至2005年) 。我們也和這方面的專家連絡，以了解目前的研究狀況。
2位文獻回顧者分別回顧了93篇文章的題目和摘要。其中挑選出35篇全文報告，並將其中符合收納條件的12篇研究的數據輸入RevMan分析。因為收納的研究的高異質性，結果以隨機效果模式進行統整。在停止治療後的第6,12,和24個月之後報告結果並以森林圖 (forest plots) 呈現。整個過程皆以勝算比 (Odds ratio) 來計算，另外也計算治療意願分析 (intentiontotreat analyses) ，以中途退出狀況來作比例歸因。綜合的估計數據以變異數倒數的方法來計算加權比重，並計算95% 信賴區間。
此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。