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Trials. 2018 Nov 14;19(1):629. doi: 10.1186/s13063-018-2997-5.

Motivational Interviewing as a tool to enhance access to mental health treatment in adolescents with chronic medical conditions and need for psychological support (COACH-MI): study protocol for a clusterrandomised controlled trial.

Author information

1
Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225, Germany. Christina.reinauer@med.uni-duesseldorf.de.
2
Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225, Germany.
3
Department of Psychology, University of Potsdam, Potsdam, Germany.
4
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
5
Division of Pulmonology and Immunology, Department of Paediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin, Germany.
6
German Rheumatism Research Centre Berlin, Leibniz Institute, Berlin, Germany.
7
Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany.
8
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
9
Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany.

Abstract

BACKGROUND:

This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents' utilisation of psychological health care for symptoms of anxiety or depression.

METHODS/DESIGN:

In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session.

DISCUSSION:

This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents' long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood.

TRIAL REGISTRATION:

German Trials Register (DRKS), DRKS00014043 . Registered on 26 April 2018. Düsseldorf University study ID: 2017114504.

KEYWORDS:

Adolescents; adherence to medical treatment; anxiety; chronic condition; depression; motivational interviewing

PMID:
30428891
PMCID:
PMC6236943
DOI:
10.1186/s13063-018-2997-5
[Indexed for MEDLINE]
Free PMC Article

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