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CompletedNCT03459677B2SUpdated Mar 15, 2023

Back2School - CBT Intervention for School Absenteeism

An interventional study of Back2School and Treatment As Usual in Anxiety Symptoms, Depressive Symptoms and Behavioral Problem, sponsored by University of Aarhus. Completed at 1 site in Denmark. Open to participants aged 7 Years to 18 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-03-15.

Sponsored by University of Aarhus · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
155
Allocation
Randomized
Ages
7 Years to 18 Years
Sex
All
01

Study summary

The main objective of this study is to examine the efficacy of a new psychological intervention, called Back2School, in helping youths with problematic school absenteeism to return to school. Furthermore, the study will examine how well this program fares against the treatment or interventions that are usually given to youths with school absenteeism (treatment as usual or TAU).

Based on previous studies we hypothesize that the Back2School intervention will be better at improving levels of school attendance as compared with treatment as usual (TAU).

Read the detailed description

Primary objective The main objective of this study is to examine the efficacy on school attendance and wellbeing of a modular trans-diagnostic CBT intervention for youths with problematic school absenteeism in a randomized controlled trial. Based on previous studies we hypothesize that the B2S intervention will show a significant difference in impact for school attendance, in favor of Back2School intervention as compared with TAU

Trial design The study is a randomized controlled superiority trial (RCT) that compares a modular trans-diagnostic CBT intervention (Back2School), treating school absenteeism in youths aged 7-17 years with treatment as usual (TAU). The design will follow a two (Back2School and TAU) by four (Time: pre, post, 3-month, and 1-year assessment) mixed between-within design.

The study is a collaboration project between Aarhus University and Aarhus Municipality, Denmark. The setting for both the B2S and TAU interventions are within Aarhus municipality. The Back2School intervention is organized and conducted by the University Clinic, at Aarhus University. Treatment as usual interventions are organized and conducted by Aarhus Municipality.

There are considerable negative long-term consequences related to youths with school absenteeism. If the B2S intervention proves to be effective in reducing school absenteeism, it could be implemented in other municipalities in Denmark, and help to systematically treat and help youths with school absenteeism. This could possibly reduce both personal and societal costs significantly

02

Conditions studied

  • Anxiety Symptoms
  • Depressive Symptoms
  • Behavioral Problem
  • School Absenteeism

Keywords

  • School Refusal
  • Truancy
  • School Absenteeism
  • Anxiety
  • Depression
  • Behavioral problems
  • CBT
03

Who can participate

Ages eligible
7 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria:

  • Youths are enrolled in a public school within the municipality of Aarhus.
  • Aged 7-18 years and in 0-9th grade (excluding second semester of the 9th grade).
  • Report more than 10% absenteeism during the last 3 months of school (excluding legal absence, e.g. permitted extra holidays).
  • The youth and at least one of the two parents understand and speak Danish sufficiently to participate in treatment and complete questionnaires.
  • At least one of the parents is motivated for working on increasing the youths' school attendance.
  • The participating families are willing to participate in assessment, intervention procedures, and acceptance of random assignment to intervention.
  • Written informed consent from the holders of the parental rights and responsibilities (usually both parents).
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
155 participants (actual)

Study arms

  • Experimental
    Back2School Condition

    The Back2School condition is a Modular Trans-Diagnostic Cognitive Behavioral Therapy (MTCBT) treating school absenteeism in youths. The MTCBT intervention consist of 10 sessions and 4 school meetings, conducted over a period of 4 months.

    Behavioral: Back2School

  • Active comparator
    Treatment As Usual Condition

    The Treatment As Usual condition (TAU) consist of an array of interventions that the municipality is required to give youths presenting school absenteeism. The TAU condition will last for 4 months.

    Other: Treatment As Usual

Interventions

  • BehavioralBack2School

    Modular Trans-diagnostic Cognitive Behavioral Therapy treating school absenteeism in youths

    Also known as: B2S

  • OtherTreatment As Usual

    Aarhus municipality's treatment as usual for youths presenting school absenteeism

    Also known as: TAU

05

What researchers measure

Primary outcomes

  1. Change in School Attendance - Registry data

    Aarhus Municipality's registry data of the youths' school attendance

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  2. Change in School Attendance - Self-reported data

    Self-reported school attendance in the previous two weeks, reported by parents.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

Secondary outcomes

  1. The Strength and Difficulties Questionnaire (SDQ)

    The SDQ measures psychopathology in youths (3-16 years). There is a SDQ version for youths (SDQ), parents (SDQ-P), and teachers (SDQ-T). The different versions consist of the same items, and are scored identically. Total of 25 items, rated on a 3-point scale (0-2), divided into 5 sub-scales consisting of 5 items. Sub-scales: Emotional symptoms, Conduct problems, Hyperactivity/inattention, Peer relationships problems, Pro-social behavior For each sub-scale, minimum score is 0 and maximum total score is 10 The total score is computed by summing up the sub-scales, with the exception of the "pro-social behavior" sub-scale. Minimum total score is 0, and maximum total score is 40. The extended version of the SDQ includes an impact scale with additional 8 items, regarding child distress and interference. The Impact scale is scored on a 4-point scale (0-3). The impact scale is summed up by counting only scores of 2 or 3. Minimum score 0, and maximum score 24.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  2. The Spence Children's Anxiety Scale (SCAS)

    Self-report rating scale assessing youths symptoms of anxiety, rated by youths (SCAS) and parents (SCAS-P). Total of 38 items, rated on a 4-point scale (0-3), divided into 6 sub-scales. The SCAS includes 6 positive filler items not included in the computation of sub-scores or total score. Sub-scales: Social Phobia (6 items), Panic disorder and agoraphobia (9 items), Generalized anxiety disorder (6 items, range 0-18), Obsessive-compulsive disorder (6 items, range 0-18), separation anxiety disorder (6 items, range 0-18), Fear of physical injury (5 items, , range 0-15). Minimum total score is 0, and maximum total score is 114. The SCAS-P is identical to the SCAS in form an scoring, but does not include the 6 positive filler items.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  3. The Mood and Feelings Questionnaire (MFQ)

    Covers a broad range of cognitive and vegetative symptoms of depression in youths. There is both a youth (MFQ) and parent (MFQ-P) version of the MFQ. The MFQ consistTotal of 33 items, rated on a 3-point scale (0-2). The MFQ-P consist of 34 items. Both the scores for MFQ and MFQ-P are computed by summing up all items. Higher scores indicating more sever depressive symptoms. Minimum MFQ score is 0, maximum score is 66. Minimum MFQ-P score is 0, maximum score is 68.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  4. The Child Health Utility 9D Index (CHU-9D)

    Designed to determine how health affect youths's lives, rated by youths. Consist of 9 items, rated on a 5-point scale. Each item is related to a dimension to how the youths are feeling worried, sad, pain, tired, annoyed, schoolwork/ homework, sleep, daily routine, and participating in activities. Higher scores for each item is related to a higher perceived difficulty related to a dimension. Each dimension/item has a minimum score of 1, and a maximum score of 5.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  5. The Self-efficacy Questionnaire for School Situations (SEQ-SS)

    Measures self-efficacy expectations to different school situations, rated by youths. Consist of 12 items, rated on a 5-point scale (1-5), and divided into 2 sub-scales both consisting of 6 items. Minimum SEQ-SS score is 12, maximum score is 60. Higher scores reflect greater self-efficacy expectations.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  6. Self-Efficacy Questionnaire for Responding to School Attendance Problems (SEQ-RSAP)

    Measures parents self-efficacy expectations to different school situations, rated by parents. Consist of 13 items, rated on a 4-point scale (1-4). Minimum score is 13, and maximum score is 52. Higher scores reflect greater self-efficacy expectations in parents ability to help their child in different school situations.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

  7. The Family Assessment Device (FAD)

    Assess different dimensions of family function, rated by youths (12 years and older) and parents. Only the sub-scale regarding General Function is used in this study. The sub-scale consist of 12 items, rated on a 4 point-scale (1-4). The FAD is scored by calculating the mean scores of all items. Higher means are related to a more unhealthy or non-functional family function.

    Time frame: Baseline, post-treatment (4-months), 3-months follow-up, 12-months follow-up

Other outcomes

  1. The Experience of Service Questionnaire (ESQ)

    Assess the satisfaction with the treatment, rated by youths and parents. The treatment satisfaction for the youths consist of 7 items rated on a 3 point-scale (0-2), with 1 open question. Treatment satisfaction for parents is assessed using 10 items, rated on a 3-point-scale (0-2), with 3 open questions. Higher scores is associated with

    Time frame: Post-treatment (4-months), 3-months follow-up.

  2. Collaboration with the school

    Assess the collaboration between the family and the school/teacher. Consist of 3 items rated on a 4-point scale (1-4). Higher scores are related to a good relationship and collaboration with the school. Both parents and teachers respond to this questionnaire.

    Time frame: Post-treatment (4-months), 3-months follow-up, 12-months follow-up

06

Study locations

1 site
  • Aarhus University, Department of Psychology and Behavioural Sciences
    Århus, 8000, Denmark
07

References and documents

Publications

  • Johnsen DB, Lomholt JJ, Heyne D, Jeppesen P, Jensen MB, Silverman WK, Thastum M. Sociodemographic and clinical characteristics of youths and parents seeking psychological treatment for school attendance problems. PLoS One. 2022 Jan 26;17(1):e0261449. doi: 10.1371/journal.pone.0261449. eCollection 2022. PubMed 35081106 ↗
  • Thastum M, Johnsen DB, Silverman WK, Jeppesen P, Heyne DA, Lomholt JJ. The Back2School modular cognitive behavioral intervention for youths with problematic school absenteeism: study protocol for a randomized controlled trial. Trials. 2019 Jan 8;20(1):29. doi: 10.1186/s13063-018-3124-3. PubMed 30621787 ↗
08

Registry details

Key details

Study ID
NCT03459677
Lead sponsor
University of Aarhus
Collaborators
Aarhus County, Denmark, Innovation Fund Denmark, The Danish Mental Health Foundation, TRYG Foundation
Responsible party
Sponsor
First posted
Mar 9, 2018
Start date
Aug 25, 2017
Primary completion
Dec 1, 2020
Completion
Dec 1, 2020
Last update
Mar 15, 2023

Study contacts

Mikael Thastum, Professor
principal investigator · Aarhus University, Department of Psychology and Behavioural Sciences
Johanne L Jeppesen, PhD
study director · Aarhus University, Department of Psychology and Behavioural Sciences
Daniel B Johnsen, PhD Fellow
study director · Aarhus University, Department of Psychology and Behavioural Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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