世界卫生组织和联合国儿童基金会发布新的心理干预措施以支持青少年及其照顾者

WHO and UNICEF publish new psychological intervention to support adolescents and their caregivers

<WHO - News> December 20， 2023

世界卫生组织 (WHO) 和联合国儿童基金会发布了一项新的心理干预措施——青少年早期情绪技能 (EASE)，以支持受困扰的青少年及其照顾者。

全球有七分之一的青少年患有心理健康问题，但这些问题大多未被发现和治疗。EASE是世卫组织和联合国儿童基金会首个心理干预措施，旨在解决遭受困扰的青少年心理保健严重短缺的问题。

关于EASE

EASE旨在为经历痛苦的10-15岁青少年及其照顾者提供支持。该干预措施解决了一系列内化问题，例如抑郁、焦虑和压力症状。

EASE包括针对青少年的七场小组课程，重点培养应对痛苦的技能，以及针对照顾者的三场小组课程，以促进支持性养育并帮助青少年练习EASE技能。EASE技能改编自认知行为疗法的各个方面，包括心理教育、压力管理、行为激活和问题解决。它在文化和背景上进行了调整，并在四个国家进行了实地测试：约旦、黎巴嫩、巴基斯坦和坦桑尼亚，其中包括在约旦和巴基斯坦进行的两项大型随机对照试验。

EASE可以由经过培训和监督的非专业帮助者提供，这些帮助者接受心理健康专业人员的持续监督。这种任务共享方法已成功应用于成人的类似干预措施中，例如问题管理增强版（PM+），自发布以来已得到广泛实施。

EASE的任务共享方法使其适合在儿童和青少年心理健康专家很少的情况下提供。EASE可以在社区、健康和保护服务等各种环境中提供。

扩大心理干预

过去十年来，世卫组织实施了一项工作规划，旨在支持扩大为受逆境影响的人们提供心理健康和社会心理支持服务。

EASE是世界卫生组织发布的一系列低强度干预措施中的第六种心理干预措施。通过该系列，世卫组织旨在加强非专业人员提供循证干预措施，并改善获得循证心理干预措施的机会。

对青少年进行有效的团体心理帮助

EASE在约旦和巴基斯坦的两项全功效随机对照试验中获得成功。在约旦，471名10-14岁且自我报告痛苦的青少年叙利亚难民参与其中，并被随机分配到干预组 (EASE) 或对照组（照常加强护理）。所有参与者在随机分组前、干预后一周以及三个月后再次完成评估。与随机分配到对照组的青少年相比，随机分配到干预组的青少年在干预后和干预后3个月内出现的内化问题在统计学上显着减少。此外，在三个月的随访中，与对照组相比，EASE干预组的看护者压力和管教养育方式显着改善。在巴基斯坦，566名13-15岁且自我报告痛苦的青少年参加了试验，并被随机分配到干预组 (EASE) 或对照组（候补名单控制）。与约旦的试验一样，所有参与者都在随机分组前以及一周和三个月的随访时完成了评估。预计很快就会以科学文章的形式发表结果。

【英文原文】

The World Health Organization (WHO) and UNICEF have published a new psychological intervention, Early Adolescent Skills for Emotions (EASE), to support adolescents affected by distress and their caregivers.

1 in 7 adolescents globally experience mental health conditions, which mostly go unseen and untreated. EASE is the first WHO-UNICEF psychological intervention to address the critical shortage of mental health care for adolescents experiencing distress.

About EASE

EASE is designed to support adolescents aged 10-15 years old who experience distress and their caregivers. The intervention addresses a range of internalizing problems such as symptoms of depression, anxiety and stress.

EASE includes seven group sessions for adolescents focused on building skills to cope with distress and three group sessions for their caregivers to promote supportive parenting and assist the adolescents in practicing the EASE skills. The EASE skills are adapted from aspects of Cognitive Behavioural Therapy and include psychoeducation, stress management, behavioural activation, and problem solving. It was culturally and contextually adapted and field-tested in four countries: Jordan, Lebanon, Pakistan and Tanzania, which included two large randomized controlled trials in Jordan and Pakistan. 

EASE can be delivered by trained and supervised non-specialist helpers who receive ongoing supervision by mental health professionals. This task-sharing approach has been successfully adopted in similar interventions for adults such as Problem Management Plus (PM+), which has been implemented widely since its release.

EASE’s task-sharing approach makes it suitable for delivery in contexts where there are few child and adolescent mental health specialists. EASE can be delivered in various settings such as the community, health, and protection services. 

Scaling up psychological interventions

Over the past ten years, WHO has implemented a programme of work aiming to support scale up of mental health and psychosocial support services for people affected by adversity.

EASE is the sixth psychological intervention in a series of low-intensity interventions released by WHO. With the series, WHO aims to strengthen delivery of evidence-based interventions by the non-specialist workforce and improve access to evidence-based psychological interventions. 

Effective group psychological help for adolescents

EASE was successfully tested in two fully-powered randomized controlled trials in Jordan and Pakistan. In Jordan, 471 adolescent Syrian refugees aged 10-14 years with self-reported distress participated and were randomized into the intervention arm (EASE) or into the control arm (enhanced care as usual). All participants completed assessments before randomization, one week after the intervention and again 3 months later. Adolescents who were randomized into the intervention arm had statistically significant fewer internalizing problems directly after the intervention and 3 months after the intervention compared to adolescents who were randomized into the control arm. In addition, caregiver distress and disciplinary parenting significantly improved at three-month follow-up in the EASE intervention arm relative to the control arm. In Pakistan, 566 adolescents aged 13-15 years with self-reported distress participated in the trial and were randomized into the intervention arm (EASE) or into the control arm (waitlist control). Like the trial in Jordan, all participants completed assessments before randomization, and at one-week and 3-month follow-up. Publication of the results in a scientific article is expected soon.

（需要英文原版《青少年早期情绪技能 (EASE)》的朋友，请联系微信：iacmsp）