Asian journal of psychiatry · 2026
Efficacy of dual-track group CBT on emotion-related school attendance challenges and parent-adolescent perceptual bias among Chinese adolescents with depression: A non-randomized controlled trial.
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Xu Hao, Wang Yanping, Wang Yunhui, Li Jiuju, Xu Jiahua, Tan Shuping
Аннотация
BACKGROUND: Interventions addressing emotion-related school attendance challenges in adolescents with depression often face limited efficacy, partly due to parent-adolescent perceptual biases. The effectiveness of dual-track family interventions remains underexplored. This study evaluated the preliminary clinical effectiveness of a dual-track parent-adolescent group cognitive behavioral therapy (GCBT) program and explored parent-adolescent perceptual bias as a potential process marker.
METHODS: This quasi-experimental study included 71 adolescents with depression and school refusal. Participants were allocated to an 8-week dual-track GCBT (n = 39; adolescent offline and parent online sessions) or treatment-as-usual (TAU; n = 32). The primary outcome was family-reported school-return status at week 8. Secondary outcomes included cross-informant clinical symptoms. Exploratory process analyses involved longitudinal trajectories of parent-adolescent emotional perceptual biases within the GCBT group.
RESULTS: At week 8, the proportion of adolescents attending school increased from 16.7% to 66.7% in the GCBT group, compared with 46.9-50.0% in the TAU group (GEE group × time interaction: β = 2.06, P = .001). For secondary outcomes, parent-reported SDQ total difficulties and emotional symptoms showed significantly greater improvements after FDR correction (adjusted P = .002 and.003, respectively), whereas adolescent-reported PHQ-9 and GAD-7 showed non-significant improvement trends after FDR correction (adjusted P = .085 and.084, respectively). Exploratory within-intervention process analyses showed a reduction in parental positive bias over the 8-week program, with parent-adolescent perceptual bias decreasing at an average rate of 3.2 points per week (P = .02).
CONCLUSIONS: The scalable dual-track GCBT model demonstrated preliminary effectiveness improving family-reported school-return status among adolescents with depression and school refusal. Exploratory within-intervention process analyses suggested that reductions in parental cognitive misjudgments and parent-adolescent perceptual discrepancies may represent potential therapeutic process markers, offering a practical approach for real-world clinical settings.
METHODS: This quasi-experimental study included 71 adolescents with depression and school refusal. Participants were allocated to an 8-week dual-track GCBT (n = 39; adolescent offline and parent online sessions) or treatment-as-usual (TAU; n = 32). The primary outcome was family-reported school-return status at week 8. Secondary outcomes included cross-informant clinical symptoms. Exploratory process analyses involved longitudinal trajectories of parent-adolescent emotional perceptual biases within the GCBT group.
RESULTS: At week 8, the proportion of adolescents attending school increased from 16.7% to 66.7% in the GCBT group, compared with 46.9-50.0% in the TAU group (GEE group × time interaction: β = 2.06, P = .001). For secondary outcomes, parent-reported SDQ total difficulties and emotional symptoms showed significantly greater improvements after FDR correction (adjusted P = .002 and.003, respectively), whereas adolescent-reported PHQ-9 and GAD-7 showed non-significant improvement trends after FDR correction (adjusted P = .085 and.084, respectively). Exploratory within-intervention process analyses showed a reduction in parental positive bias over the 8-week program, with parent-adolescent perceptual bias decreasing at an average rate of 3.2 points per week (P = .02).
CONCLUSIONS: The scalable dual-track GCBT model demonstrated preliminary effectiveness improving family-reported school-return status among adolescents with depression and school refusal. Exploratory within-intervention process analyses suggested that reductions in parental cognitive misjudgments and parent-adolescent perceptual discrepancies may represent potential therapeutic process markers, offering a practical approach for real-world clinical settings.