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Berskjöldun fyrir börn með kvíðaraskanir: Könnun meðal íslenskra sálfræðinga um notkun berskjöldunar í meðhöndlun kvíðaraskana hjá börnum og unglingum

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Authors
Ástrós Elma Sigmarsdóttir
Hrafnkatla Agnarsdóttir
Aron Eydal Sigurðarson
Sindri Lárusson
Guðmundur Skarphéðinsson
Issue Date
2019

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Other Titles
Exposure Therapy Practices for Pediatric Anxiety Disorder: A survey of Icelandic clinical psychologists treating youth with anxiety disorders
Citation
Ástrós Elma Sigmarsdóttir, Hrafnkatla Agnarsdóttir, Aron Eydal Sigurðarson et al. Berskjöldun fyrir börn með kvíðaraskanir: Könnun meðal íslenskra sálfræðinga um notkun berskjöldunar í meðhöndlun kvíðaraskana hjá börnum og unglingum. Sálfræðiritið. 2019;24: 73-83.
Abstract
Berskjöldun (exposure) er gagnreynd aðferð til að draga úr hamlandi kvíða hjá börnum með kvíðaraskanir og hafa rannsóknir sýnt að hún sé áhrifaríkasti hluti hugrænnar atferlismeðferðar. Bandarískar rannsóknir benda til þess að berskjöldun sé vannýtt á klínískum vettvangi en staðan innan Evrópu er enn óljós. Tilgangur rannsóknarinnar var að kortleggja stöðu íslenskra sálfræðinga í notkun berskjöldunar við kvíðaröskunum barna (almennri kvíðaröskun, aðskilnaðarkvíða og félagskvíða). Önnur markmið rannsóknarinnar voru að meta viðhorf meðferðaraðila til berskjöldunar, þjálfun þeirra í beitingu aðferðarinnar og val á aðferðum í meðferð. Allir sálfræðingar innan Sálfræðingafélags Íslands fengu sendan spurningalista og til að geta tekið þátt þurfti viðkomandi að hafa meðhöndlað að minnsta kosti eitt barn á aldrinum fimm til 17 ára með kvíðaröskun sem aðalröskun á síðastliðnum 12 mánuðum. Samtals svöruðu 50 félagsmenn könnuninni. Í ljós kom að flestir þátttakendur voru með meistaragráðu og flestir unnu á heilsugæslustöð, Barnaog unglingageðdeild eða á einkarekinni stofu. Niðurstöður sýndu að langflestir nota HAM og berskjöldun (94%) til þess að meðhöndla börn og unglinga með kvíðaröskun. Einnig voru viðhorf gagnvart aðferðinni að öllu jöfnu jákvæð. Þrátt fyrir það virðist skorta þjálfun og innleiðingu á aðferðinni. Í samanburði við Bandaríkin virðist Ísland standa ágætlega hvað varðar notkun á berskjöldun þó svo að gæði aðferðinnar í meðferð séu óljós. Í framhaldi af þessari rannsókn væri gagnlegt að rannsaka meðferðarfylgni meðferðaraðila í því skyni að fá betri innsýn í það hvort verið sé að veita börnum á Íslandi meðferðarúrræði sem skilar árangri.
Exposure is an evidence-based method and previous studies have shown that it is the most effective part of cognitive behavior therapy (CBT) for children with anxiety disorders. Research within the US suggests that exposure-based treatment is still underutilized in clinical practice while data on use of exposure in Europe is still unclear. The aim of this study was to examine the use of exposure amongst psychologists in Iceland while treating children with anxiety disorders (general anxiety disorder, separation anxiety, social anxiety). Attitude towards exposure, training, and the use of exposure-based methods were considered. An Internet-based survey was sent via email to all members of the Icelandic Psychological Association. Criteria for participation was to have treated at least one child aged 5-17 with an anxiety disorder in the last 12 months. Fifty members answered the questionnaire. Most of respondents have a master‘s degree and were working at a health clinic, the Child and Adolescent psychiatric department or a private practice. The results suggest that exposure-based therapy is widely used among children and adolescents (94%) and attitude towards exposure is mainly positive. However, it seems that exposure-based training is lacking as many of the psychologist reported that they did not receive appropriate training. Compared to US studies, exposure-based treatment in Iceland seems to be accepted and widely used. In light of these results, further research is needed to better understand treatment quality and fidelity.
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Icelandic Journal Articles (Peer Reviewed)

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