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Behav Res Ther. 2014 Sep;60:60-6. doi: 10.1016/j.brat.2014.06.010. Epub 2014 Jul 11.

Feasibility of two modes of treatment delivery for child anxiety in primary care.

Author information

1
University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA; University of California San Diego, Department of Psychiatry, La Jolla, CA, USA. Electronic address: dchavira@psych.ucla.edu.
2
San Diego State University, Department of Psychology, San Diego, CA, USA.
3
University of San Diego, Department of School, Family, and Mental Health Professions, San Diego, CA, USA.
4
University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.

Abstract

In this study, we examine the feasibility of cognitive behavior therapy (CBT) for children with anxiety in primary care, using two modes of treatment delivery. A total of 48 parents and youth (8-13) with anxiety disorders were randomly assigned to receive 10-sessions of CBT either delivered by a child anxiety specialist in the primary care clinic or implemented by the parent with therapist support by telephone (i.e., face-to-face or therapist-supported bibliotherapy). Feasibility outcomes including satisfaction, barriers to treatment participation, safety, and dropout were assessed. Independent evaluators, blind to treatment condition, administered the Anxiety Disorders Interview Schedule for Children (ADIS) and the Clinical Global Impression of Improvement (CGI-I) at baseline, post-treatment and 3-month follow-up; clinical self-report questionnaires were also administered. Findings revealed high satisfaction, low endorsement of barriers, low drop out rates, and no adverse events across the two modalities. According to the CGI-I, 58.3%-75% of participants were considered responders (i.e., much or very much improved) at the various time points. Similar patterns were found for remission from "primary anxiety disorder" and "all anxiety disorders" as defined by the ADIS. Clinically significant improvement was seen on the various parent and child self-report measures of anxiety. Findings suggest that both therapy modalities are feasible and associated with significant treatment gains in the primary care setting. (clinicaltrials.gov unique identifier: NCT00769925).

KEYWORDS:

Child anxiety; Cognitive behavior therapy; Primary care; Randomized controlled trial; Therapist-supported bibliotherapy

PMID:
25075802
PMCID:
PMC4303047
DOI:
10.1016/j.brat.2014.06.010
[Indexed for MEDLINE]
Free PMC Article
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