COMMUNITY CLINIC TEST OF YOUTH ANXIETY TREATMENT

描述(改编自申请人的摘要)：结构化，手册 已经开发出针对许多精神健康问题的治疗方法， 儿童和青少年的精神障碍，其中一些已经表明 在临床试验中有很强的有益效果。这些发现导致了 建议使用经验性支持的治疗方法来改善 一些研究表明，传统临床治疗的结果可能 效果不是很好。但这些经过实验室测试的治疗方法真的能在 以服务为导向的诊所，为转介的青少年？现有的证据不能 告诉我们，因为实验室里的治疗师、病症和客户 药效试验往往与临床实践中的试验有很大的不同。 为了评估经过疗效测试的治疗的临床潜力，我们需要 在熔炉中测试这些治疗方法的有效性研究 临床实践。为了帮助开始这一进程，拟议的研究 重点关注针对特定疾病群的特定治疗计划： Kendall(1994)针对儿童和儿童的认知-行为“应对猫”计划 青少年焦虑症。该计划显示出了不同寻常的积极。 在美国和澳大利亚进行的一系列临床试验的影响，但它 从未在现实世界的临床条件下进行过测试。建议进行的研究 将在门诊转诊的青少年中测试治疗的有效性， 在社区诊所接受治疗，由诊所工作人员进行治疗 心理医生。大约128名9-14岁的年轻人被转介患有焦虑症并被诊断为 患有焦虑症的人，将被随机分配到 诊所的常规治疗，或肯德尔计划，由诊所执行 经过熟练培训的员工。这两个人的治疗师 治疗条件也将随机选择，从 志愿者。治疗后即刻、1年和 为期两年的跟踪调查，将测试霍格伍德的四个领域的效果， Jensen，Petti和Burns(1996)服务结果模型：(1)症状和 诊断，(2)功能，(3)消费者观点，(4)系统 (即治疗减少进一步服务使用的程度)。

DESCRIPTION (Adapted from applicant's abstract): Structured, manualized treatments have been developed for numerous mental health problems and disorders among children and adolescents, and a number of these have shown strong beneficial effects in clinical trials. Such findings have led to proposals that the empirically supported treatments be used to improve outcomes of conventional clinic treatment, which some research suggests may not be very effective. But can these lab-tested treatments actually work in service-oriented clinics with referred youth? Available evidence cannot tell us, because the therapists, conditions, and clientele in the laboratory efficacy tests tend to differ so markedly from those of clinical practice. To assess the clinical potential of efficacy-tested treatments, we need effectiveness research that tests these treatments in the crucible of clinical practice. To help begin this process, the proposed research focuses on a specific treatment program for a specific cluster of disorders: Kendall's (1994) cognitive-behavioral "Coping Cat" program for child and adolescent anxiety disorders. The program has shown unusually positive effects across a series of clinical trials in the U.S. and Australia, but it has never been tested in real-world clinical conditions. The proposed study will test the effectiveness of the treatment with clinic-referred youth, treated in community clinics, with the treatment carried out by clinic staff therapists. Some 128 youth, aged 9-14, referred for anxiety and diagnosed with anxiety disorders, will be randomly assigned to receive either the usual treatment in the clinic, or the Kendall program, carried out by clinic staff who have been trained to proficiency. Therapists for the two treatment conditions will also be chosen randomly, from a pool of volunteers. Outcome assessment at immediate post-treatment, 1-year, and 2-year follow-ups, will test effects across four domains of the Hoagwood, Jensen, Petti, and Burns (1996) services outcome model: (1) symptoms and diagnosis, (2) functioning, (3) consumer perspectives, and (4) systems (i.e., degree to which treatment reduces further service use).