Treatment of Child Anxiety in Nonpsychiatric Settings

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Description (provided by applicant): Anxiety disorders in youth are highly prevalent and associated with long-term negative consequences (e.g., depression, substance use). Yet, these disorders often go unidentified and untreated. The purpose of this application is to address this problem by developing skills to implement and evaluate early detection and intervention programs for child anxiety disorders in nonpsychiatric settings, including schools and pediatric medical settings. To accomplish these goals, a career development plan has been designed to: (1) obtain training in efficacy and effectiveness research methods, (2) adapt empirically-supported assessments and treatments for school and medical settings, (3) learn about the barriers to screening and intervention for anxiety disorders in these environments, and (4) receive training in statistical methods applied to naturalistic assessment, longitudinal data, and evaluation of clinical trials. Training will be provided via formal coursework, supervision and consultation with a panel of experts, and a research plan that complements the career development activities outlined in this application. The proposed research project will evaluate the relative efficacy of a manualized school-based cognitive-behavioral intervention to an attention control condition for adolescents with social anxiety disorder in a 2 (intervention condition) by 3 (pre-intervention, post-intervention, follow-up) mixed model factorial design with random assignment to condition and repeated measures on the second factor. It is expected that school-based cognitive-behavioral intervention will lead to significantly greater reduction of social phobia symptoms and greater improvement in general functioning than a non-specific intervention, and that these relative advantages will persist over time. Findings from this study will be used to inform the Candidate's application for an RO1 to conduct a full-scale study, and to guide the development of intervention programs in pediatric clinics.