CD Rom Child Anxiety Treatment

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DESCRIPTION (provided by applicant): Empirical support exists for cognitive-behavioral therapy (CBT) for child anxiety, but the development and evaluation of cost-effective and transportable CBT approaches is critical. A widely endorsed goal is to disseminate evidence-based treatments to community settings. For the millions who have limited access to mental health facilities, a more accessible treatment is very much needed. A CD-ROM based CBT could increase, by a significant magnitude, the number of anxious youth for whom CBT would become available. Reports indicate that most of the 2.5 million American children seen in clinical practice each year receive interventions that have never been tested in a clinical trial, and CBT has been found to be underutilized by mental health providers. A CD-ROM therapist training program could provide a cost- effective and efficient way to train therapists in providing empirically supported CBT for anxious youth and promote the dissemination of evidence-based treatments. The primary goal of Phase I was to develop 4 sessions of the "Coping Cat CD" (CCCD) to examine its feasibility and acceptability. The preliminary data indicated its' acceptability and feasibility with anxious youth. The goal of Phase II is to develop and evaluate the full 12-session CCCD and supplemental materials (i.e., a Notebook and a Coach's Manual) for children aged 8-13 years diagnosed with a principle DSM-IV anxiety disorder. To communicate the CBT content, the CCCD uses interactive strategies (e.g., self- navigation) and immerses the user in an engaging (e.g., flash animation) and age-appropriate learning environment. The effects of the CCCD will be evaluated in Study 1 (n=60): a comparison of (a) CCCD, (b) a previously evaluated individual CBT, and (c) a 12-week attention control. The CCCD does not rely on trained or experienced practitioners for delivery. This Phase II project will also evaluate a CD-Based Training (CDBT) program designed to train therapists in the implementation of CBT. A separate trial, Study 2 (n=60), will compare the impact of (a) CDBT, (b) traditional manual based training, versus (c) waitlist control, on child treatment outcome. Outcomes will be assessed using independent diagnostic interviews, and self-, parent-, and teacher-reports. Maintenance of gains will be evaluated at 3-month follow-up. The larger goals are to develop an effective and affordable CD-ROM version of CBT for anxious youth and a CD-ROM based therapist training program to make evidence-based treatment available to a wide range of youth through educators, healthcare workers, service agencies, and therapists.