Feasibility of Brief CBT for Youth Anxiety

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DESCRIPTION (provided by applicant): The goal of this R34 is to develop a brief version of CBT (BCBT) for anxiety disorders in 7- 13 year old youth and to evaluate the feasibility of enrolling, retaining, and treating the youth with BCBT. Having an anxiety disorder in youth is associated with a higher likelihood of mental health problems in adulthood and treating youth with anxiety disorders may reduce the likelihood of subsequent problems. Currently, both cost and time are potential barriers to implementation and dissemination of treatment for anxiety disorders in youth (Egger & Burns, 2004). Treatment efficiency and accessibility may be improved with the availability of a brief form of CBT. The present project includes two phases. Phase I involves the design, development, and refining of BCBT intervention materials for anxious youth, including a therapist treatment manual and a child treatment workbook. The intervention strategies and treatment components to be included in BCBT will be chosen based on available research and expert reviews. Specifically, the 16-week CBT program will be shortened to an 8-week program by including those treatment components having received the strongest research support and the strongest endorsement from expert reviewers. In Phase I, the expert reviews will be iterative: reviewing initial materials and the revised materials. The goal is a research-guided determination of the features to be included in BCBT. The BCBT program will be evaluated during Phase II using a sample of 20 youth with a primary anxiety diagnosis of Separation Anxiety Disorder, Generalized Anxiety Disorder, or Social Phobia. We will examine BCBT for anxious youth by assessing rates of recruitment and retention of participants, as well as therapist adherence, acceptance, and deviation from the BCBT protocol. Pre- and post-treatment evaluations, as well as two- and four-month follow-up evaluations, will be conducted by independent evaluators using multiple methods of assessment. Analyses will be conducted to estimate the degree of change and variability of response to BCBT on primary outcome measures (e.g., diagnoses derived from structured diagnostic interview data, Clinician Severity Ratings). Expert evaluations in Phase II will include reviewing randomly selected treatment cases in their entirety (i.e. all sessions). Public Health Relevance Statement: Anxiety in youth is among the most prevalent forms of psychopathology in childhood (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003); yet, currently fewer than half of children with anxiety disorders are receiving care (Chavira, Stein, Bailey, & Stein, 2004). The creation of a brief CBT program for anxious youth could potentially make dissemination more feasible by reducing treatment costs as well as increasing the number of clients for whom a trained therapist could provide services.