Disseminating evidence-based practice to the schools: CBT for child anxiety

描述（由申请人提供）：美国心理协会（阿帕）和美国儿童和青少年精神病学学会（AACAP）支持的一项重要运动是为有心理健康需求的青少年提供循证实践（EBP）。然而，研究表明，年轻人在社区中没有接受EBP。学校环境可能是运输EBP的首选服务提供环境，因为青少年大部分时间都在学校，并且有资格的个人（例如，学校辅导员、学校心理学家）提供服务。这项拟议的研究是一个为期五年的项目，旨在研究计算机辅助认知行为治疗（CACBT）对青少年焦虑的运输，实施和可持续性。CACBT是针对儿童焦虑症的认知行为治疗（EBP）的计算机辅助版本。该研究采用队列序列设计，在五年的时间内，分别跟踪[20]所不同的学校三年，共有[80名治疗师]参与。每个学校将提供至少四个人（例如，辅导员、社会工作者、学校心理学家和教师）。[第一阶段包括一个学期的数据收集，以确定焦虑症在1至4年级儿童中的患病率，并记录学校解决儿童焦虑症的常用方法（治疗作为治疗：TAU）。第二阶段是对学校人员进行一个学期的培训，以执行《儿童全面保护措施》。任何一至四年级的儿童，如通过儿童行为评估系统，第二版，教师评定量表（BASC-2 TRS）的教师报告评估，将被邀请参加。第三阶段包括两年的数据收集，以（a）审查方案的可持续性（即，学校继续使用CACBT和BASC-2 TRS）和（B）评估组织社会背景变量作为CACBT和BASC-2 TRS可持续性的预测因子。该项目的成果将通过学校工作人员增加使用CACBT和通过BASC-2 TRS增加识别患有令人痛苦的焦虑的青年来衡量。系统变量（例如，文化、组织氛围）将作为可持续性的预测因素进行评估。探索性变量（例如，治疗师培训，知识，坚持，技能），可能会有差异地影响运输EBP到学校设置也将进行检查。拟议的研究结果将告知外地关于EBP在学校环境中的传播，实施和可持续性。 公共卫生相关性：拟议的项目将通过增加获得医疗支持的治疗（儿童焦虑的认知行为疗法）来改善公共卫生。通过在学校推广这种治疗方法，我们不仅将扩大接受这种治疗的青年人数，而且还将培训新的管理人员。

DESCRIPTION (provided by applicant): An important movement supported by the American Psychological Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) is the provision of evidence-based practice (EBP) to youth with mental health needs. However, research suggests that youth do not receive EBP in the community. The school setting may be a preferred service provision setting in which to transport EBP given that youth spend the majority of their time at school and qualified individuals (e.g., school counselors, school psychologists) are available to provide services. The proposed study is a [three-phase] five-year project examining the transportation, implementation, and sustainability of a computer-assisted cognitive-behavioral treatment (CACBT) for youth anxiety. CACBT is a computer-assisted version of cognitive-behavioral treatment for child anxiety, an EBP. The study uses a cohort-sequential design and follows [20] separate schools for three years each within a five-year period, with a total of [80 therapist] participants. Each school will provide at least four individuals (e.g., counselors, social workers, school psychologists, and teachers) who can implement the intervention. [Phase I involves one semester of data collection to determine the prevalence of anxiety disorders in 1st to 4th grade children and document the schools' usual approach for addressing anxiety disorders in children (Treatment-As-Usual: TAU). Phase II involves one semester of training school personnel in the implementation of CACBT. Any child in 1st to 4th grade with distressing anxiety, as assessed by teacher-report via the Behavioral Assessment System for Children, Second Edition, Teacher Rating Scale (BASC-2 TRS), will be invited to participate. Phase III involves two years of data collection to (a) examine the sustainability of the program (i.e., the school's continued use of CACBT and the BASC-2 TRS) and (b) evaluate organizational social context variables as predictors of sustainability of CACBT and the BASC-2 TRS. The outcome of the project will be measured in terms of school personnel's increased use of CACBT and increased identification of youth with distressing anxiety via the BASC-2 TRS. Systems variables (e.g., culture, organizational climate) will be assessed as predictors of sustainability. Exploratory variables (e.g., therapist training, knowledge, adherence, skill) that may differentially affect the transportation of EBP to school settings will also be examined.] The results of the proposed study will inform the field regarding the dissemination, implementation, and sustainability of EBP in the school setting. PUBLIC HEALTH RELEVANCE: The proposed project will improve public health by increasing access to an empirically-supported treatment (cognitive-behavioral therapy for child anxiety). By disseminating this treatment into schools we will not only expand the number of youth who are served by this treatment but also train new personnel to administer it.