COMMUNITY CLINIC TEST OF YOUTH ANXIETY TREATMENT

描述（改编自申请人的摘要）：结构化，手动化 已经开发了许多心理健康问题的治疗方法， 儿童和青少年的疾病，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 建议使用经验支持的治疗方法来改善 传统临床治疗的结果，一些研究表明， 不是很有效。 但这些实验室测试的治疗方法真的能在 为年轻人提供服务的诊所 现有证据不能 告诉我们，因为实验室里的治疗师，条件和客户 功效测试往往与临床实践的那些显著不同。 为了评估经过疗效测试的治疗方法的临床潜力，我们需要 有效性研究，测试这些治疗在坩埚， 临床实践 为了帮助开始这一进程，拟议的研究 专注于针对特定疾病群的特定治疗方案： Kendall（1994）的认知行为“应对猫”计划， 青少年焦虑症 该计划显示出不同寻常的积极性 在美国和澳大利亚的一系列临床试验中， 从未在现实世界的临床条件下进行过测试。 拟定研究 将在诊所转介的年轻人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岁的青少年因焦虑而被转介， 焦虑症患者，将被随机分配接受 通常在诊所治疗，或肯德尔计划，由诊所进行 受过熟练培训的工作人员。 两人的治疗师 治疗条件也将从一组随机选择， 志愿者 治疗后即刻、1年和 2-一年的随访，将测试Hoagwood四个领域的效果， 詹森，佩蒂和伯恩斯（1996年）服务结果模型：（1）症状和 诊断，（2）功能，（3）消费者观点，（4）系统 (i.e.,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).