Feasibility of Brief CBT for Youth Anxiety

描述(由申请人提供)：本R34的目标是开发针对7-13岁青少年焦虑症的简明版CBT(BCBT)，并评估招募、保留和治疗患有BCBT的青少年的可行性。在年轻人中患有焦虑症与成年后出现心理健康问题的可能性更高有关，治疗患有焦虑症的年轻人可能会降低随后出现问题的可能性。目前，成本和时间都是实施和传播青少年焦虑症治疗的潜在障碍(Egger&Burns，2004)。随着一种简单形式的CBT的出现，治疗效率和可获得性可能会得到改善。本项目包括两个阶段。第一阶段涉及为焦虑的青少年设计、开发和完善BCBT干预材料，包括治疗师治疗手册和儿童治疗工作簿。将在现有研究和专家评审的基础上选择纳入BCBT的干预策略和治疗成分。具体地说，为期16周的CBT计划将缩短为8周计划，包括那些得到最强有力的研究支持和专家审查者最强烈认可的治疗成分。在第一阶段，专家审查将是反复进行的：审查初始材料和订正材料。目标是以研究为导向确定BCBT中要包括的特征。BCBT计划将在第二阶段使用20名最初被诊断为分离焦虑症、广泛性焦虑症或社交恐惧症的青少年样本进行评估。我们将通过评估参与者的招募和留存率以及治疗师对BCBT方案的依从性、接受度和偏差来检查焦虑青年的BCBT。治疗前和治疗后评价以及为期两个月和四个月的后续评价将由独立评价人员使用多种评估方法进行。将进行分析，以评估对BCBT的反应在主要结果指标(例如，来自结构化诊断访谈数据的诊断、临床医生严重程度评级)上的变化程度和可变性。第二阶段的专家评价将包括对随机挑选的治疗案例进行整体审查(即所有会议)。公共卫生相关声明：青少年中的焦虑是儿童时期最普遍的精神病理形式之一(Costello，Mustillo，Erkanli，Keeler，&AnGold，2003)；然而，目前只有不到一半的焦虑症儿童得到治疗(Chavira，Stein，Bailey，&Stein，2004)。为焦虑的年轻人创建一个简短的CBT计划，可能会通过降低治疗成本和增加训练有素的治疗师可以为其提供服务的客户数量，使传播更具可行性。

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.