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（APA）和美国儿童与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，青少年并没有在社区中接受到EBP。鉴于青少年大部分时间都在学校度过，并且有合格的个人（如学校辅导员、学校心理学家）可以提供服务，学校环境可能是运送EBP的首选服务提供环境。这项被提议的研究是一个为期五年的项目，研究计算机辅助认知行为治疗（CACBT）对青少年焦虑症的传输、实施和可持续性。CACBT是针对儿童焦虑的认知行为治疗的计算机辅助版本，即EBP。这项研究采用了队列序列设计，在5年的时间里，对100所不同的学校进行了为期3年的跟踪调查，总共有80名治疗师参与。每所学校将提供至少四名可以实施干预的个人（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，以确定一至四年级儿童焦虑症的患病率，并记录学校解决儿童焦虑症的通常方法（照旧治疗：TAU）。]第二阶段包括一个学期的培训学校人员实施CACBT。通过教师报告《儿童行为评估系统第二版教师评定量表》（BASC-2 TRS）评估的任何一至四年级患有焦虑的儿童都将被邀请参加。第三阶段包括为期两年的数据收集，以(a)检查项目的可持续性（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可持续性的预测因素。该项目的结果将根据学校人员增加使用CACBT以及通过BASC-2 TRS增加对患有焦虑的青少年的识别来衡量。系统变量（如文化、组织气候）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，依从性，技能）可能会不同地影响EBP到学校环境的运输也将被检查。[建议的研究结果将为学校环境中EBP的传播、实施和可持续性提供信息。

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.