Feasibility of Brief CBT for Youth Anxiety

描述（由申请人提供）：本R34的目标是为7- 13岁青少年的焦虑症开发一个简短的CBT（BCBT）版本，并评估使用BCBT招募、保留和治疗青少年的可行性。青少年焦虑症与成年后心理健康问题的可能性较高有关，治疗青少年焦虑症可能会降低后续问题的可能性。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）。提供简短形式的CBT可能会提高治疗效率和可及性。本项目包括两个阶段。第一阶段涉及设计，开发和完善BCBT干预材料焦虑的青年，包括治疗师治疗手册和儿童治疗手册。BCBT中包含的干预策略和治疗成分将根据现有研究和专家评论进行选择。具体来说，16周的CBT计划将缩短为8周，包括那些获得最强有力的研究支持和专家评审员最有力认可的治疗成分。在第一阶段，专家审评将是反复进行的：审评初始材料和修订材料。目标是以研究为指导确定BCBT中包含的功能。BCBT计划将在第二阶段使用20名患有分离焦虑症，广泛性焦虑症或社交恐惧症的主要焦虑诊断的青少年样本进行评估。我们将通过评估参与者的招募和保留率，以及治疗师的依从性，接受度和BCBT协议的偏离来检查BCBT对焦虑青年的影响。治疗前和治疗后评价以及2个月和4个月的随访评价将由独立评价者使用多种评估方法进行。将进行分析，以估计BCBT对主要结局指标（例如，诊断来源于结构化诊断访谈数据，临床医生严重性评级）。II期的专家评价将包括审查随机选择的全部治疗病例（即所有疗程）。公共卫生相关性声明：青少年的焦虑是儿童期最常见的精神病理学形式之一（Costello，Mustillo，Erkanli，Keeler，& Angold，2003）;然而，目前只有不到一半的焦虑症儿童接受护理（Chavira，Stein，Bailey，& Stein，2004）。为焦虑的青少年创建一个简短的CBT计划可能会通过降低治疗成本以及增加训练有素的治疗师可以提供服务的客户数量来使传播更加可行。

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.