The sizeable gap between youth who need mental health services and those who actually receive evidence supported treatment (EST) reflects a growing public health concern. While traditional randomized controlled trials have now amassed convincing evidence supporting the efficacy of interventions for youth psychopathology, little is understood about 1) the effectiveness of ESTs for youth when delivered under the parameters of real-world practice settings, and 2) the most efficient process of disseminating ESTs into service provider settings. Although schools provide the lionshare of mental health services for youth, ESTs have largely been developed and tested in isolation from school settings and thus are not well-designed to be transported into existing school mental health service delivery systems without explicit consideration of school-specific contextual factors in the dissemination process. The proposed study uses a programmatic dissemination model as a guiding framework for testing an evidence-supported treatment (EST) for child anxiety disorders in the school setting. The main goal of the proposed project is to conduct the first of a planned series of partial effectiveness tests (group-design randomized controlled trials) evaluating the impact of a modular cognitive behavioral therapy (CBT) program for childhood anxiety disorders with one selected element of the practice setting: the school clinic environment. Fifty children aged 5-11 years old with anxiety disorders attending two elementary schools in the greater Los Angeles area will be individually randomized to receive the modular school-based CBT program either immediately or after a 3-month waiting period.
The specific aims of the project are to examine the impact of the modular intervention on diagnostic status, anxiety symptomatology as well as outcomes relevant to children's daily functioning including social adjustment, academic performance, and health utilization practices of youth. Additionally, the proposed work aims to explore potential change mechanisms of the intervention when implemented in the school clinic setting. This work will contribute to the field by using theory-driven research to directly address the dissemination process, clarifying the effect of an evidence-supported intervention when administered in the school clinic setting, and expanding knowledge on the applicability, feasibility, and utility of implementing this intervention in schools with an ethnically diverse sample of youth with anxiety disorders. This project directly addresses the federal public health priority of closing the research-practice gap in children's mental health services by applying basic intervention research in real-world settings in an effort to reduce youth mental illness, alleviate the burden of youth psychopathology, and enhance children's daily functioning. ? ? ?
| Chiu, Angela W; Langer, David A; McLeod, Bryce D et al. (2013) Effectiveness of modular CBT for child anxiety in elementary schools. Sch Psychol Q 28:141-153 |
