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.
The proposed project will improve public health by increasing access to an empirically-supported treatment (cognitive-behavioral therapy for child anxiety). By disseminating this treatment into schools we will not only expand the number of youth who are served by this treatment but also train new personnel to administer it.
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