Improving Access to Child Anxiety Treatment

Description

There is strong evidence that cognitive behavioral therapy (CBT) with exposure is the preferred treatment for youth with anxiety disorders, but outpatient services that provide this type of treatment are limited. Even for those who do have access to anxiety-specific treatment, a traditional outpatient model of treatment delivery may not be suitable. Among the numerous logistical barriers to treatment access and response is the inability to generalize treatment tools to settings outside of the office. Patient-centered (home-based or telehealth; patient-centered telehealth closed as of 5/1/21) treatment models that target symptoms in the context in which they occur could be more effective, efficient, and accessible for families. The present study aims to compare the efficacy, efficiency, and feasibility of patient centered home-based CBT and patient centered telehealth CBT with a traditional office-based model of care. The question proposed, including proposed outcomes, have been generated and developed by a group of hospital, payer, patient and family stakeholders who will also contribute to the iterative process of protocol revision. The investigators anticipate 379 anxious youth to be randomized to receive outpatient treatment using telehealth (patient-centered telehealth closed as of 5/1/21), home-based services, or treatment as usual using a traditional outpatient model. Results of this study are expected to provide evidence for the efficacy and efficiency of patient-centered treatment, as well as increase treatment access and family engagement in the treatment process.

Conditions

Obsessive-Compulsive Disorder, Anxiety Disorders, Pediatric Disorder, Anxiety, OCD, Phobia, Agoraphobia, Generalized Anxiety, Generalized Anxiety Disorder, Selective Mutism, Separation Anxiety, Social Anxiety, Social Anxiety Disorder, Panic Disorder

Study Overview

Study Details

Study overview

There is strong evidence that cognitive behavioral therapy (CBT) with exposure is the preferred treatment for youth with anxiety disorders, but outpatient services that provide this type of treatment are limited. Even for those who do have access to anxiety-specific treatment, a traditional outpatient model of treatment delivery may not be suitable. Among the numerous logistical barriers to treatment access and response is the inability to generalize treatment tools to settings outside of the office. Patient-centered (home-based or telehealth; patient-centered telehealth closed as of 5/1/21) treatment models that target symptoms in the context in which they occur could be more effective, efficient, and accessible for families. The present study aims to compare the efficacy, efficiency, and feasibility of patient centered home-based CBT and patient centered telehealth CBT with a traditional office-based model of care. The question proposed, including proposed outcomes, have been generated and developed by a group of hospital, payer, patient and family stakeholders who will also contribute to the iterative process of protocol revision. The investigators anticipate 379 anxious youth to be randomized to receive outpatient treatment using telehealth (patient-centered telehealth closed as of 5/1/21), home-based services, or treatment as usual using a traditional outpatient model. Results of this study are expected to provide evidence for the efficacy and efficiency of patient-centered treatment, as well as increase treatment access and family engagement in the treatment process.

Comparison of Patient-Centered Versus Provider-Centered Delivery of Cognitive Behavioral Treatment (CBT) for Pediatric Anxiety and Obsessive Compulsive Disorder (OCD)

Improving Access to Child Anxiety Treatment

Condition
Obsessive-Compulsive Disorder
Intervention / Treatment

-

Contacts and Locations

Riverside

Bradley Hospital, Riverside, Rhode Island, United States, 02915

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * age 5-18 inclusive
  • * primary or co-primary DSM-V diagnosis of anxiety or OCD
  • * symptom duration of at least 3 months
  • * outpatient care needed
  • * presence of a stable parent, or guardian, who can participate in treatment
  • * other primary or co-primary psychiatric disorder which requires initiation of other active current treatment
  • * documented mental retardation
  • * thought disorder or psychotic symptoms
  • * conduct disorder
  • * acute suicidality
  • * concurrent psychotherapy
  • * chronic medical illness that would preclude their active participation in treatment
  • * treatment with psychotropic medication that is not stable

Ages Eligible for Study

5 Years to 18 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Bradley Hospital,

Jennifer Freeman, PhD, PRINCIPAL_INVESTIGATOR, Warren Alpert Medical School of Brown University

Study Record Dates

2025-02-01