Does Cognitive Behavioral Therapy for Youth Anxiety Outperform Usual Care in Community Clinics? An Initial Effectiveness Test

Autor/inn/en	Southam-Gerow, Michael A.; Weisz, John R.; Chu, Brian C.; McLeod, Bryce D.; Gordis, Elana B.; Connor-Smith, Jennifer K.
Titel	Does Cognitive Behavioral Therapy for Youth Anxiety Outperform Usual Care in Community Clinics? An Initial Effectiveness Test
Quelle	In: Journal of the American Academy of Child & Adolescent Psychiatry, 49 (2010) 10, S.1043-1052 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-8567
DOI	10.1016/j.jaac.2010.06.009
Schlagwörter	Anxiety Disorders; Cognitive Restructuring; Adolescents; Geometric Concepts; Therapy; Clinics; Outcomes of Treatment; Youth; Epistemology; Counseling Effectiveness; Tests; Children; Evaluation Methods; Whites; Latin Americans; African Americans + Suchen Sie Ihr Suchwort? Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Elementare Geometrie; Therapie; Erkenntnistheorie; Examination; Prüfung; Examen; Child; Kind; Kinder; White; Weißer; Latin America; People; Lateinamerika; Bevölkerung; Volk; Afroamerikaner
Abstract	Objective: Most tests of cognitive behavioral therapy (CBT) for youth anxiety disorders have shown beneficial effects, but these have been efficacy trials with recruited youths treated by researcher-employed therapists. One previous (nonrandomized) trial in community clinics found that CBT did not outperform usual care (UC). The present study used a more stringent effectiveness design to test CBT versus UC in youths referred to community clinics, with all treatment provided by therapists employed in the clinics. Method: A randomized controlled trial methodology was used. Therapists were randomized to training and supervision in the Coping Cat CBT program or UC. Forty-eight youths (56% girls, 8 to 15 years of age, 38% Caucasian, 33% Latino, 15% African-American) diagnosed with "DSM-IV" anxiety disorders were randomized to CBT or UC. Results: At the end of treatment more than half the youths no longer met criteria for their primary anxiety disorder, but the groups did not differ significantly on symptom (e.g., parent report, eta-square = 0.0001; child report, eta-square = 0.09; both differences favoring UC) or diagnostic (CBT, 66.7% without primary diagnosis; UC, 73.7%; odds ratio 0.71) outcomes. No differences were found with regard to outcomes of comorbid conditions, treatment duration, or costs. However, youths receiving CBT used fewer additional services than UC youths (chi[superscript 2[subscript 1]] = 8.82, p = 0.006). Conclusions: CBT did not produce better clinical outcomes than usual community clinic care. This initial test involved a relatively modest sample size; more research is needed to clarify whether there are conditions under which CBT can produce better clinical outcomes than usual clinical care. (Contains 1 figure and 1 table.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10