Journal of the American Academy of Child & Adolescent Psychiatry
Volume 49, Issue 10 , Pages 1043-1052 , October 2010

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

  • Michael A. Southam-Gerow, Ph.D.

      Affiliations

    • Virginia Commonwealth University
    • Corresponding Author InformationCorrespondence to Michael A. Southam-Gerow, Ph.D., VCU Department of Psychology, 806 W. Franklin St., Richmond, VA 23284
    • ,
  • John R. Weisz, Ph.D., A.B.P.P.

      Affiliations

    • Harvard University and the Judge Baker Children's Center
    • ,
  • Brian C. Chu, Ph.D.

      Affiliations

    • Rutgers and the State University of New Jersey
    • ,
  • Bryce D. McLeod, Ph.D.

      Affiliations

    • Virginia Commonwealth University
    • ,
  • Elana B. Gordis, Ph.D.

      Affiliations

    • University of Albany and the State University of New York
    • ,
  • Jennifer K. Connor-Smith, Ph.D.

      Affiliations

    • Portland State University

,Accepted 17 June 2010.

References 

  1. Schoenwald SK, Hoagwood K. Effectiveness, transportability, and dissemination of interventions: what matters when?. Psychiatr Serv. 2001;52:1190
  2. Weisz JR. Psychotherapy for Children and Adolescents: Evidence-Based Treatments and Case Examples. Cambridge, UK: Cambridge University Press; 2004;
  3. Southam-Gerow MA, Hourigan SE, Allin RB. Adapting evidence-based mental health treatments in community settings: Preliminary results from a partnership approach. Behav Modif. 2009;33:82–103
  4. Silverman WK, Pina AA, Viswesvaran C. Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. J Clin Child Adolesc Psychol. 2008;37:105–130
  5. Kendall PC, Hudson JL, Gosch E, Flannery-Schroeder E, Suveg C. Cognitive-behavioral therapy for anxiety disordered youth: a randomized clinical trial evaluating child and family modalities. J Consult Clin Psychol. 2008;76:282–297
  6. Silverman W, Kurtines W, Ginsburg G, Weems C, Rabian B, Serafini L. Contingency management, self-control, and education support in the treatment of childhood phobic disorders: A randomized clinical trial. J Consult Clin Psychol. 1999;67:675–687
  7. Walkup JT, Albano AM, Piacentini JC, et al. Cognitive behavioral therapy, Sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359:2753–2766
  8. Barrington J, Prior M, Richardson M, Allen K. Effectiveness of CBT versus standard treatment for childhood anxiety disorders in a community clinic setting. Behav Change. 2005;22:29–43
  9. Baer S, Garland EJ. Pilot study of community-based cognitive behavioral group therapy for adolescents with social phobia. J Am Acad Child Adolesc Psychiatry. 2005;44:258–264
  10. Farrell LJ, Barrett PM, Claassens S. Community trial of an evidence-based anxiety intervention for children and adolescents (the FRIENDS program): a pilot study. Behav Change. 2005;22:236–248
  11. Kendall PC. Treating anxiety disorders in children: results of a randomized clinical trial. J Consult Clin Psychol. 1994;62:100–110
  12. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994;
  13. Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM, Southam-Gerow M, Henin A, Warman M. Therapy for youths with anxiety disorders: a second randomized clinical trial. J Consult Clin Psychol. 1997;65:366–380
  14. Weisz JR, Southam-Gerow MA, Gordis EB, et al. Cognitive behavioral therapy versus usual clinical care for youth depression: an initial test of transportability to community clinics and clinicians. J Consult Clin Psychol. 2009;77:383–396
  15. Hoagwood K, Jensen PS, Petti T, Burns BJ. Outcomes of mental health care for children and adolescents: I (A comprehensive conceptual model). J Am Acad Child Adolesc Psychiatry. 1996;35:1055–1063
  16. Schwab-Stone ME, Shaffer D, Dulcan MK, Jensen PS. Criterion validity of the NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3). J Am Acad Child Adolesc Psychiatry. 1996;35:878–888
  17. Rubio-Stipec M, Shrout PE, Canino G, et al. Empirically defined symptom scales using the DISC 2.3. J Abnorm Child Psychol. 1996;24:67–83
  18. Shaffer D, Fisher P, Dulcan MK, Davies M. The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA study. J Am Acad Child Adolesc Psychiatry. 1996;35:865–877
  19. Spielberger CD. Manual for State-Trait Anxiety Inventory for Children. Palo Alto, CA: Consulting Psychologists Press; 1973;
  20. Southam-Gerow MA, Chorpita BF. Anxiety in children and adolescents. In:  Mash EJ,  Barkley RA editor. Assessment of Childhood Disorders. 4th ed.. New York: Guilford Press; 2007;p. 347–397
  21. Southam-Gerow MA, Flannery-Schroeder EC, Kendall PC. A psychometric evaluation of the parent report form the State-Trait Anxiety Inventory for Children–Trait Version. J Anxiety Disord. 2003;17:427–446
  22. Achenbach TM. Manual for the Youth Self Report and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry; 1991;
  23. Horwitz S, Hoagwood K, Stiffman A, et al. Reliability of the Services Assessment for Children and Adolescents. Psychiatr Serv. 2001;52:1088–1094
  24. Hoagwood K, Horwitz S, Stiffman A, et al. Concordance between parent reports of children's mental health services and service records: the Services Assessment for Children and Adolescents (SACA). J Child Fam Stud. 2000;9(3):315–331
  25. Stiffman AR, Horwitz SM, Hoagwood K, et al. The Service Assessment for Children and Adolescents (SACA): adult and child reports. J Am Acad Child Adolesc Psychiatry. 2000;39:1032–1039
  26. Friedman LM, Furberg CD, DeMets DL. Fundamentals of Clinical Trials. New York: Springer; 1998;
  27. Kendall PC, Kane M, Howard B, Siqueland L. Cognitive-Behavioral Treatment of Anxious Children: Treatment Manual. Ardmore, PA: Workbook Publishing; 1990;
  28. McLeod BD, Weisz JR. The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale. J Clin Child Adolesc Psychol. 2010;39:436–443
  29. Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6:65–70
  30. Jaccard J, Guilamo-Ramos V. Analysis of variance frameworks in clinical child and adolescent psychology: issues and recommendations. J Clin Child Adolesc Psychol. 2002;31:130–146
  31. Hendrickson AE, White P. Promax: a quick method for rotation to oblique simple structure. Br J Math Stat Psychol. 1964;17:66–70
  32. Kline RB. Beyond Significance Testing: Reforming Data Analysis Methods in Behavioral Research. Washington, DC: American Psychological Association; 2004;
  33. Southam-Gerow MA, Weisz JR, Kendall PC. Youth with anxiety disorders in research and service clinics: examining client differences and similarities. J Clin Child Adolesc Psychology. 2003;32:375–385
  34. Southam-Gerow MA, Chorpita BF, Miller LM, Gleacher AA. Are children with anxiety disorders privately referred to a university clinic like those referred from the public mental health system?. Admin Policy Mental Health Mental Health Serv Res. 2008;35:168–180
  35. Weisz JR, Chu BC, Polo AJ. Treatment dissemination and evidence-based practice: strengthening intervention through clinician-researcher collaboration. Clin Psychol Sci Pract. 2004;11:300–307
  36. McLeod BD. Understanding why therapy allegiance is linked to clinical outcomes. Clin Psychol Sci Pract. 2009;16:69–72
  37. Perepletchikova F, Kazdin AE. Treatment integrity and therapeutic change: Issues and research recommendations. Clin Psychol Sci Pract. 2005;12:365–383
  38. Weisz JR, Doss AJ, Hawley KM. Youth psychotherapy outcome research: a review and critique of the evidence base. Annu Rev Psychol. 2005;56:337–363
  39. Barber JP, Sharpless B, Klostermann S, McCarthy K. Assessing intervention competence and its relation to therapy outcome: a selected review derived from the outcome literature. Professional Psychol Res Pract. 2007;38:493–500
  40. Weisz JR, Jensen-Doss A, Hawley KM. Evidence-based youth psychotherapies versus usual clinical care: a meta-analysis of direct comparisons. Am Psychol. 2006;61:671–689

 The study was supported by grant R01-MH574347 from the NIMH to Dr. Weisz.

 We thank Philip C. Kendall (Temple University) and Donna K. McClish (Virginia Commonwealth University) for their consultation on the project. We also thank our clinic partners for their help, in many forms, throughout the study. These include Herb Blaufarb, Susan Hall-Marley, and Terry Rattray (Child and Family Guidance Center); Kita Curry, Cynthia Kelly, and Marian Williams (Didi Hirsch Community Mental Health Center); Anita Feltes (Edelman Westside Mental Health); Jill Morgan and David Slay (Greater Long Beach Child Guidance Center); Joseph Ho, Philip Pannell, and Robert Parsons (Pacific Clinics); and Thomas Ciesla, Carol Falender, Allison Pinto, and Rebecca Refuerzo (St. John's Health Center). We also thank the therapists, parents, and youths who participated in the study, and our project administrative and graduate student colleagues, including Amie Bettencourt, C. Ashley Borders, Jen Durham-Fowler, Aileen Echiverri, Samantha Fordwood, Sarah Francis, Andrea Kasimian, May Lim, Tamara Sharpe, Irina Tauber, and Alanna Updegraff (University of California–Los Angeles); Kristin Hawley (University of Missouri); Amanda Jensen-Doss (University of Miami); David Langer (Judge Baker Children's Center); Antonio Polo (DePaul University); and V. Robin Weersing (San Diego State University).

 Disclosure: Dr. Southam-Gerow and Dr. McLeod receive financial support from the NIMH. Dr. Weisz receives financial support from the NIMH, the Norlien Foundation, and the John D. and Catherine T. MacArthur Foundation. Drs. Chu, Gordis, and Connor-Smith report no biomedical financial interests or potential conflicts of interest.

PII: S0890-8567(10)00494-6

doi: 10.1016/j.jaac.2010.06.009

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 49, Issue 10 , Pages 1043-1052 , October 2010

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