Innovations in the psychosocial treatment of youth with anxiety disorders: implications for a stepped care approach.

Ollendick, TH; Öst, L-G; Farrell, LJ

Innovations in the psychosocial treatment of youth with anxiety disorders: implications for a stepped care approach.

Ollendick, TH Öst, L-G Farrell, LJ

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Publisher:: BMJ
Publication Type:: Journal Article
Citation:: Evid Based Ment Health, 2018, 21, (3), pp. 112-115
Issue Date:: 2018-08

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Field	Value	Language
dc.contributor.author	Ollendick, TH
dc.contributor.author	Öst, L-G
dc.contributor.author	Farrell, LJ
dc.date.accessioned	2022-09-11T01:36:41Z
dc.date.available	2018-06-05
dc.date.available	2022-09-11T01:36:41Z
dc.date.issued	2018-08
dc.identifier.citation	Evid Based Ment Health, 2018, 21, (3), pp. 112-115
dc.identifier.issn	1362-0347
dc.identifier.issn	1468-960X
dc.identifier.uri	http://hdl.handle.net/10453/161646
dc.description.abstract	Anxiety disorders are highly prevalent among children and adolescents and frequently result in impairments across multiple domains of life. While psychosocial interventions, namely cognitive-behavioural therapy (CBT), have been found to be highly effective in treating these conditions, significant numbers of youth simply do not have access to these evidence-based interventions, and of those who do, a substantial proportion (up to 40%) fail to achieve remission. Thus, there is a pressing need for innovation in both the delivery of evidence-based treatments and efforts to enhance treatment outcomes for those who do not respond to standard care. This paper reviews current innovations attempting to address these issues, including evidence for brief, low-intensity approaches to treatment; internet delivered CBT and brief, high-intensity CBT. Moreover, we propose a model of stepped care delivery of evidence-based mental health interventions for children and youth with anxiety. In general, a stepped care approach begins with a lower intensity, evidence-based treatment that entails minimal therapist involvement (ie, brief, low-intensity self-help or internet delivered CBT) and then proceeds to more intensive treatments with greater therapist involvement (ie, brief high-intensity CBT), but only for those individuals who show a poor response at each step along the way. Future research is needed in order to evaluate such a model, and importantly, to identify predictors and moderators of response at each step, in order to inform an evidence-based, fully-integrated stepped care approach to service delivery.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ
dc.relation.ispartof	Evid Based Ment Health
dc.relation.isbasedon	10.1136/eb-2018-102892
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Psychiatry
dc.subject.mesh	Adolescent
dc.subject.mesh	Anxiety Disorders
dc.subject.mesh	Child
dc.subject.mesh	Cognitive Behavioral Therapy
dc.subject.mesh	Humans
dc.subject.mesh	Outcome and Process Assessment, Health Care
dc.subject.mesh	Humans
dc.subject.mesh	Anxiety Disorders
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Cognitive Behavioral Therapy
dc.subject.mesh	Outcome and Process Assessment, Health Care
dc.title	Innovations in the psychosocial treatment of youth with anxiety disorders: implications for a stepped care approach.
dc.type	Journal Article
utslib.citation.volume	21
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-11T01:36:38Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	21
utslib.citation.issue	3

Abstract:

Anxiety disorders are highly prevalent among children and adolescents and frequently result in impairments across multiple domains of life. While psychosocial interventions, namely cognitive-behavioural therapy (CBT), have been found to be highly effective in treating these conditions, significant numbers of youth simply do not have access to these evidence-based interventions, and of those who do, a substantial proportion (up to 40%) fail to achieve remission. Thus, there is a pressing need for innovation in both the delivery of evidence-based treatments and efforts to enhance treatment outcomes for those who do not respond to standard care. This paper reviews current innovations attempting to address these issues, including evidence for brief, low-intensity approaches to treatment; internet delivered CBT and brief, high-intensity CBT. Moreover, we propose a model of stepped care delivery of evidence-based mental health interventions for children and youth with anxiety. In general, a stepped care approach begins with a lower intensity, evidence-based treatment that entails minimal therapist involvement (ie, brief, low-intensity self-help or internet delivered CBT) and then proceeds to more intensive treatments with greater therapist involvement (ie, brief high-intensity CBT), but only for those individuals who show a poor response at each step along the way. Future research is needed in order to evaluate such a model, and importantly, to identify predictors and moderators of response at each step, in order to inform an evidence-based, fully-integrated stepped care approach to service delivery.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/161646