Anxiety Disorders Clinical Trial
Official title:
Feasible Delivery of CBT for Rural Latino Youth With Anxiety
This pilot study will examine the feasibility of two modes of service delivery (e.g., a minimal therapist contact, self-help program, and a more intensive therapist supported, telephone-based approach) in a rural, primarily Latino, population. These modes of delivery may ultimately improve access to evidence based treatments and mental health outcomes among underserved groups.
Children with anxiety disorders are often characterized by an unmet need for treatment
however, in special populations such as Latino and rural youth, such disparities are
compounded by the effects of culture and geographic isolation. More specifically, barriers
related to language, stigma, and access often lead to lower rates of utilization and poorer
outcomes among children in need of mental health services (Alvidrez and Azocar, 1999; McCabe
et al., 2002; Myers et al., 2008; Vega et al., 2001). These findings are disappointing given
abundant data supporting the effectiveness of cognitive behavior and behavior therapies for
children with anxiety disorders (Barrett et al., 1996; Beidel et al., 2007; Kendall &
Southam-Gerow, 1996; Walkup et al., 2008). Efforts to examine feasible methods to deliver
evidence-based treatments to children with anxiety disorders are critical in order to extend
quality care to underserved groups. The goal of this R34 is to address these disparities, by
translating and tailoring an existing child anxiety cognitive behavior therapy program (The
Cool Kids Outreach Program; Lyneham and Rapee, 2006), to fit the needs of Spanish-speaking
rural families and examining the feasibility, acceptability, tolerability and safety of
implementing this intervention using varying modes of delivery.
A pilot study for children (age 8-13) with anxiety disorders (i.e., separation anxiety
disorder, generalized anxiety disorder, social anxiety disorder, and specific phobias) will
be conducted and 40 children will be randomized to two service delivery modes which represent
varying levels of therapist contact: 1) 20 families will be randomized to a telephone-based,
therapist-supported CBT program, and; 2) 20 families will be randomized to a more minimal
contact bibliotherapy condition (primarily CBT self-help materials). All families will be
recruited from primary care settings, given its defacto mental health service status.
Feasibility and clinical outcomes will be measured at baseline, midtreatment and
post-treatment. Additionally, during exit interviews, participants (as well as those who may
have dropped out of the program) will be asked to discuss the perceived usefulness,
acceptability, and impact of the intervention. This pilot study will provide important data
regarding the feasibility, acceptability, tolerability and safety of the intervention
conditions as well as the opportunity to pilot procedures that will be used in a larger
effectiveness trial with rural Latino youth.
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