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Community Clinic Test of Youth Anxiety Treatment

Not Applicable
Completed
Conditions
Depression
Anxiety
Interventions
Behavioral: Cognitive behavioral therapy for youth anxiety
Other: Usual clinic care
Behavioral: Cognitive behavioral treatment for youth depression
Registration Number
NCT01005836
Lead Sponsor
Harvard University
Brief Summary

Structured, manualized treatments have been developed for numerous mental health problems and disorders among children and adolescents, and a number of these have shown strong beneficial effects in clinical trials. Such findings have led to proposals that the empirically supported treatments be used to improve outcomes of conventional clinic treatment, which some research suggests may not be very effective. But can these lab-tested treatments actually work in service-oriented clinics with referred youth? Available evidence cannot tell us, because the therapists, conditions, and clientele in the laboratory efficacy tests tend to differ so markedly from those of clinical practice. To assess the clinical potential of efficacy-tested treatments, we need effectiveness research that tests these treatments in the crucible of clinical practice. To help begin this process, the proposed research focuses on a specific treatment program for a specific cluster of disorders: Kendall's (1994) cognitive-behavioral "Coping Cat" program for child and adolescent anxiety disorders. The program has shown unusually positive effects across a series of clinical trials in the U.S. and Australia, but it has never been tested in real-world clinical conditions. The proposed study will test the effectiveness of the treatment with clinic-referred youth, treated in community clinics, with the treatment carried out by clinic staff therapists. Some 128 youth, aged 9-14, referred for anxiety and diagnosed with anxiety disorders, will be randomly assigned to receive either the usual treatment in the clinic, or the Kendall program, carried out by clinic staff who have been trained to proficiency. Therapists for the two treatment conditions will also be chosen randomly, from a pool of volunteers. Outcome assessment at immediate post-treatment, 1-year, and 2-year follow-ups, will test effects across many outcomes. It is hypothesized that outcomes for youths treated using the cognitive-behavioral treatment will be superior to those treated using usual care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
105
Inclusion Criteria
  • Primary DSM-IV anxiety or depressive disorder
Exclusion Criteria
  • Pervasive developmental disorder
  • Psychotic disorder
  • Mental retardation

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Cognitive-behavioral therapy: AnxietyCognitive behavioral therapy for youth anxietyCBT for child anxiety. Coping Cat.
Usual care: DepressionUsual clinic careUsual clinic care for depression
Usual care: AnxietyUsual clinic careUsual clinic care
Cognitive behavioral therapy: depressionCognitive behavioral treatment for youth depressionCBT for youth depression. The Primary and Secondary Control Enhancement Training protocol.
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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