Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings?

Meghan M. Smith; Bryce D. McLeod; Michael A. Southam-Gerow; Amanda Doss; Philip C. Kendall; John R. Weisz

doi:10.1016/j.beth.2016.07.004

Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings?

Meghan M. Smith, Bryce D. McLeod, Michael A. Southam-Gerow, Amanda Doss, Philip C. Kendall, John R. Weisz

Psychology

Research output: Contribution to journal › Article

13 Citations (Scopus)

Abstract

Does delivery of the same manual-based individual cognitive-behavioral treatment (ICBT) program for youth anxiety differ across research and practice settings? We examined this question in a sample of 89 youths (M age = 10.56, . SD = 1.99; 63.70% Caucasian; 52.80% male) diagnosed with a primary anxiety disorder. The youths received (a) ICBT in a research setting, (b) ICBT in practice settings, or (c) non-manual-based usual care (UC) in practice settings. Treatment delivery was assessed using four theory-based subscales (Cognitive-behavioral, Psychodynamic, Client-Centered, Family) from the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale (TPOCS-RS). Reliable independent coders, using the TPOCS-RS, rated 954 treatment sessions from two randomized controlled trials (1 efficacy and 1 effectiveness trial). In both settings, therapists trained and supervised in ICBT delivered comparable levels of cognitive-behavioral interventions at the beginning of treatment. However, therapists trained in ICBT in the research setting increased their use of cognitive-behavioral interventions as treatment progressed whereas their practice setting counterparts waned over time. Relative to the two ICBT groups, the UC therapists delivered a significantly higher dose of psychodynamic and family interventions and a significantly lower dose of cognitive-behavioral interventions. Overall, results indicate that there were more similarities than differences in manual-based ICBT delivery across research and practice settings. Future research should explore why the delivery of cognitive-behavioral interventions in the ICBT program changed over time and across settings, and whether the answers to these questions could inform implementation of ICBT programs.

Original language	English (US)
Journal	Behavior Therapy
DOIs	https://doi.org/10.1016/j.beth.2016.07.004
State	Accepted/In press - Mar 2 2016

Fingerprint

Anxiety

Research

Therapeutics

Family Therapy

Anxiety Disorders

Psychotherapy

Randomized Controlled Trials

Keywords

Cognitive-Behavioral Treatment
Evidence-Based
Implementation
Youth

ASJC Scopus subject areas

Clinical Psychology

Cite this

Smith, M. M., McLeod, B. D., Southam-Gerow, M. A., Doss, A., Kendall, P. C., & Weisz, J. R. (Accepted/In press). Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings? Behavior Therapy. https://doi.org/10.1016/j.beth.2016.07.004

Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings? / Smith, Meghan M.; McLeod, Bryce D.; Southam-Gerow, Michael A.; Doss, Amanda; Kendall, Philip C.; Weisz, John R.

In: Behavior Therapy, 02.03.2016.

Research output: Contribution to journal › Article

Smith, MM, McLeod, BD, Southam-Gerow, MA, Doss, A, Kendall, PC & Weisz, JR 2016, 'Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings?', Behavior Therapy. https://doi.org/10.1016/j.beth.2016.07.004

Smith MM, McLeod BD, Southam-Gerow MA, Doss A, Kendall PC, Weisz JR. Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings? Behavior Therapy. 2016 Mar 2. https://doi.org/10.1016/j.beth.2016.07.004

Smith, Meghan M. ; McLeod, Bryce D. ; Southam-Gerow, Michael A. ; Doss, Amanda ; Kendall, Philip C. ; Weisz, John R. / Does the Delivery of CBT for Youth Anxiety Differ Across Research and Practice Settings?. In: Behavior Therapy. 2016.

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abstract = "Does delivery of the same manual-based individual cognitive-behavioral treatment (ICBT) program for youth anxiety differ across research and practice settings? We examined this question in a sample of 89 youths (M age = 10.56, . SD = 1.99; 63.70{\%} Caucasian; 52.80{\%} male) diagnosed with a primary anxiety disorder. The youths received (a) ICBT in a research setting, (b) ICBT in practice settings, or (c) non-manual-based usual care (UC) in practice settings. Treatment delivery was assessed using four theory-based subscales (Cognitive-behavioral, Psychodynamic, Client-Centered, Family) from the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale (TPOCS-RS). Reliable independent coders, using the TPOCS-RS, rated 954 treatment sessions from two randomized controlled trials (1 efficacy and 1 effectiveness trial). In both settings, therapists trained and supervised in ICBT delivered comparable levels of cognitive-behavioral interventions at the beginning of treatment. However, therapists trained in ICBT in the research setting increased their use of cognitive-behavioral interventions as treatment progressed whereas their practice setting counterparts waned over time. Relative to the two ICBT groups, the UC therapists delivered a significantly higher dose of psychodynamic and family interventions and a significantly lower dose of cognitive-behavioral interventions. Overall, results indicate that there were more similarities than differences in manual-based ICBT delivery across research and practice settings. Future research should explore why the delivery of cognitive-behavioral interventions in the ICBT program changed over time and across settings, and whether the answers to these questions could inform implementation of ICBT programs.",

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