Community Clinic Test of Youth Anxiety Treatment

Study Overview
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Brief Summary
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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.

Official Title
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Community Clinic Test of Youth Anxiety and Depression Study

Conditions
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Anxiety, Depression

Intervention / Treatment
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* Behavioral: Cognitive behavioral therapy for youth anxiety
* Other: Usual clinic care
* Behavioral: Cognitive behavioral treatment for youth depression


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary DSM-IV anxiety or depressive disorder Exclusion Criteria: Pervasive developmental disorder Psychotic disorder Mental retardation

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive-behavioral therapy: Anxiety<br>CBT for child anxiety. Coping Cat. | Behavioral: Cognitive behavioral therapy for youth anxiety<br> <br> * Other names: Coping Cat;|
| Other: Usual care: Anxiety<br>Usual clinic care | Other: Usual clinic care<br> <br> |
| Experimental: Cognitive behavioral therapy: depression<br>CBT for youth depression. The Primary and Secondary Control Enhancement Training protocol. | Behavioral: Cognitive behavioral treatment for youth depression<br> <br> * Other names: PASCET;|
| Other: Usual care: Depression<br>Usual clinic care for depression | Other: Usual clinic care<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive behavioral therapy, Anxiety treatment, Depression treatment, Child treatment, Usual care