ABSTRACT
BACKGROUND: Anxiety disorders are prevalent among adolescents and may have long-lasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low-intensity CBT in schools may improve access to evidence-based services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group-based and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school-based interventions for youth anxiety and to determine whether a less intensive intervention is non-inferior to a more intensive intervention. METHODS/DESIGN: The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12-16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co-therapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety-related functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non-inferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post-intervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. DISCUSSION: The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large-scale implementation in school health services. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered.
Subject(s)
Adolescent Behavior , Anxiety/therapy , Child Behavior , Cognitive Behavioral Therapy/methods , School Health Services , Adolescent , Anxiety/diagnosis , Anxiety/psychology , Child , Clinical Protocols , Female , Humans , Male , Norway , Patient Care Team , Psychiatric Status Rating Scales , Research Design , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
This study tested the effectiveness of an existing private online CBT-based group intervention designed to help people with hoarding. Web-group participants were hypothesized to show more improvement in hoarding symptoms over time compared to those placed on a naturalistic waitlist. This web-based self-help group (N = 106 members, N = 155 waitlisted) includes a formal application process and requires that participants post action steps and progress at least once monthly. Members have access to educational resources on hoarding, cognitive strategies, and a chat-group. Potential research participants were invited to complete an anonymous web-based survey about their hoarding behaviors and clinical improvement on five occasions (3 months apart). The sample was mainly middle-aged, female and White. Regression analyses show that Recent members reported greater improvement and less clutter at 6 months (than Waitlist). Long-term members reported milder hoarding symptoms than Recent ones, suggesting benefits from group participation over time. All members showed reductions in clutter and hoarding symptoms over 15 months. Less posting activity was associated with greater hoarding severity. Online CBT-based self-help for hoarding appears to be a promising intervention strategy that may extend access to treatment. Evaluating the benefits of internet self-help groups is critical given growing popularity of and demand for web-based interventions.
Subject(s)
Compulsive Behavior/therapy , Delivery of Health Care/methods , Internet , Adult , Aged , Cognitive Behavioral Therapy/methods , Education/methods , Female , Humans , Male , Middle Aged , Obsessive-Compulsive Disorder/therapy , Regression Analysis , Time Factors , Treatment Outcome , White PeopleABSTRACT
An evidence-based practice (EBP) movement is underway in social work that promises to change the very nature and methods of clinical education and practice. Growing demands for accountability, increasingly sophisticated clients, heightened threats of malpractice liability, and a host of additional factors arising within and external to the profession have contributed to the growth of EBP. This review examines indices of the growing influence of EBP, reasons for the emergence of EBP, misgivings about and potentially positive features of EBP, and examines one school of social work's efforts to implement an evidence-based clinical practice curriculum. It is important that clinicians be aware of current developments in relation to evidence-based clinical education and practice as these will likely significantly shape the face of social work direct practice in the coming years.
