nach oben

Administration and Policy in Mental Health and Mental Health Services Research

18.04.2024 | Original Article

The Content of Usual Clinical Care for Youth with Primary Anxiety Problems

verfasst von: Bryce D. McLeod, Stephanie Violante, Erica Ross, Alexys Weihl, Navneet Kaur, Michael A. Southam-Gerow, Heather A. Jones, John R. Weisz, Bruce F. Chorpita

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research

Einloggen, um Zugang zu erhalten

Abstract

The current study was designed to describe usual clinical care for youth with primary anxiety problems in community mental health centers. The observer-rated Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies scale (TPOCS-RS), designed to assess therapeutic techniques from five theory-based domains, was used to code sessions (N = 403) from the usual clinical care group of two randomized effectiveness trials: (a) Youth Anxiety Study (YAS) with 21 youth (M age = 10.44 years, SD = 1.91; 49.2% Latinx; 46.6%, 53.4% male) and 16 clinicians (77.5% female; 43.8% White), and (b) Child STEPS Multisite Trial with 17 youth (M age = 10.00 years, SD = 1.87; 58.8% male; 41.2% White) and 13 clinicians (M age = 40.00 years; SD = 9.18; 76.9% female; 61.5% White). The average number of TPOCS-RS items observed per treatment session was more than 10, and multiple techniques were used together in each session. All TPOCS-RS items were observed at least once throughout a clinical case, and most items reoccurred (i.e., observed in two or more sessions). The dosage of TPOCS-RS in all items was below 5 on a 7-point scale. In conclusion, clinicians in both usual care samples used a wide range of techniques from several theory-based domains at a low to medium dose. However, the type and dosage of the techniques used did vary across the two samples.

Nur mit Berechtigung zugänglich

Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S., & Midgley, N. (2013). Psychodynamic psychotherapy for children and adolescents: A meta-analysis of short-term psychodynamic models. Journal of the American Academy of Child and Adolescent Psychiatry, 52(8), 863–875. https://doi.org/10.1016/j.jaac.2013.05.014.CrossRefPubMed

Abdi, H., & Williams, L. J. (2010). Principal component analysis. Wiley Interdisciplinary Reviews: Computational Statistics, 2, 433–459. https://doi.org/10.1002/wics.101.CrossRef

Achenbach, T., & Rescorla, L. (2000). Child Behavior Checklist for ages 1.5-5. ASEBA.

Brookman-Frazee, L. I., Taylor, R., & Garland, A. F. (2010). Characterizing community-based mental health services for children with autism spectrum disorders and disruptive behavior problems. Journal of Autism and Developmental Disorders, 40(10), 1188–1201. https://doi.org/10.1007/s10803-010-0976-0.CrossRefPubMedPubMedCentral

Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability Framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8, 117.CrossRefPubMedPubMedCentral

Chorpita, B. F., & Daleiden, E. L. (2018). Coordinated strategic action: Aspiring to wisdom in mental health service systems. Clinical Psychology: Science & Practice, 4, e12264.

Cicchetti, D. V. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6(4), 284–290. https://doi.org/10.1037/1040-3590.6.4.284.CrossRef

Daleiden, E. L., & Chorpita, B. F. (2005). From data to wisdom: Quality improvement strategies supporting large-scale implementation of evidence-based services. Child and Adolescent Psychiatric Clinics of North America, 14(2), 329–349. https://doi.org/10.1016/j.chc.2004.11.002.CrossRefPubMed

Garland, A. F., Bickman, L., & Chorpita, B. F. (2010a). Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health, 37(1–2), 15–26. https://doi.org/10.1007/s10488-010-0279-y.CrossRefPubMedPubMedCentral

Garland, A. F., Brookman-Frazee, L., Hurlburt, M. S., Accurso, E. C., Zoffness, R. J., Haine-Schlagel, R., & Ganger, W. (2010b). Mental health care for children with disruptive behavior problems: A view inside therapists’ offices. Psychiatric Services (Washington D C), 61(8), 788–795. https://doi.org/10.1176/ps.2010.61.8.788.CrossRefPubMed

Gorsuch, R. L. (1973). Using Bartlett’s significance test to determine the number of factors to extract. Educational and Psychological Measurement, 33(2), 361–364.CrossRef

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis: A global perspective. Prentice Hall.

Herschell, A. D., Taber-Thomas, S. M., Kolko, D. J., McLeod, B. D., & Jackson, C. B. (2020). Treatment-as-usual for child physical abuse in community mental health centers: Therapist characteristics, client profiles, and therapy processes. Journal of Emotional and Behavioral Disorders, 28(4), 223–234. https://doi.org/10.1177/1063426619866188.CrossRef

Higa-McMillan, C., Kotte, A., Jackson, D., & Daleiden, E. L. (2017). Overlapping and non-overlapping practices in usual and evidence-based care for youth anxiety. The Journal of Behavioral Health Services & Research, 44, 684–694.CrossRef

High-McMillan, C., Park, A., Daleiden, E. L., Becker, K. D., Bernstein, A., & Chorpita, B. F. (2023). Getting more out of clinical documentation. Can clinical dashboards yield clinically helpful information? Manuscript submitted for publication.

Hogue, A., Liddle, H. A., & Rowe, C. (1996). Treatment adherence process research in family therapy: A rationale and some practical guidelines. Psychotherapy: Theory Research Practice Training, 33(2), 332–345. https://doi.org/10.1037/0033-3204.33.2.332.CrossRef

Hogue, A., Dauber, S., & Henderson, C. E. (2014). Therapist self-report of evidence-based practices in usual care for adolescent behavior problems: Factor and construct validity. Administration and Policy in Mental Health, 41(1), 126–139. https://doi.org/10.1007/s10488-012-0442-8.CrossRefPubMed

Hogue, A., Dauber, S., Henderson, C. E., Bobek, M., Johnson, C., Lichvar, E., & Morgenstern, J. (2015). Randomized trial of family therapy versus nonfamily treatment for adolescent behavior problems in usual care. Journal of Clinical Child and Adolescent Psychology, 44(6), 954–969. https://doi.org/10.1080/15374416.2014.963857.CrossRefPubMed

Hogue, A., Bobek, M., Dauber, S., Henderson, C. E., McLeod, B. D., & Southam-Gerow, M. A. (2019). Core elements of family therapy for adolescent behavior problems: Empirical distillation of three manualized treatments. Journal of Clinical Child and Adolescent Psychology, 48(1), 29–41. https://doi.org/10.1080/15374416.2018.1555762.CrossRefPubMedPubMedCentral

Horn, J. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30, 179–185.CrossRefPubMed

Institute of Medicine (2015). Psychosocial interventions for mental and substance use disorders: A framework for establishing evidence-based standards. Retrieved from: http://iom.nationalacademies.org/Reports/2015/Psychosocial-Interventions-Mental-Substance-Abuse-Disorders.aspx.

Kaiser, H. F. (1970). A second generation little jiffy. Psychometrika, 35, 401–415. https://doi.org/10.1007/BF02291817.CrossRef

Kaiser, H. F., & Rice, J. (1974). Little Jiffy, Mark IV. Educational and Psychological Measurement, 34(1), 111–117. https://doi.org/10.1177/001316447403400115.CrossRef

Lambert, M., & Hill, C. (1994). Assessing psychotherapy outcomes and processes. In A. Bergin, & S. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 72–113). Wiley.

Marques, L., Valentine, S. E., Kaysen, D., Mackintosh, M. A., De Silva, D., Ahles, L. E., & Stirman, E. M., S. W (2019). Provider fidelity and modifications to cognitive processing therapy in a diverse community health clinic: Associations with clinical change. Journal of Consulting and Clinical Psychology, 87(4), 357–369.CrossRefPubMedPubMedCentral

McLeod, B. D., & Weisz, J. R. (2010). The therapy process observational coding system for child psychotherapy strategies scale. Journal of Clinical Child and Adolescent Psychology, 39(3), 436–443. https://doi.org/10.1080/15374411003691750.CrossRefPubMed

McLeod, B. D., Smith, M. M., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2015). Measuring treatment differentiation for implementation research: The therapy process observational coding system for child psychotherapy revised strategies scale. Psychological Assessment, 27(1), 314–325. https://doi.org/10.1037/pas0000037.CrossRefPubMed

McLeod, B. D., Southam-Gerow, M. A., Jensen-Doss, A., Hogue, A., Kendall, P. C., & Weisz, J. R. (2019). Benchmarking treatment adherence and therapist competence in individual cognitive-behavioral treatment for youth anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 48(S1), S234–S246.CrossRefPubMed

McLeod, B. D., Martinez, R., Southam-Gerow, M. A., Weisz, J. R., & Chorpita, B. F. (2022). Can a single measure estimate protocol adherence for two psychosocial treatments for youth anxiety delivered in community mental health settings? Behavior Therapy, 53(1), 119–136. https://doi.org/10.1016/j.beth.2021.06.008.CrossRefPubMed

Merry, S. N., Hopkins, S., Lucassen, M. F., Stasiak, K., Weisz, J. R., Frampton, C. M. A., & Crengle, S. (2020). Clinician training in the Modular Approach to Therapy for children to enhance the use of empirically supported treatments and clinical outcomes: A randomized clinical trial. JAMA Network Open, 3(8), e2011799.CrossRefPubMedPubMedCentral

Orlinsky, D. E., Rønnestad, M. H., & Willutzki, U. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change. In M. Lambert (Ed.), Bergin and Garfi’ld’s Handbook of Psychotherapy and Behavior Change (5th ed.). Wiley.

Revelle, W. (2024). psych: Procedures for Psychological, Psychometric, and Personality Research. Northwestern University, Evanston, Illinois. R package version 2.4.1, https://CRAN.R-project.org/package=psych.

RStudio Team (2024). RStudio: Integrated development environment for r. RStudio, PBC. http://www.rstudio.com/.

Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428. https://doi.org/10.1037/0033-2909.86.2.420.CrossRefPubMed

Smith, M. M., McLeod, B. D., Southam-Gerow, M. A., Jensen-Doss, A., Kendall, P. C., & Weisz, J. R. (2017). Does the delivery of CBT for Youth Anxiety Differ Across Research and practice settings? Behavior Therapy, 48(4), 501–516.CrossRefPubMed

Southam-Gerow, M. A., Weisz, J. R., Chu, B. C., McLeod, B. D., Gordis, E. B., & Connor-Smith, J. K. (2010). Does cognitive behavioral therapy for youth anxiety outperform usual care in community clinics? An initial effectiveness test. Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 1043–1052. https://doi.org/10.1016/j.jaac.2010.06.009.CrossRefPubMedPubMedCentral

Tabachnick, B. G., & Fidell, L. S. (2001). Principal components and factor analysis. Using Multivariate Statistics, 4(1), 582–633.

Weersing, V. R., Weisz, J. R., & Donenberg, G. R. (2002). Development of the Therapy procedures Checklist: A therapist-report measure of technique use in child and adolescent treatment. Journal of Clinical Child and Adolescent Psychology, 31, 168–180. https://doi.org/10.1207/153744202753604458.CrossRefPubMed

Weisz, J. R., Southam-Gerow, M. A., Gordis, E. B., Connor-Smith, J. K., Chu, B. C., Langer, D. A., McLeod, B. D., Jensen-Doss, A., Updegraff, A., & Weiss, B. (2009). Cognitive-behavioral therapy versus usual clinical care for youth depression: An initial test of transportability to community clinics and clinicians. Journal of Consulting and Clinical Psychology, 77, 383–396. https://doi.org/10.1037/a0013877.CrossRefPubMedPubMedCentral

Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., & Research Network on Youth Mental Health. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: A randomized effectiveness trial. Archives of General Psychiatry, 69(3), 274–282.CrossRefPubMed

Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., Jensen-Doss, A., Hawley, K. M., Marchette, K., Chu, L. S., Weersing, B. C., V. R., & Fordwood, S. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79–117. https://doi.org/10.1037/a0040360.CrossRefPubMed

Weisz, J. R., Bearman, S. K., Ugueto, A. M., Herren, J. A., Evans, S. C., Cheron, D. M., & Jensen-Doss, A. (2020). Testing robustness of child STEPs effects: A randomized controlled effectiveness trial. Journal of Clinical Child and Adolescent Psychology, 49(6), 883–896. https://doi.org/10.1080/15374416.2019.1655757.CrossRefPubMed

Weller, E. B., Weller, R. A., Rooney, M. T., & Fristad, M. A. (1999a). CHIPS-Children’s interview for Psychiatric syndromes. American Psychiatric.

Weller, E. B., Weller, R. A., Rooney, M. T., & Fristad, M. A. (1999b). Children’s interview for Psychiatric syndromes-parent version (P-ChIPS). American Psychiatric Association Washington, DC.

Titel: The Content of Usual Clinical Care for Youth with Primary Anxiety Problems
verfasst von: Bryce D. McLeod
Stephanie Violante
Erica Ross
Alexys Weihl
Navneet Kaur
Michael A. Southam-Gerow
Heather A. Jones
John R. Weisz
Bruce F. Chorpita
Publikationsdatum: 18.04.2024
Verlag: Springer US
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-024-01378-y

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

The Content of Usual Clinical Care for Youth with Primary Anxiety Problems

Abstract

Neu im Fachgebiet Psychiatrie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

So wirken verschiedene Alkoholika auf den Blutdruck

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

ADHS-Medikation erhöht das kardiovaskuläre Risiko

Update Psychiatrie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet Psychiatrie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

So wirken verschiedene Alkoholika auf den Blutdruck

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

ADHS-Medikation erhöht das kardiovaskuläre Risiko

Update Psychiatrie