Utilizing Health Information Technology to Improve Health Care Quality

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Project Details -
Completed

Anxiety disorders are common among children, and untreated symptoms can have a profound effect on later functioning. Cognitive behavioral therapy (CBT) is the gold standard to treat anxiety in youth, but dissemination of CBT is limited. The overall objective of this project was to examine the effectiveness, feasibility, and acceptability of an established computer-assisted cognitive behavioral therapy program (CCBT) among anxious children at community mental health centers.

The specific aims of the project were as follows:

  • Assess a CCBT protocol for clarity, completeness, and feasibility in a pilot study of children ages 7-13 years, with clinically significant anxiety within a community mental health center setting. 
  • Conduct a randomized controlled trial to determine the efficacy of the CCBT protocol, relative to active patient-directed intervention (i.e., treatment as usual) within a community mental health center population. 

For the first aim, the investigators examined a CCBT protocol among youth aged 7-13 years to determine its acceptability and feasibility. They collected feedback from consumers, providers, and administrators to help refine assessment and treatment delivery protocols and address barriers in preparation for the randomized trial. One hundred youth were randomized to receive either the CCBT program or treatment as usual to evaluate the efficacy of CCBT with clinically significant anxiety disorders and to examine whether CCBT resulted in improved global functioning and reduced child- and parent-rated anxiety symptoms relative to standard care.

Those randomized to the CCBT had more favorable outcomes on primary anxiety outcomes compared to those in the treatment as usual arm. High levels of satisfaction with the program were reported among participants and staff. These data provide support that CCBT is an efficacious treatment for anxious youth when used within community mental centers.