TY - JOUR
T1 - Using session recordings to understand the content of community-based treatment for childhood anxiety disorders and response to technology-based training
AU - Whiteside, Stephen P.H.
AU - Sawchuk, Nicholas R.
AU - Brennan, Elle
AU - Lebow, Jocelyn R.
AU - Sawchuk, Craig N.
AU - Biggs, Bridget K.
AU - Dammann, Julie E.
AU - Tiede, Michael S.
AU - Hofschulte, Deanna R.
AU - Reneson-Feeder, Stephanie
AU - Cunningham, Megan
AU - Allison, M. Le Mahieu
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/10
Y1 - 2023/10
N2 - Objective: The goal of the current study is to advance efforts to increase the quality of care for childhood anxiety disorder (CADs) through (1) detailing the content of community-based treatment sessions, (2) exploring the validity of therapist surveys, (3) examining the influence of setting differences, and (4) testing the effects of a technology-based training on use of nonexposure strategies. Methods: Thirteen therapists were randomly assigned to technology-based training in the use of exposure therapy or treatment as usual (TAU) for CADs. Therapeutic techniques were coded from 125 community-based treatment sessions. Results: Consistent with survey responses community therapists spent the majority of session time reviewing symptoms (34% of session time), implementing nonexposure cognitive behavioral therapy (CBT; 36%), and rarely engaged in exposure (3%). An integrated behavioral health setting was associated with greater endorsement of exposure on survey, p < 0.05, although this difference was not significant in session recordings, p = 0.14. Multilevel models indicated that technology-based training that has been shown to increase exposure, also decreased use of nonexposure CBT techniques (2% vs. 29%, p < 0.001). Conclusion: The study supports the validity of survey-based findings that community-based care for CADs consists of non-exposure CBT techniques. Efforts should be invested in dissemination of within-session exposure.
AB - Objective: The goal of the current study is to advance efforts to increase the quality of care for childhood anxiety disorder (CADs) through (1) detailing the content of community-based treatment sessions, (2) exploring the validity of therapist surveys, (3) examining the influence of setting differences, and (4) testing the effects of a technology-based training on use of nonexposure strategies. Methods: Thirteen therapists were randomly assigned to technology-based training in the use of exposure therapy or treatment as usual (TAU) for CADs. Therapeutic techniques were coded from 125 community-based treatment sessions. Results: Consistent with survey responses community therapists spent the majority of session time reviewing symptoms (34% of session time), implementing nonexposure cognitive behavioral therapy (CBT; 36%), and rarely engaged in exposure (3%). An integrated behavioral health setting was associated with greater endorsement of exposure on survey, p < 0.05, although this difference was not significant in session recordings, p = 0.14. Multilevel models indicated that technology-based training that has been shown to increase exposure, also decreased use of nonexposure CBT techniques (2% vs. 29%, p < 0.001). Conclusion: The study supports the validity of survey-based findings that community-based care for CADs consists of non-exposure CBT techniques. Efforts should be invested in dissemination of within-session exposure.
KW - anxiety
KW - anxiety management strategies
KW - child
KW - dissemination
KW - exposure
KW - technology
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U2 - 10.1002/jclp.23537
DO - 10.1002/jclp.23537
M3 - Article
C2 - 37209422
AN - SCOPUS:85159719752
SN - 0021-9762
VL - 79
SP - 2251
EP - 2269
JO - Journal of Clinical Psychology
JF - Journal of Clinical Psychology
IS - 10
ER -