Expanding Therapy’s Reach: ‘Low-Intensity Interventions’ for Childhood Anxiety Disorders

By Alison Herman

Thirty-three percent on an assessment would be considered acute failure; our mental health systems regularly fail children and teenagers when less than a third of these patients receive the help they need. Given that “half of all lifetime anxiety disorders emerge before age 12,” neglect of this patient population remains both unwarranted and unacceptable. Cathy Creswell and her colleagues may have found a work-around of the under-supported psychiatry and psychotherapy industries.

Our mental health systems regularly fail children and teenagers when less than a third of these patients receive the help they need.

Two short-term treatment regimens, parent-guided cognitive behavioral therapy (CBT) and solution-focused therapy, were evaluated in a randomized control trial. Caregivers in the parent-guided CBT condition received self-help guidebooks in addition to eight sessions with therapists to prepare for the small-scale treatment plan that emphasizes skill-acquisition and recognizing and working against cognitive distortions. Solution focused therapy is “future-focused and works with the strengths and resources of the individual to build solutions.”

Altogether, both interventions require only five hours of contact with therapists. Length of treatment diminishes costs to patients and their families, and, in the case of this study, the “use of brief telephone contacts reduced the need for face-to-face consultations and associated travel costs and time off work or school to attend clinic appointments.” Researchers employed the Clinical Global Impressions of Improvement (CGI-I) to track the progress of the five- to twelve-year old subjects, with both therapies leading to patient betterment in most cases.

Paul Stallard, commenting on the study in The Lancet Psychiatry, summarizes the magnitude of the studies’ impact: “Twice as many children could be treated by brief guided parent-delivered CBT, [which researchers found to be the more cost-effective,] and solution-focused brief therapy than by traditional CAMHS interventions, which typically involve 12–16 sessions.”

Widespread implementation of parent-guided CBT, then, would still exclude approximately one-third of children and adolescents suffering from mental health afflictions. Further research into innovative, cost-minimizing solutions is needed. Early lessons on effective mental health management could save many from excess suffering in adulthood.

 

Sources

Creswell, Cathy, Mara Violato, Hannah Fairbanks, Elizabeth White, Monika Parkinson, Gemma Abitabile, Alessandro Leidi, and Peter Cooper. 2017. “Clinical Outcomes and Cost-Effectiveness of Brief Guided Parent-Delivered Cognitive Behavioural Therapy and Solution-Focused Brief Therapy for Treatment of Childhood Anxiety Disorders: A Randomised Controlled Trial.” The Lancet Psychiatry 4 (7): 529–39.

Stallard, Paul. 2017. “Low-Intensity Interventions for Anxiety Disorders.” The Lancet Psychiatry, May.

 

 

 

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