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

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

doi:10.1007/s10488-024-01378-y

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

Adm Policy Ment Health. 2024 Apr 18. doi: 10.1007/s10488-024-01378-y. Online ahead of print.

Authors

Bryce D McLeod¹, Stephanie Violante², Erica Ross³, Alexys Weihl⁴, Navneet Kaur⁴, Michael A Southam-Gerow⁴, Heather A Jones⁴, John R Weisz⁵, Bruce F Chorpita⁶

Affiliations

¹ Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA. bmcleod@vcu.edu.
² Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
³ School of Education, Virginia Commonwealth University, Richmond, USA.
⁴ Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA.
⁵ Department of Psychology, Harvard University, Cambridge, USA.
⁶ Department of Psychology, University of California, Los Angeles, USA.

PMID: 38635134
DOI: 10.1007/s10488-024-01378-y

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.

Keywords: Anxiety; Community mental health; Usual Clinical care; Youth mental health care.

Grants and funding

MH086529/MH/NIMH NIH HHS/United States