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Are Children with Anxiety Disorders Privately Referred to a University Clinic Like Those Referred from the Public Mental Health System?

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Abstract

Compared two groups of children with anxiety disorders served at a single mental health clinic whose referral source differed: private referrals (i.e., parent/legal guardian initiated) and public referrals (e.g., via state contracts—Departments of Health and Education, juvenile justice system). Comparisons were made across three domains of variables: (a) symptoms/diagnoses, (b) functioning, and (c) environments. Few symptom differences emerged. However, large differences were evident for contextual variables like family income and life stressors. Overall, the pattern of differences point to possible directions for adaptation of treatments for use with children with anxiety disorders served in public mental health systems.

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References

  • Achenbach, T. M. (1991). Manual for the child behavior checklists/4-18 and 1991 profile. Burlington: University of Vermont.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC: Author.

    Google Scholar 

  • Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176–181.

    Article  Google Scholar 

  • Berman, S. L., Weems, C. F., Silverman, W. K., & Kurtines, W. M. (2000). Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic and anxiety disorders in children. Behavior Therapy, 31, 713–731.

    Article  Google Scholar 

  • Bird, H. R., Canino, G. J., Davies, M., Ramirez, R., Chavez, L., Duarte, C., et al. (2005). The Brief Impairment Scale (BIS): A multidimensional scale of functional impairment for children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 699–707.

    Article  PubMed  Google Scholar 

  • Bird, H., Shaffer, D., Fisher, P., Gould, M., Staghezza, B., Chen, J., et al. (1993). The Columbia Impairment Scale (CIS): Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3, 167–176.

    Google Scholar 

  • Brent, D. A., Kolko, D. J., Birmaher, B., Baugher, M., Bridge, J., Roth, C., et al. (1998). Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 906–914.

    Article  PubMed  CAS  Google Scholar 

  • Burns, B. J., & Hoagwood, K. (Eds.) (2002). Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford.

    Google Scholar 

  • Capage, L. C., Bennett, G. M., & McNeil, C. B. (2001). A comparison between African American and Caucasian children referred for treatment of disruptive behavior disorders. Child and Family Behavior Therapy, 23, 1–14.

    Article  Google Scholar 

  • Chorpita, B. F. (2002). Treatment manuals for the real world: Where do we build them? Clinical Psychology: Science and Practice, 9, 431–433.

    Article  Google Scholar 

  • Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43, 309–322.

    Article  PubMed  Google Scholar 

  • Chorpita, B. F., Plummer, C., & Moffitt, C. E. (2000). Relations of tripartite dimensions of emotion to childhood anxiety and mood disorders. Journal of Abnormal Child Psychology, 28, 299–310.

    Article  PubMed  CAS  Google Scholar 

  • Chorpita, B. F., & Southam-Gerow, M. A. (2006). Treatment of anxiety disorders in youth. In E. J. Mash & R. A. Barkley (Eds.), Treatment of childhood disorders, 3rd edn. New York: Guilford Press.

    Google Scholar 

  • Chorpita, B. F., Yim, L. M., Donkervoet, J. C., Arensdorf, A., Amundsen, M. J., McGee, C., et al. (2002). Toward large-scale implementation of empirically supported treatments for children: A review and observations by the Hawai’i Empirical Basis to Services Task Force. Clinical Psychology: Science and Practice, 9, 165–190.

    Article  Google Scholar 

  • Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38, 835–855.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences, 2nd edn. Hillsdale: Lawrence Erlbaum Associates, Inc.

    Google Scholar 

  • Cunningham, P. B., & Henggeler, S. W. (1999). Engaging multiproblem families in treatment: Lessons learned throughout the development of multisystemic therapy. Family Process, 38, 265–286.

    Article  PubMed  CAS  Google Scholar 

  • de Ross, R., Gullone, E., & Chorpita, B. F. (2002). The Revised Child Anxiety and Depression Scale: A psychometric investigation with Australian youth. Behaviour Change, 19, 90–101.

    Article  Google Scholar 

  • Francis, S. E., & Chorpita, B. F. (2004). Behavioral assessment of children in outpatient settings. In S. N. Haynes & E. M. Heiby (Eds.), Comprehensive handbook of psychological assessment: Vol. 3. Behavioral assessment (pp. 291–319). Hoboken: John Wiley & Sons.

    Google Scholar 

  • Griffith, J. D., Knight, D. K., Joe, G. W., & Simpson, D. D. (1998). Implications of family and peer relations for treatment engagement and follow-up outcomes: An integrative model. Psychology of Addictive Behaviors, 12, 113–126.

    Article  Google Scholar 

  • Hammen, C., Rudolph, K., Weisz, J., Rao, U., & Burge, D. (1999). The context of depression in clinic-referred youth: Neglected areas in treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 64–71.

    Article  PubMed  CAS  Google Scholar 

  • Henggeler, S. W., Schoenwald, S. K., Rowland, M. D., & Cunningham, P. B. (2002). Serious emotional disturbance in children and adolescents: Multisystemic therapy. New York: Guilford Publications, Inc.

    Google Scholar 

  • Hoagwood, K., Jensen, P. S., Petti, T., & Burns, B. J. (1996). Outcomes of mental health care for children and adolescents: I. A comprehensive conceptual model. Journal of the American Academy of Child and Adolescent Psychology, 35, 1055–1063.

    Article  CAS  Google Scholar 

  • Hoagwood, K., & Olin, S. S. (2002). The NIMH blueprint for change report: research priorities in child and adolescent mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 760–767.

    Article  PubMed  Google Scholar 

  • Hodges, K., & Wong, M. M. (1996). Psychometric characteristics of a multidimensional measure to assess impairment: The child and adolescent functional assessment scale. Journal of Child and Family Studies, 5, 445–467.

    Article  Google Scholar 

  • Hodges, K., & Wong, M. M. (1997). Use of the Child and Adolescent Functional Assessment Scale to predict service utilization and cost. Journal of Mental Health Administration, 24, 278–290.

    Article  PubMed  CAS  Google Scholar 

  • Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.

    Google Scholar 

  • Huey, S. J., & Polo, A. J. (in press). Evidence-based psychosocial treatments for ethnic minority youth: A review and meta-analysis. Journal of Clinical Child & Adolescent Psychology.

  • Jaccard, J., & Guilamo-Ramos, V. (2002). Analysis of variance frameworks in clinical child and adolescent psychology: Advanced issues and recommendations. Journal of Clinical Child and Adolescent Psychology, 31, 278–294.

    Article  PubMed  Google Scholar 

  • Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., et al. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 311–318.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Clinical and Consulting Psychology, 65, 453–463.

    Article  CAS  Google Scholar 

  • Kazdin, A. E., Siegel, T. C., & Bass, D. (1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60, 733–740.

    Article  PubMed  CAS  Google Scholar 

  • Kazdin, A. E., & Wassell, G. (1999). Barriers to treatment participation and therapeutic change among children referred for conduct disorder. Journal of Clinical Child Psychology, 28, 60–172.

    Google Scholar 

  • Kendall, P. C., Marrs-Garcia, A., Nath, S., & Sheldrick, R. C. (1999). Normative comparisons for the evaluation of clinical significance. Journal of Consulting and Clinical Psychology, 67, 285–299.

    Article  PubMed  CAS  Google Scholar 

  • Kendall, P. C., & Sugarman, A. (1997). Attrition in the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 65, 883–888.

    Article  PubMed  CAS  Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales, 2nd edn. Sydney: Psychology Foundation of Australia.

    Google Scholar 

  • McKay, M. M., McCadam, K., & Gonzales, J. J. (1996). Addressing the barriers to mental health services for inner city children and their caretakers. Community Mental Health Journal, 32, 353–361.

    Article  PubMed  CAS  Google Scholar 

  • McMahon, R. J., Wells, K. C., & Kotler, J. S. (2006). Conduct problems. In E. J. Mash & R. A. Barkley (Eds.), Treatment of childhood disorders, 3rd edn. New York: Guilford Press.

    Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10, 155–180.

    Article  Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73, 872–879.

    Article  PubMed  Google Scholar 

  • Patterson, G. R., & Chamberlain, P. (1994). A functional analysis of resistance during parent training therapy. Clinical Psychology: Science and Practice, 1, 53–70.

    Article  Google Scholar 

  • Persons, J. B., & Silberschatz, G. (1998). Are results of randomized controlled trials useful to psychotherapists? Journal of Consulting and Clinical Psychology, 66, 126–135.

    Article  PubMed  CAS  Google Scholar 

  • Rodríguez, M. D., Rodríguez, J., & Davis, M. (2006). Recruitment of first-generation Latinos in a rural community: The essential nature of personal contact. Family Process, 45, 87–100.

    Article  PubMed  Google Scholar 

  • Rogers, J. L., Howard, K. I., & Vessey, J. T. (1993). Using significance tests to evaluate equivalence between two experimental groups. Psychological Bulletin, 113, 553–565.

    Article  PubMed  CAS  Google Scholar 

  • Rohde, P., Clarke, G. N., Mace, D. E., Jorgensen, J. S., & Seeley, J. R. (2004). An efficacy/effectiveness study of cognitive-behavioral treatment for adolescents with comorbid major depression and conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 660–668.

    Article  PubMed  Google Scholar 

  • Safren, S. A., Gonzalez, R. E., Horner, K. J., Leung, A. W., Heimberg, R. G., & Juster, H. R. (2000). Anxiety in ethnic minority youth: Methodological and conceptual issues and review of the literature. Behavior Modification, 24, 147–183.

    Article  PubMed  CAS  Google Scholar 

  • Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when. Psychiatric Services, 52, 1190–1197.

    Article  PubMed  CAS  Google Scholar 

  • Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A children’s global assessment scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.

    PubMed  CAS  Google Scholar 

  • Silverman, W. K., & Albano, A. M. (1996). Anxiety disorders interview schedule for DSM-IV: Child version. San Antonio: Psychological Corporation.

    Google Scholar 

  • Silverman, W. K., & Nelles, W. B. (1988). The influence of gender on children’s ratings of fear in self and same-aged peers. Journal of Genetic Psychology, 149, 17–21.

    PubMed  CAS  Google Scholar 

  • Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: Child and parent versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 937–944.

    Article  PubMed  CAS  Google Scholar 

  • Siqueland, L., Crits-Christoph, P., Gallop, B., Gastfriend, D., Lis, J., Frank, A., Griffin, M., Blaine, J., & Luborsky, L. (2002). Who starts treatment: Engagement in the NIDA collaborative cocaine treatment study. American Journal on Addictions, 11, 10–23.

    Article  PubMed  Google Scholar 

  • Southam-Gerow, M. A. (2005). Using partnerships to adapt evidence-based mental health treatments for use outside labs. Report on Emotional and Behavioral Disorders in Youth, 5, 58–60, 77–79.

  • Southam-Gerow, M. A., Austin, A. A., & Marder, A. M. (in press). Transportability and dissemination of psychological treatments: Research models and methods. In D. McKay (Ed.), Handbook of research methods in abnormal and clinical psychology. Newbury Park: Sage.

  • Southam-Gerow, M. A., Kendall, P. C., & Weersing, V. R. (2001). Examining outcome variability: Correlates of treatment response in a child and adolescent anxiety clinic. Journal of Clinical Child Psychology, 30, 422–436.

    Article  PubMed  CAS  Google Scholar 

  • Southam-Gerow, M. A., Ringeisen, H. L., & Sherrill, J. T. (2006). Introduction to Special Issue: Integrating interventions and services research: Progress and prospects. Clinical Psychology: Science and Practice, 13, 1–8.

    Article  Google Scholar 

  • Southam-Gerow, M. A., Silverman, W. K., & Kendall, P. C. (2006). Client similarities and differences in two childhood anxiety disorders research clinics. Journal of Clinical Child and Adolescent Psychology, 35, 528–538.

    Article  PubMed  Google Scholar 

  • Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2003). Youth with anxiety disorders in research and service clinics: Examining client differences and similarities. Journal of Clinical Child and Adolescent Psychology, 32, 375–385.

    Article  PubMed  Google Scholar 

  • U.S. Department of Health and Human Services. (2003). Outreach notebook for the inclusion, recruitment and retention of women and minority subjects in clinical research (NIH publication no. 03-7036). Retrieved 1 Nov 2007, from http://orwh.od.nih.gov/pubs/outreach.pdf

  • Weiss, B., Catron, T., & Harris, V. (2000). A 2-year follow-up of the effectiveness of traditional child psychotherapy. Journal of Consulting and Clinical Psychology, 68, 1094–1101.

    Article  PubMed  CAS  Google Scholar 

  • Weisz, J. R. (2000). Lab-clinic differences and what we can do about them: I. The Clinic-Based Treatment Development Model. Clinical Child Psychology Newsletter, 15(1–3), 10.

    Google Scholar 

  • Weisz, J. R., Donenberg, G. R., Han, S. S., & Weiss, B. (1995). Bridging the gap between laboratory and clinic in child and adolescent psychotherapy. Journal of Consulting and Clinical Psychology, 63, 688–701.

    Article  PubMed  CAS  Google Scholar 

  • Weisz, J. R., McCarty, C. A., & Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychological Bulletin, 132, 132–149.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Southam-Gerow, M. A., Gordis, E. B., & Connor-Smith, J. K. (2003). Primary and Secondary Control Enhancement Training for youth depression: Applying the Deployment-Focused Model of treatment development and testing. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based treatments for children and adolescents (pp. 165–183). New York: Guilford.

  • Weisz, J. R., Weiss, B., & Donenberg, G. R. (1992). The lab versus the clinic: Effects of child and adolescent psychotherapy. American Psychologist, 47, 1578–1585.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

Preparation of this article was supported in part by National Institute of Mental Health Grant K23 MH69421 to Southam-Gerow and R03 MH60134 to Chorpita as well an award from the University of Hawai’i Research Council, and awards from the Hawai’i Departments of Health and Education to Chorpita. We are grateful to Tina Donkervoet and John Weisz for their support and to A. Aukahi Austin, Sarah Francis, Jennifer Gray, Farrah Greene, Cassian Kimhan, Catherine Moffitt, Brad Nakamura, and John Young for their assistance with data collection.

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Correspondence to Michael A. Southam-Gerow.

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Southam-Gerow, M.A., Chorpita, B.F., Miller, L.M. et al. Are Children with Anxiety Disorders Privately Referred to a University Clinic Like Those Referred from the Public Mental Health System?. Adm Policy Ment Health 35, 168–180 (2008). https://doi.org/10.1007/s10488-007-0154-7

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