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20-11-2019

School-Based Treatment for Anxiety Research Study (STARS): a Randomized Controlled Effectiveness Trial

Auteurs: Golda S. Ginsburg, Jeffrey E. Pella, Paige J. Pikulski, Jenn-Yun Tein, Kelly L. Drake

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 3/2020

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Abstract

The current study compared the effectiveness of a school-clinician administered cognitive behavioral treatment (CBT) to treatment as usual (TAU) at post-treatment (i.e., after 12 weeks) and at a 1 year follow-up. Sixty-two school-based clinicians (37 in CBT; 25 in TAU) and 216 students (148 students in CBT; 68 in TAU) participated. Students were ages 6–18 (mean age 10.87; 64% Caucasian & 29% African American; 48.6% female) and all met DSM-IV diagnostic criteria for a primary anxiety disorder. Independent evaluators (IEs) assessed clinical improvement, global functioning, and loss of anxiety diagnoses; children and parents completed measures of anxiety symptoms. At post-treatment, no significant treatment main effects emerged on the primary outcome; 42% and 37% of youth were classified as treatment responders in CBT and TAU respectively. However, parent-report of child anxiety showed greater improvements in CBT relative to TAU (d = .29). Moderation analyses at post-treatment indicated that older youth, those with social phobia and more severe anxiety at baseline were more likely to be treatment responders in CBT compared to TAU. At the 1 year follow-up, treatment gains were maintained but no treatment group differences or moderators emerged. CBT and TAU for pediatric anxiety disorders, when delivered by school clinicians were generally similar in effectiveness for lowering anxiety and improving functioning at both post-treatment (on all but the parent measure and for specific subgroups) and 1 year follow-up. Implications for disseminating CBT in the school setting are discussed.
Voetnoten
1
The original study protocol published on ClinicalTrials.gov varies from the current manuscript in that some secondary outcome measures will appear in a separate manuscript and several new outcome measures (e.g., remission variable) were added to facilitate comparisons to published RCTs. The current study also under-recruited.
 
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Metagegevens
Titel
School-Based Treatment for Anxiety Research Study (STARS): a Randomized Controlled Effectiveness Trial
Auteurs
Golda S. Ginsburg
Jeffrey E. Pella
Paige J. Pikulski
Jenn-Yun Tein
Kelly L. Drake
Publicatiedatum
20-11-2019
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 3/2020
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-019-00596-5