Project Summary

COVID-19-Related Project Enhancement

For youth with anxiety disorders, COVID-19 may increase symptoms. Also, the lack of therapists makes it hard to get treatment in many places. In response to COVID-19, many health systems have shifted from in-person care to telehealth. Telehealth provides care to patients remotely using phone, video, or other devices to help manage care.

With this enhancement, the research team will look at whether it is possible for exposure therapy coaches (working together with a psychologist) to deliver anxiety treatment to youth entirely by telehealth. As in the original award, coaches have a college degree and receive training on treating youth with anxiety.

Enhancement Award Amount: $499,327

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Feeling anxious is a normal way to react to stressful events or situations. But youth with an anxiety disorder have fear, worry, or nervousness that may keep them from doing their regular daily activities. Obsessive-compulsive disorder, or OCD, is a type of anxiety disorder. People with OCD have uncontrollable and repeated thoughts and behaviors. Cognitive behavioral therapy, or CBT, is the preferred treatment for anxiety and OCD. With CBT, patients learn to change their patterns of thinking and behaving. Usually, people go to an office or clinic to get CBT from mental health specialists like psychologists.

In this study, the research team is comparing two ways to provide CBT treatment for youth with anxiety or OCD. The first is CBT at a psychologist’s office. The second is CBT at a psychologist’s office and at the patient’s home. The team is looking at how well these treatments work to improve patients’ symptoms and quality of life.

Who can this research help?

Mental health clinicians can use results from this study when planning how to care for youth with anxiety or OCD.

What is the research team doing?

The research team is recruiting 333 youth ages 5 to 18 in Rhode Island. Patients must have had symptoms of anxiety or OCD for at least three months before starting the study. Patients must also have a parent or caregiver who can participate in treatment.

The research team is assigning patients by chance to one of two treatment groups:

  • Office-based CBT. Patients see a psychologist in an office for 60-minute CBT treatments four times a month for six months.
  • Home-based CBT. Patients see a psychologist in an office for 60-minute CBT treatments once a month for six months. Patients also get a 90-minute home visit with a trained mobile exposure coach three times a month for six months. Coaches have a bachelor’s degree and receive training from psychologists on treating youth with anxiety and OCD. These coaches help patients get the mental health care they need. The treating psychologist supervises the coaches through weekly meetings.

The research team is using interviews and surveys to ask patients and parents about anxiety and OCD symptoms. They also ask about quality of life and satisfaction with mental health services. Patients and parents answer questions at the start of the study and every six weeks for six months. They also answer questions three and six months later.

Patients, families, health insurers, and health system administrators are working with the research team to plan and conduct the study.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population 333 youth ages 5 to 18 diagnosed with anxiety or OCD who have had symptoms for at least 3 months before starting the study
Interventions/
Comparators
  • Office-based CBT
  • Home-based CBT
Outcomes

Primary: anxiety symptoms and severity, OCD symptoms and severity

Secondary: family engagement with treatment, family satisfaction with mental health services, quality of life, functional impairment, caregiver burden, family accommodation, barriers to treatment access, time course of response to treatment, durability of treatment gains, provider volume and capacity, efficiency in treatment

Timeframe Up to 6-month follow-up for primary outcomes

Project Information

Jennifer Freeman, PhD
Emma Pendleton Bradley Hospital
$3,650,235

Key Dates

36 months
November 2017
April 2024
2017

Study Registration Information

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Last updated: December 4, 2020