Search

This brief report presents the results of an open trial of a telehealth adaptation of a novel team-based approach to cognitive behavioral treatment (CBT) for pediatric anxiety and obsessive-compulsive disorder (OCD). This telehealth modification was necessary as a response to COVID-19 to allow clients to continue to receive treatment during a pause to in-person care in a larger trial of team-based treatment for anxious youth. Participants included 46 youth between the ages of 5 and 18 who received telehealth delivered CBT via a task-sharing model whereby patients and families met monthly with a supervising licensed clinician and with non-licensed staff all other weeks of the month. Participants received treatment for up to 6 months and completed symptom assessments every 6 weeks throughout treatment. Descriptive results demonstrated high patient and caregiver treatment engagement and satisfaction. Anxiety and OCD symptoms decreased significantly from baseline to post-treatment with 68% of participants classified as treatment responders. Patient- and caregiver-reported Top Problems and caregiver-reported quality of life improved significantly from baseline to post-treatment. In addition, the clinical capacity of the licensed provider increased more than two-fold by leveraging non-licensed staff. This novel telehealth delivery model using team-based care has potential to increase provider capacity and reduce barriers to mental health care access for youth. [ABSTRACT FROM AUTHOR]

Partial hospital programs (PHPs) represent an important part of the continuum of care for youth with severe and/or refractory OCD, yet little is known about clinical or utilization outcomes in this setting. The current study aimed to characterize symptom improvement and length of stay (LOS) among 185 youth with OCD treated in a PHP setting and to identify demographic, clinical, and treatment characteristics that predict these outcomes. Results demonstrate a 77.3% treatment response rate and a median LOS of 52 days. Holding other predictors constant, less symptom improvement was observed for youth with lower symptom severity at admission, in a racial or ethnic minoritized group, without comorbid anxiety, and receiving more treatment hours per day. Shorter LOS was observed among youth with public (vs. commercial) insurance, receiving more hours of treatment per day, and not taking a serotonin reuptake inhibitor (SRI). Clinical implications and directions for future research are discussed, including a critical need to understand and improve outcomes for minoritized youth. [ABSTRACT FROM AUTHOR]

Youth of parents who are experiencing psychopathology are more likely to develop emotional concerns, and these mental health symptoms can have a deleterious impact on parents' mental health. However, the relationship between the presentation of specific symptoms in parents and youth is infrequently examined. Symptom network analysis is an analytic approach that is increasingly being used to better understand the relationship of symptoms within and between disorders and can also be used to examine symptom relations within a dyad. The present study used symptom network analysis to examine bidirectional relationships among depressive and anxiety psychopathology in a transdiagnostic sample of treatment-seeking youth and their primary caregiver. Parental anhedonia and child worthlessness exhibited the greatest centrality within the network, suggesting that these may act as risk and maintenance factors for parent–child psychopathology and may be important intervention targets. Findings support the use of symptom network analysis to inform an understanding of the complex relationships among parent and child depressive and anxiety symptoms. Future research should consider the use of network analytic methods to examine the temporal relationships between parent and child psychopathology and to inform joint parent–child interventions for those with internalizing concerns. [ABSTRACT FROM AUTHOR]

"Harm avoidance, incompleteness, and disgust presentations of OCD symptoms and their implications for clinical care using exposure and response prevention." [ABSTRACT FROM AUTHOR]