Overlapping and Non-overlapping Practices in Usual and Evidence-Based Care for Youth Anxiety

• Published in: The journal of behavioral health services & research 2017-10, Vol.44 (4), p.684-694
• Main Authors: Higa-McMillan, Charmaine, Kotte, Amelia, Jackson, David, Daleiden, Eric L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anxiety; Anxiety disorders; Anxiety Disorders - diagnosis; Anxiety Disorders - therapy; Attention Deficit and Disruptive Behavior Disorders - therapy; Care; Child; Child, Preschool; Community and Environmental Psychology; Community Mental Health Services; Discrepancies; Evidence based; Evidence-Based Practice - methods; Evidence-Based Practice - statistics & numerical data; Female; Functional impairment; Hawaii; Health Informatics; Health Promotion and Disease Prevention; Health Psychology; Humans; Male; Medical diagnosis; Medicine; Medicine & Public Health; Mental disorders; Mental health services; Psychiatry; Psychology, Adolescent - methods; Psychology, Child - methods; Psychosocial factors; Public Health; Regression Analysis; Therapists; Young Adult; Youth
• ISSN: 1094-3412; 1556-3308
• DOI: 10.1007/s11414-016-9502-2

This study compared consistencies and discrepancies in usual care with practices derived from the evidence-base (PDEB) for youth anxiety in a public mental health system. Youth-level factors (diagnosis, functional impairment) as predictors of the discrepancies were also examined. Psychosocial and service data from 2485 youth with an anxiety disorder and/or receiving services for an anxiety treatment target were extracted. Therapists ( N  = 616) identified the treatment targets and practices youth received. Although many PDEB for youth anxiety were used by therapists in this sample, Exposure was only used in 15% of cases. Practices not consistent with youth anxiety treatment were also reported and included: PDEB for other conditions, practices common to all therapies, and practices that are not consistent with evidence-based care. Age and diagnosis predicted the delivery of PDEB for youth anxiety. Usual care incorporated many components of evidence-based care but was more diffuse and less focused on well-supported practices.