Can school counselors deliver cognitive‐behavioral treatment for social anxiety effectively? A randomized controlled trial

Warner, Carrie Masia; Colognori, Daniela; Brice, Chad; Herzig, Kathleen; Mufson, Laura; Lynch, Chelsea; Reiss, Philip T.; Petkova, Eva; Fox, Jeremy K.; Moceri, Dominic C.; Ryan, Julie L.; Klein, Rachel G.

doi:10.1111/jcpp.12550

Cited by 71 publications

(43 citation statements)

References 37 publications

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“…We found 19 eligible articles representing 19 studies [13, 14, 46–62] (one article reported on two different studies [55] and another two articles [51, 60] reported outcomes for the same trial). These studies represent 18 strategies.…”

Section: Resultsmentioning

confidence: 99%

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Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review

et al. 2017

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BackgroundSome outcomes for children with mental health problems remain suboptimal because of poor access to care and the failure of systems and providers to adopt established quality improvement strategies and interventions with proven effectiveness. This review had three goals: (1) assess the effectiveness of quality improvement, implementation, and dissemination strategies intended to improve the mental health care of children and adolescents; (2) examine harms associated with these strategies; and (3) determine whether effectiveness or harms differ for subgroups based on system, organizational, practitioner, or patient characteristics.MethodsSources included MEDLINE®, the Cochrane Library, PsycINFO, and CINAHL, from database inception through February 17, 2017. Additional sources included gray literature, additional studies from reference lists, and technical experts. Two reviewers selected relevant randomized controlled trials (RCTs) and observational studies, extracted data, and assessed risk of bias. Dual analysis, synthesis, and grading of the strength of evidence for each outcome followed for studies meeting inclusion criteria. We also used qualitative comparative analysis to examine relationships between combinations of strategy components and improvements in outcomes.ResultsWe identified 18 strategies described in 19 studies. Eleven strategies significantly improved at least one measure of intermediate outcomes, final health outcomes, or resource use. Moderate strength of evidence (from one RCT) supported using provider financial incentives such as pay for performance to improve the competence with which practitioners can implement evidence-based practices (EBPs). We found inconsistent evidence involving strategies with educational meetings, materials, and outreach; programs appeared to be successful in combination with reminders or providing practitioners with newly collected clinical information. We also found low strength of evidence for no benefit for initiatives that included only educational materials or meetings (or both), or only educational materials and outreach components. Evidence was insufficient to draw conclusions on harms and moderators of interventions.ConclusionsSeveral strategies can improve both intermediate and final health outcomes and resource use. This complex and heterogeneous body of evidence does not permit us to have a high degree of confidence about the efficacy of any one strategy because we generally found only a single study testing each strategy.Trial registrationPROSPERO, CRD42015024759.

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Section: Resultsmentioning

confidence: 99%

“…This evidence base for KQ 1 consisted of 19 studies [13, 14, 46–62]. Of these, one addressed KQ 2 (harms) and four addressed KQ 3 (moderators of effectiveness).…”

Section: Resultsmentioning

confidence: 99%

Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review

et al. 2017

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“…Data for the present study was collected as part of a controlled trial of Skills for Academic and Social Success (SASS), a school-based group CBT intervention for adolescent SAD [14]. The trial was approved by the Institutional Board of Research Associates at ( institution omitted ).…”

Section: Methodsmentioning

confidence: 99%

“…Adolescents were eligible for the trial if assigned a primary diagnosis of SAD. For further description of trial procedures, see Masia Warner et al [14]. …”

Section: Methodsmentioning

confidence: 99%

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Assessing Clinical Improvement in School-Based Treatment for Social Anxiety Disorder: Agreement Between Adolescents, Parents, and Independent Evaluators

Fox

Warner

2016

Child Psychiatry Hum Dev

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The Clinical Global Impressions of Improvement (CGI-I) scale is widely used in clinical trials to monitor clinically meaningful change during treatment. Although it is standard practice in research to have independent evaluators (IEs) complete the CGI-I, this approach is not practical in school and community settings. Few studies have explored the potential utility of other informants, such as youth and parents. Therefore, this study aimed to investigate agreement between IEs and both adolescents and parents in CGI-I improvement ratings in the context of a randomized controlled trial of cognitive-behavioral therapy for social anxiety disorder, as delivered by psychologists and school counselors. Multilevel growth models indicated that IEs were generally more conservative in their ratings of positive treatment response across time and treatment conditions, though greater agreement was observed between parents and IEs by post-intervention and five-month follow-up. Possible explanations for these findings and suggestions for alternative approaches are discussed.

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Cognitive behavioural therapy for anxiety disorders in children and adolescents

James

Reardon

Soler

et al. 2020

Cochrane Database of Systematic Reviews

139

124

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Can school counselors deliver cognitive‐behavioral treatment for social anxiety effectively? A randomized controlled trial

Abstract: With training, school counselors are effective treatment providers to adolescents with social anxiety, yielding benefits comparable to those obtained by specialized psychologists. Questions remain regarding means to maintain counselors' practice standards without external support.

Cited by 71 publications

References 37 publications

Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review

Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review

Assessing Clinical Improvement in School-Based Treatment for Social Anxiety Disorder: Agreement Between Adolescents, Parents, and Independent Evaluators

Cognitive behavioural therapy for anxiety disorders in children and adolescents

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