The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders

Wu, Monica S.; Caporino, Nicole E.; Peris, Tara S.; Pérez, Jocelyn; Thamrin, Hardian; Albano, Anne Marie; Kendall, Philip C.; Walkup, John T.; Birmaher, Boris; Compton, Scott N.; Piacentini, John

doi:10.1007/s10802-019-00574-x

Cited by 20 publications

(14 citation statements)

References 62 publications

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“…A meta-analysis of 50 randomized trials found a significant, positive effect of SSIs on mental health problems, versus control conditions, at post-intervention (g=.32;Schleider & Weisz, 2017)-an effect comparable to that observed for longer-term therapies lasting 16 weeks on average (g = .46; Weisz et al, 2017). SSIs may also improve treatment expectancies, which predict subsequent engagement and response (Swift et al, 2012;Thiruchselvam et al, 2019;Wu et al, 2020). For instance, relative to a placebo control, a 15-minute, online SSI teaching that emotions are malleable strengthened adults' beliefs that therapy could be effective (Schleider & Weisz, 2018).…”

Section: What Are Single-session Interventions and Why Deliver Them? mentioning

confidence: 89%

Open Pilot Trial of a Single-Session Consultation Service for Clients on Psychotherapy Wait-Lists

Jl¹,

Sung²,

Bianco³

et al. 2020

Preprint

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Background. The demand for psychological services outpaces the number of available providers. Waitlists at mental health clinics range from weeks to months in length, and longer wait-times predict less favorable outcomes once treatment begins. There is a need for efficient, sustainable service models that provide faster access to care. Offering interim, low-intensity supports to treatment-seekers may both strengthen clinically-relevant proximal outcomes and prevent clinical deterioration while waiting for longer-term treatment. Thus, we tested the acceptability and short-term effects of a solution-focused single-session consultation (SSC), offered to individuals waiting for therapy at two outpatient mental health clinics. Method. Clients wait-listed for outpatient therapy at either clinic were offered an SSC. Participants self-reported overall psychological distress at baseline and two-week follow-up, along with levels of hopelessness and perceived agency at baseline and post-intervention. Participants also rated the SSC’s acceptability. Results. Of 90 treatment-seeking individuals offered an SSC, 46 (51.11%) scheduled an appointment, and 30 (65.21%) attended the session (M age = 31.2, 72.67% female). SSC recipients reported significant pre- to post-intervention improvements in perceived agency (d_z = 1.11, p < .001) and hopelessness (d_z = 1.43, p < .001). Psychological distress significantly decreased from baseline to follow-up (d_z = .73, p = .002). Participants rated SSC sessions as highly acceptable, useful, and worth recommending to others. Conclusions. A solution-focused single-session consultation was associated with improvements in hopelessness, agency, and psychological distress in treatment-seeking adults. Pending larger-scale controlled trials, the SSC may help prevent clinical deterioration among individuals on therapy wait-lists.

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Section: What Are Single-session Interventions and Why Deliver Them? mentioning

confidence: 89%

Open Pilot Trial of a Single-Session Consultation Service for Clients on Psychotherapy Wait-Lists

Jl¹,

Sung²,

Bianco³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Youth compliance and mastery of exposure are associated with better CBT response (Peris et al, 2017). In addition, those with more positive expectations about the value of exposure in therapy are more compliant with practice (Wu et al, 2019), underscoring the importance of psychoeducation. Indeed, compliance with exposure practice mediates the link between treatment expectations and anxiety symptom improvement (Wu et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…In addition, those with more positive expectations about the value of exposure in therapy are more compliant with practice (Wu et al, 2019), underscoring the importance of psychoeducation. Indeed, compliance with exposure practice mediates the link between treatment expectations and anxiety symptom improvement (Wu et al, 2019). Other work has considered the role of therapeutic alliance and patient engagement, finding evidence for reciprocal relationships throughout the course of treatment (McLeod, Southam‐Gerow, & Kendall, 2017).…”

Section: Resultsmentioning

confidence: 99%

Research Review: Pediatric anxiety disorders – what have we learnt in the last 10 years?

Strawn

Peris³

et al. 2020

Child Psychology Psychiatry

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Background Anxiety disorders first emerge during the critical developmental periods of childhood and adolescence. This review synthesizes recent findings on the prevalence, risk factors, and course of the anxiety disorders; and their neurobiology and treatment. Methods For this review, searches were conducted using PubMed, PsycINFO, and http://clinicaltrials.gov. Findings related to the epidemiology, neurobiology, risk factors, and treatment of pediatric anxiety disorders were then summarized. Findings Anxiety disorders are high prevalence, and early‐onset conditions associated with multiple risk factors including early inhibited temperament, environment stress, and structural and functional abnormalities in the prefrontal‐amygdala circuitry as well as the default mode and salience networks. The anxiety disorders are effectively treated with cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and serotonin–norepinephrine reuptake inhibitors (SNRIs). Conclusions Anxiety disorders are high prevalence, early‐onset conditions associated with a distinct neurobiological fingerprint, and are consistently responsive to treatment. Questions remain regarding who is at risk of developing anxiety disorders as well as the way in which neurobiology predicts treatment response.

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“…Furthermore, clients who report more positive attitudes toward the video lesson are hypothesized to report a greater use of coping skills, given that higher treatment expectations have been linked to greater homework compliance and skills use. 20,21 Collectively, these data highlight the utility of COVID-19-specific digital tools in real-world settings, and can inform the development and dissemination of such content within blended care programs.…”

Section: Introductionmentioning

confidence: 85%

Development, Acceptability, and Feasibility of a Digital Module for Coping with COVID-19 Distress: Pragmatic Retrospective Study

Lau

Wilks

et al. 2021

Telemedicine Reports

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Background: The coronavirus disease 2019 pandemic and the measures to help contain it have taken a significant toll on mental health. Blended care psychotherapy combining provider-led care with digital tools can help alleviate this toll. This study describes the development of digital activities designed to teach cognitive-behavioral skills for coping with COVID-19 distress, and evaluates initial acceptability and feasibility data. Materials and Methods: Using a pragmatic retrospective cohort design, data from 664 U.S.-based individuals enrolled in blended care psychotherapy were analyzed. Descriptive analyses summarized acceptability for the digital activities. Ordinal logistic regression analyses were conducted on a subsample (n = 162) to explore the association between clients' attitudes toward the digital lesson and reported practice of skills in the exercise. Results: The majority of clients completed the assigned digital lesson and exercise. Clients reported finding the lesson valuable and relevant for coping with COVID-19 distress, and they intended to apply the skills to their lives. Higher agreement with these attitude questions was associated with a significantly greater number of skills practiced on the digital exercise. Discussion: Clients who were assigned a cognitive-behaviorally oriented digital lesson and/or exercise within a blended care model largely engaged with the materials and found them valuable. Clients with more positive attitudes about the digital lesson reported using more coping skills. Conclusions: Digital modules that teach specific skills for coping with COVID-19 can be integrated into treatment and minimize provider burden. Future study should investigate the clinical impact of these digital activities on psychiatric symptoms and personalizing the content.

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The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders

Cited by 20 publications

References 62 publications

Open Pilot Trial of a Single-Session Consultation Service for Clients on Psychotherapy Wait-Lists

Open Pilot Trial of a Single-Session Consultation Service for Clients on Psychotherapy Wait-Lists

Research Review: Pediatric anxiety disorders – what have we learnt in the last 10 years?

Development, Acceptability, and Feasibility of a Digital Module for Coping with COVID-19 Distress: Pragmatic Retrospective Study

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