Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting
We examined the naturalistic effectiveness of exposure-based cognitive behavioral therapy (Ex-CBT) for pediatric anxiety and obsessive-compulsive disorder in a community mental health setting. We also characterized adaptations made to Ex-CBT and whether treatment factors varied by whether youth were...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Journal of Mood and Anxiety Disorders |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950004425000264 |
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| author | Emily M. Becker-Haimes Michal Weiss Temma Schaechter Sophia Young Amanda L. Sanchez |
| author_facet | Emily M. Becker-Haimes Michal Weiss Temma Schaechter Sophia Young Amanda L. Sanchez |
| author_sort | Emily M. Becker-Haimes |
| collection | DOAJ |
| description | We examined the naturalistic effectiveness of exposure-based cognitive behavioral therapy (Ex-CBT) for pediatric anxiety and obsessive-compulsive disorder in a community mental health setting. We also characterized adaptations made to Ex-CBT and whether treatment factors varied by whether youth were Medicaid recipients or not. To do so, we conducted a three-year, retrospective chart review of consecutively treated youth in an Ex-CBT treatment center embedded in a community mental health setting (N = 94; 72.3 % Medicaid recipients, 68.1 % female). We abstracted baseline demographic and clinical characteristics, treatment techniques delivered, and treatment process and response variables to examine whether these varied as a function of Medicaid status and identify predictors of treatment response. Medicaid youth were more racially and linguistically diverse than non-Medicaid youth; there otherwise were no differences in baseline demographic and clinical variables. Ex-CBT was delivered in more than twice as many sessions compared to typical clinical trials. Coded session data indicated a more diverse suite of techniques delivered by clinicians not typically included in Ex-CBT protocols (e.g., case management, discussion of cultural and contextual factors) alongside Ex-CBT. Techniques employed by clinicians varied by insurance status. However, response rates were comparable to those seen in clinical trials (51–70 %, depending on response definition). Receiving a higher dose of exposure predicted greater likelihood of treatment response, as did younger age and male gender; Medicaid status and racial/ethnic minority status did not predict response. Overall, data supported Ex-CBT effectiveness in this setting. Ex-CBT was adapted in ways that differed based on whether youth were Medicaid recipients or not. |
| format | Article |
| id | doaj-art-ac08452c201f4a4280977fef70a26ab4 |
| institution | OA Journals |
| issn | 2950-0044 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Mood and Anxiety Disorders |
| spelling | doaj-art-ac08452c201f4a4280977fef70a26ab42025-08-20T02:33:15ZengElsevierJournal of Mood and Anxiety Disorders2950-00442025-09-011110012910.1016/j.xjmad.2025.100129Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health settingEmily M. Becker-Haimes0Michal Weiss1Temma Schaechter2Sophia Young3Amanda L. Sanchez4Department of Psychiatry, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104, USA; Hall Mercer Community Mental Health, University of Pennsylvania Health System, 245 South 8th Street Hall Mercer, Philadelphia, PA 19106, USA; Correspondence to: Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, 3rd floor, Philadelphia, PA 19104, USA.Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USACollege of Education, Lehigh University, 4729 Research Dr, Bethlehem, PA 18015, USADepartment of Psychiatry, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104, USADepartment of Psychology, George Mason University, 4400 University Dr MS 3F5, Fairfax, VA 22030, USAWe examined the naturalistic effectiveness of exposure-based cognitive behavioral therapy (Ex-CBT) for pediatric anxiety and obsessive-compulsive disorder in a community mental health setting. We also characterized adaptations made to Ex-CBT and whether treatment factors varied by whether youth were Medicaid recipients or not. To do so, we conducted a three-year, retrospective chart review of consecutively treated youth in an Ex-CBT treatment center embedded in a community mental health setting (N = 94; 72.3 % Medicaid recipients, 68.1 % female). We abstracted baseline demographic and clinical characteristics, treatment techniques delivered, and treatment process and response variables to examine whether these varied as a function of Medicaid status and identify predictors of treatment response. Medicaid youth were more racially and linguistically diverse than non-Medicaid youth; there otherwise were no differences in baseline demographic and clinical variables. Ex-CBT was delivered in more than twice as many sessions compared to typical clinical trials. Coded session data indicated a more diverse suite of techniques delivered by clinicians not typically included in Ex-CBT protocols (e.g., case management, discussion of cultural and contextual factors) alongside Ex-CBT. Techniques employed by clinicians varied by insurance status. However, response rates were comparable to those seen in clinical trials (51–70 %, depending on response definition). Receiving a higher dose of exposure predicted greater likelihood of treatment response, as did younger age and male gender; Medicaid status and racial/ethnic minority status did not predict response. Overall, data supported Ex-CBT effectiveness in this setting. Ex-CBT was adapted in ways that differed based on whether youth were Medicaid recipients or not.http://www.sciencedirect.com/science/article/pii/S2950004425000264Exposure therapyCognitive behavioral therapyYouthCommunity mental health |
| spellingShingle | Emily M. Becker-Haimes Michal Weiss Temma Schaechter Sophia Young Amanda L. Sanchez Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting Journal of Mood and Anxiety Disorders Exposure therapy Cognitive behavioral therapy Youth Community mental health |
| title | Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting |
| title_full | Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting |
| title_fullStr | Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting |
| title_full_unstemmed | Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting |
| title_short | Practice-based research examining effectiveness of exposure-based CBT for youth in a community mental health setting |
| title_sort | practice based research examining effectiveness of exposure based cbt for youth in a community mental health setting |
| topic | Exposure therapy Cognitive behavioral therapy Youth Community mental health |
| url | http://www.sciencedirect.com/science/article/pii/S2950004425000264 |
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