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The Content of Usual Clinical Care for Youth with Primary Anxiety Problems

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Abstract

The current study was designed to describe usual clinical care for youth with primary anxiety problems in community mental health centers. The observer-rated Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies scale (TPOCS-RS), designed to assess therapeutic techniques from five theory-based domains, was used to code sessions (N = 403) from the usual clinical care group of two randomized effectiveness trials: (a) Youth Anxiety Study (YAS) with 21 youth (M age = 10.44 years, SD = 1.91; 49.2% Latinx; 46.6%, 53.4% male) and 16 clinicians (77.5% female; 43.8% White), and (b) Child STEPS Multisite Trial with 17 youth (M age = 10.00 years, SD = 1.87; 58.8% male; 41.2% White) and 13 clinicians (M age = 40.00 years; SD = 9.18; 76.9% female; 61.5% White). The average number of TPOCS-RS items observed per treatment session was more than 10, and multiple techniques were used together in each session. All TPOCS-RS items were observed at least once throughout a clinical case, and most items reoccurred (i.e., observed in two or more sessions). The dosage of TPOCS-RS in all items was below 5 on a 7-point scale. In conclusion, clinicians in both usual care samples used a wide range of techniques from several theory-based domains at a low to medium dose. However, the type and dosage of the techniques used did vary across the two samples.

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Funding

Preparation of this article was supported in part by a grant from the National Institute of Mental Health Grant (RO1 MH086529; McLeod & Southam-Gerow).

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Authors and Affiliations

  1. Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA

    Bryce D. McLeod, Alexys Weihl, Navneet Kaur, Michael A. Southam-Gerow & Heather A. Jones

  2. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA

    Stephanie Violante

  3. School of Education, Virginia Commonwealth University, Richmond, USA

    Erica Ross

  4. Department of Psychology, Harvard University, Cambridge, USA

    John R. Weisz

  5. Department of Psychology, University of California, Los Angeles, USA

    Bruce F. Chorpita

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McLeod, B.D., Violante, S., Ross, E. et al. The Content of Usual Clinical Care for Youth with Primary Anxiety Problems. Adm Policy Ment Health (2024). https://doi.org/10.1007/s10488-024-01378-y

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