title: Overlapping and Non-overlapping Practices in Usual and Evidence-Based Care for Youth Anxiety.
abstract: 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.
authors.affiliation: University of Hawai'i at Hilo, Hilo, HI, USA. higac@hawaii.edu.
authors.forename: Charmaine
authors.initials: C
authors.lastname: Higa-McMillan
authors.affiliation: University of Hawai'i at Mānoa, Honolulu, HI, USA.
authors.forename: Amelia
authors.initials: A
authors.lastname: Kotte
authors.affiliation: University of Hawai'i at Mānoa, Honolulu, HI, USA.|Hawai'i Department of Health, Child and Adolescent Mental Health Division, Honolulu, HI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Jackson
authors.affiliation: Kismetrics, LLC, Satellite Beach, FL, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Daleiden
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003156:Community Mental Health Services; D055317:Evidence-Based Practice / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii; D006801:Humans; D008297:Male; D000297:Psychology, Adolescent / Q000379:methods*; D002666:Psychology, Child / Q000379:methods*; D012044:Regression Analysis; D055815:Young Adult
keywords: Disruptive Behavior; Disruptive Behavior Disorder; Public Mental Health System; Usual Care; Youth Anxiety