Rabner Jonathan, Norris Lesley A, Olino Thomas M, Kendall Philip C
Department of Psychology and Neuroscience, Temple University.
Department of Psychiatry and Human Behavior, Brown University.
J Clin Child Adolesc Psychol. 2024 Jul 12:1-12. doi: 10.1080/15374416.2024.2372770.
At the onset of the COVID-19 pandemic, telehealth service use increased. However, little research has compared the efficacy of individual cognitive behavioral therapy (CBT) for youth with anxiety administered via (a) telehealth and (b) in-person. The present study used non-inferiority analyses to examine outcomes for youth with anxiety disorders (diagnosed by an Independent Evaluator; IE) treated via telehealth during the COVID-19 pandemic and youth treated via in-person therapy prior to the COVID-19 pandemic.
Participants ( = 92; M = 11.5 years; 60.1% female; 75.0% White) were 46 youth who completed telehealth treatment and 46 youth who completed services in-person, matched on age and principal anxiety diagnosis. One-sided t-tests for non-inferiority were first estimated. Next, ANOVAs and regression models were performed, examining treatment differences and candidate moderators (e.g. social anxiety disorder, comorbid attention problems).
Results support non-inferiority across multiple indices of outcomes (i.e. self- and caregiver-reported anxiety symptoms, IE-rated functional impairment, and IE-rated treatment response). Analyses indicate that both treatments were effective in reducing anxiety symptoms and functional impairment. Caregivers reported higher post-treatment levels of anxiety for youth treated via telehealth than youth treated in person. No variables moderated the differences in outcomes between treatment modalities.
Findings support that CBT administered via telehealth is similarly efficacious as CBT administered in-person for youth with anxiety. Implications regarding the availability and accessibility of evidence-based treatment for youth with anxiety are discussed.
在新冠疫情初期，远程医疗服务的使用有所增加。然而，很少有研究比较通过（a）远程医疗和（b）面对面方式为焦虑症青少年提供的个体认知行为疗法（CBT）的疗效。本研究采用非劣效性分析，以检验在新冠疫情期间通过远程医疗治疗的焦虑症青少年（由独立评估员诊断）和在新冠疫情之前通过面对面治疗的青少年的治疗效果。
参与者（n = 92；M = 11.5岁；60.1%为女性；75.0%为白人）包括46名完成远程医疗治疗的青少年和46名完成面对面服务的青少年，根据年龄和主要焦虑症诊断进行匹配。首先估计非劣效性的单侧t检验。接下来，进行方差分析和回归模型，检验治疗差异和候选调节因素（如社交焦虑症、共病注意力问题）。
结果支持在多个结果指标上的非劣效性（即自我和照顾者报告的焦虑症状、独立评估员评定的功能损害以及独立评估员评定的治疗反应）。分析表明，两种治疗方法在减轻焦虑症状和功能损害方面均有效。照顾者报告称，通过远程医疗治疗的青少年治疗后的焦虑水平高于面对面治疗的青少年。没有变量调节治疗方式之间结果的差异。
研究结果支持，对于焦虑症青少年，通过远程医疗实施的CBT与面对面实施的CBT疗效相似。讨论了有关为焦虑症青少年提供循证治疗的可及性和可获得性的意义。
