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Delivery of a Therapist-Facilitated Telecare Anxiety Program to Children in Rural Communities: A Pilot Study

Published online by Cambridge University Press:  22 August 2017

Lauren F. McLellan*
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
Vanessa Andrijic
Affiliation:
Royal Far West, Sydney, New South Wales, Australia
Suzanne Davies
Affiliation:
Royal Far West, Sydney, New South Wales, Australia
Heidi J. Lyneham
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
Ronald M. Rapee
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
*
Address for correspondence: Lauren F. McLellan, Centre for Emotional Health, Department of Psychology, Macquarie University, NSW 2109, Australia. Email: lauren.mclellan@mq.edu.au
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Abstract

Objective: This pilot study explored the feasibility and preliminary efficacy of a therapist-facilitated telecare cognitive behavioural anxiety program delivered through schools to children within rural communities. Method: Sixteen children aged 9–12 years (82.5% male), with a principal diagnosis of an anxiety disorder, and their mothers participated in the pilot study. The treatment program was an adaption of the Cool Kids Child and Adolescent Anxiety Management Program. Treatment was delivered by clinical psychologists and involved 10 weekly sessions with children via an interactive, real-time videoconferencing online platform at their school. Parents also received 4 phone calls during the treatment program. Outcome measures included clinician-rated diagnostic status and child- and parent-reported symptoms and interference. Results: According to combined parent and child reports, 62.5% of children no longer met diagnostic criteria for their primary anxiety disorder, and 31.25% did not meet diagnostic criteria for any anxiety disorder post-treatment. Results indicated that the severity of anxiety symptoms, functional impact of anxiety symptoms, externalising difficulties, and depressive symptoms in children decreased significantly post-treatment, as reported by both parents and children. Conclusions: A telecare model of therapy could be a feasible and effective way of delivering evidence-based intervention to children in rural communities.

Type
Standard Papers
Copyright
Copyright © The Author(s) 2017 

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References

American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
Anderson, P., Jacobs, C., & Rothbaum, B.O. (2004). Computer-supported cognitive-behavioral treatment of anxiety disorders. Journal of Clinical Psychology, 27, 459468.Google Scholar
Angold, A., Costello, E.J., Messer, S.C., Pickles, A., Winder, F., & Silver, D. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237249.Google Scholar
Barrett, P.M., Dadds, M.R., & Rapee, R.M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333342.Google Scholar
Boydell, K.M., Pong, R., Volpe, T., Tilleczek, K., Wilson, E., & Lemieux, S. (2006). Family perspectives on pathways to mental health care for children and youth in rural communities. Journal of Rural Health, 22, 182188. doi:10.1111/j.1748-0361.2006.00029.x.Google Scholar
Duncan, A.B., Velasquez, S.E., & Nelson, E.L. (2014). Using videoconferencing to provide psychological services to rural children and adolescents: A review and case example. Journal of Clinical Child & Adolescent Psychology, 43, 115127.CrossRefGoogle ScholarPubMed
Dunstan, D.A., & Tooth, S.M. (2012). Treatment via videoconferencing: A pilot study of delivery by clinical psychology trainees. Australian Journal of Rural Health, 20, 8894.Google Scholar
Elford, R., White, H., Bowering, R., Ghandi, A., Maddiggan, B., & John, K.S. (2000). A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. Journal of Telemedicine and Telecare, 6, 7382. doi:10.1258/1357633001935086.Google Scholar
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry, 38, 581586.Google Scholar
Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of American Academy of Child Adolescent Psychiatry, 40, 13371345.Google Scholar
Goodman, R., & Scott, S. (1999). Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? Journal of Abnormal Child Psychology, 27, 1724.Google Scholar
Himle, J.A., Fischer, D.J., Muroff, J.R., Van Etten, M.L., Lokers, L.M., Abelson, J.L., & Hanna, G.L. (2006). Videoconferencing-based cognitive-behavioural therapy for obsessive-compulsive disorder. Behavioural Research and Therapy, 44, 18211829.Google Scholar
Infantino, A., Donovan, C.L., & March, S. (2016). A randomized controlled trial of an audio-based treatment program for child anxiety disorders. Behaviour Research and Therapy, 79, 3545.Google Scholar
James, A.C. James, G. Cowdrey, F.A., Soler, A., & Choke, A. (2013). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD004690. doi:10.1002/14651858.CD004690.pub3 Google Scholar
Judd, F.K., Jackson, H.J., Komiti, A., Murray, G., Hodgins, G., & Fraser, C. (2002). High prevalence disorders in urban and rural communities. Australian and New Zealand Journal of Psychiatry, 36, 104113. doi:10.1046/j.1440-1614.2002.00986.x.CrossRefGoogle ScholarPubMed
Lyneham, H.J., Abbott, M.J., & Rapee, R.M. (2007). Interrater reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and parent version. Journal of the Academy of Child and Adolescent Psychiatry, 46, 731736. doi:1097/chi.0b013e3180465a09 Google Scholar
Lyneham, H.J., & Rapee, R.M. (2007). Childhood anxiety in rural and urban areas: Presentation, impact and help seeking. Australian Journal of Psychology, 59, 108118.Google Scholar
Lyneham, H.J., & Rapee, R.M. (2006). Evaluation of therapist-supported parent implemented CBT for anxiety disorders in rural children. Behaviour Research & Therapy, 44, 12871300.Google Scholar
Lyneham, H.J., & Rapee, R.M. (2005). Agreement between telephone and in-person delivery of a Structured Interview for Anxiety Disorders in Children. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 274282. doi:10.1097/00004583-200503000-00012.Google Scholar
Lyneham, H.J., Sburlati, E.S., Abbott, M.J., Rapee, R.M., Hudson, J.L., Tolin, D.F., & Carlson, S.E. (2013). Psychometric properties of the Child Anxiety Life Interference Scale (CALIS). Journal of Anxiety Disorders, 27, 711719. doi:10.1016/j.janxdis.2013.09.008.Google Scholar
March, S., Spence, S.H., & Donovan, C.L. (2009). The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology, 34, 474487.Google Scholar
Messer, S.C., Angold, A., Costello, E.J., Loeber, R., Van Kammen, W., & Stouthhamer-Loeber, M. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: Factor composition and strucutre across development. International Journal of Methods in Psychiatric Research, 5, 251262.Google Scholar
Nauta, M.H., Scholing, A., Rapee, R.M., Abbott, M., Spence, S.H., & Waters, A. (2004). A parent-report measure of children's anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behavior Research & Therapy, 42, 813839.Google Scholar
Podina, I.R., Mogoase, C., David, D., Szentagotai, A., & Dobrean, A. (2016). A meta-analysis on the efficacy of technology mediated CBT for anxious children and adolescents. Journal Rational-Emotive Cognitive-Behavior Therapy, 34, 3150. doi: 10.1007/s10942-015-0228-5.Google Scholar
Pullman, M.D., VanHooser, S., Hoffman, C., & Heflinger, C.A. (2010). Barriers to and supports of family participation in a rural system of care for children with serious emotional problems. Community Mental Health Journal, 46, 211220. doi:10.1007/s10597-009-9208-5.CrossRefGoogle Scholar
Rapee, R.M. (2012). Family factors in the development and management of anxiety disorders. Clinical Child and Family Psychology Review, 15, 6980. doi:10.1007/s10567-011-0106-3.Google Scholar
Rapee, R.M., Abbott, M.J., & Lyneham, H.J. (2006). Bibliotherapy for children with anxiety disorders using written materials for parents: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74, 436444. doi:10.1037/0022-006x.74.3.436.Google Scholar
Rapee, R.M., Lyneham, H.J., Schniering, C.A., Wuthrich, V., Abbott, M.J., Hudson, J.L., & Wignall, A. (2006). The Cool Kids® Child and Adolescent Anxiety Program. Sydney, Australia: Centre for Emotional Health, Macquarie University.Google Scholar
Rapee, R.M., Wignall, A., Spence, S.H., Cobham, V.E., & Lyneham, H. (2008). Helping your anxious child: A step-by-step guide for parents (2nd ed.). Oakland, CA: New Harbinger.Google Scholar
Reynolds, S., Wilson, C., Austin, J., & Hooper, L. (2012). Effects of psychotherapy for anxiety in children and adolescents: A meta-analytic review. Clinical Psychology Review, 32, 251262.Google Scholar
Richardson, L.K., Freuh, B.C., Grubaugh, A.L., Johnson, R.H., Egede, L., Johnson, R.H., & Elhai, J.E. (2009). Current directions in videoconferencing tele-mental health research. Clinical Psychology: Science and Practice, 16, 323338.Google ScholarPubMed
Richardson, T., Stallard, P., & Velleman, S. (2010). Computerised cognitive behavioural therapy for the prevention and treatment of dpression and anxiety in children and adolescents: A systematic review. Clinical Child and Family Psychology Review, 13, 275290.CrossRefGoogle Scholar
Rooksby, M., Elouafkaoui, P., Humphris, G., Clarkson, J., & Freeman, R. (2015). Internet-assisted delivery of cognitive behavioural therapy (CBT) for childhood anxiety: Systematic review and meta-analysis. Journal of Anxiety Disorders, 29, 8392.Google Scholar
Slone, N.C., Reese, R.J., & McClellan, M.J. (2012). Telepsychology outcome research with children and adolescents: A review of the literature. Psychological Services, 9, 272292.Google Scholar
Silverman, W.K., & Albano, A. (1996). The Anxiety Disorders Interview Schedule for Children — IV (Child and parent versions). San Antonio, TX: Psychological Corporation.Google Scholar
Silverman, W.K., Pina, A.A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 37, 105130. doi:10.1080/15374410701817907.Google Scholar
Spence, S.H. (1998). A measure of anxiety symptoms among children. Behaviour Research & Therapy, 36, 545566.CrossRefGoogle ScholarPubMed
Spence, S.H., Donovan, C.L., March, S., Gamble, A., Anderson, R., Prosser, S., Kercher, A., & Kenardy, J. (2008). Online CBT in the treatment of child and adolescent anxiety disorder: Issues in the development of BRAVE-ONLINE and two case illustrations. Behavioural and Cognitive Psychotherapy, 36, 411430. doi:10.1017/S135246580800444X.Google Scholar
Vallury, K.D., Jones, M., & Oosterbroek, C. (2015). Computerized cognitive behaviour therapy for anxiety and depression in rural areas: A systematic review. Journal of Medical Internet Research, 17, e139. doi:10.2196/jmir.4145.Google Scholar
Vigerland, S., Ljotsson, B., Thulin, U., Ost, L., Andersson, G., & Serlachius, E. (2016). Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial. Behaviour Research and Therapy, 76, 4756. doi:j.brat.2015.11.006 Google Scholar
Wei, C., & Kendall, P.C. (2014). Parental involvement: Contribution to childhood anxiety and its treatment. Clinical Child & Family Psychology Review, 17, 319339. doi 10.1007/s10567-014-0170-6 Google Scholar