@article{17025f89ea0d4264bc73d8d314289566,
title = "Integrating evidence-based assessment into clinical practice for pediatric anxiety disorders",
abstract = "Background: Although evidence-based assessments are the cornerstone of evidence-based treatments, it remains unknown whether incorporating evidence-based assessments into clinical practice enhances therapists{\textquoteright} judgment of therapeutic improvement. This study examined whether the inclusion of youth- and parent-reported anxiety rating scales improved therapists{\textquoteright} judgment of treatment response and remission compared to the judgment of treatment-masked independent evaluators (IEs) after (a) weekly/biweekly acute treatment and (b) monthly follow-up care. Methods: Four hundred thirty six youth received cognitive-behavioral therapy (CBT), medication, CBT with medication, or pill placebo through the Child/Adolescent Anxiety Multimodal Study. Participants and parents completed the following anxiety scales at pretreatment, posttreatment, and follow-up: Screen for Childhood Anxiety and Related Disorders (SCARED) and Multidimensional Anxiety Scale for Children (MASC). IEs rated anxiety on the Clinical Global Impression of Severity (CGI-S) and Improvement (CGI-I) at posttreatment and follow-up. Therapists rated anxiety severity and improvement using scales that paralleled IE measures. Results: Fair-to-moderate agreement was found between therapists and IEs after acute treatment (κ = 0.38–0.48), with only slight-to-fair agreement found after follow-up care (κ = 0.07–0.33). Optimal algorithms for determining treatment response and remission included the combination of therapists{\textquoteright} ratings and the parent-reported SCARED after acute (κ = 0.52–0.54) and follow-up care (κ = 0.43–0.48), with significant improvement in the precision of judgments after follow-up care (p <.02–.001). Conclusion: Therapists are good at detecting treatment response and remission, but the inclusion of the parent-report SCARED optimized agreement with IE rating—especially when contact was less frequent. Findings suggest that utilizing parent-report measures of anxiety in clinical practice improves the precision of therapists{\textquoteright} judgment.",
keywords = "adolescents, anxiety disorders, assessment, children, evidence-based assessment",
author = "McGuire, {Joseph F.} and Caporino, {Nicole E.} and Palitz, {Sophie A.} and Kendall, {Philip C.} and Albano, {Anne Marie} and Ginsburg, {Golda S.} and Boris Birmaher and Walkup, {John T.} and John Piacentini",
note = "Funding Information: This study was supported in part by grants (U01 MH064089 to Dr. Walkup; U01 MH64092 to Dr. Albano; U01 MH64003 to Dr. Birmaher; U01 MH63747 to Dr. Kendall; U01 MH64107 to Dr. March; U01 MH64088 to Dr. Piacentini; and U01 MH064003 to Dr. Compton) from the National Institute of Mental Health (NIMH). Sertraline and matching placebo were supplied free of charge by Pfizer. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or NIH. Funding Information: Ms. Palitz has nothing to disclose. Dr. McGuire has received support from the Tourette Association of America, American Academy of Neurology, the Brain Research Foundation, and NIMH. He receives royalties from Elsevier, and serves as a consultant for Bracket and Luminopia. Dr. Caporino has received an honorarium from NICHD and grant funding from the American Psychological Foundation and the Anna‐Maria and Stephen Kellen Foundation. Dr. Kendall has received research support from NIMH. He has received honoraria from professional societies for speaking at conventions. He has received royalties from Guildford Press, Ericsson, Workbook Publishing (his spouse's employment), and Oxford University Press. Dr. Ginsburg has received support from NIMH and from the US Department of Education/Institute of Education Sciences. Dr. Albano has received royalties from Oxford University Press for the Anxiety Disorders Interview Schedule, Child and Parent Versions. She has received an Editor's Honorarium from the American Psychological Association. Dr. Birmaher has received grants from NIMH and receives royalties from APA Press, UptoDate, and Random House for previous publications. Dr. Walkup has received research support from the Tourette Syndrome Association of America and the Hartwell Foundation. He has received honoraria and travel expenses for speaking engagements and meetings sponsored by the Tourette Association of America. He has received royalties from Guilford Press and Oxford University Press for multi‐author books published about Tourette's syndrome and from Wolters Kluwer for CME activity on childhood anxiety. He has served as an unpaid advisor to the Anxiety Disorders Association of America and the Trichotillomania Learning Center. He has served as a paid speaker for the Tourette Syndrome—Center for Disease Control and Prevention outreach educational programs, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association. Dr. Piacentini has received grant or research support from NIMH, Pfizer Pharmaceuticals through the Duke University Clinical Research Institute CAPTN Network, the Tourette Association of America, and the TLC Foundation for BFRBs. He is a coauthor of the Child OCD Impact Scale‐Revised (COIS‐R), the Child Anxiety Impact Scale (CAIS), the Parent Tic Questionnaire (PTQ), and the Premonitory Urge for Tics Scale (PUTS) assessment tools, all of which are in the public domain therefore no royalties are received. He has received royalties from Guilford Press and Oxford University Press. He has served on the speakers{\textquoteright} bureau of the Tourette Association of America, and the International Obsessive Compulsive Disorder Foundation. Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",
year = "2019",
month = aug,
day = "1",
doi = "10.1002/da.22900",
language = "English (US)",
volume = "36",
pages = "744--752",
journal = "Depression and anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell",
number = "8",
}