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Translating Cognitive Behavioral Therapy for Anxious Youth to Rural-Community Settings via Tele-Psychiatry.

Emily Jones1, Katharina Manassis2, Paul Arnold2

  • 1Hospital for Sick Children, Toronto, ON, Canada. emily@drfountain.ca.

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Summary

Tele-psychiatry training effectively translated cognitive behavioral therapy (CBT) for anxious youth to rural Northern Ontario. Local therapists gained knowledge and reduced youth anxiety symptoms, showing feasibility.

Keywords:
Anxiety disordersCognitive behavioral therapyGroup-supervisionKnowledge translationTelepsychiatry

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Area of Science:

  • Child and Adolescent Psychiatry
  • Mental Health Services Research
  • Telehealth and Digital Health

Background:

  • Rural communities face challenges accessing specialized mental health services for youth.
  • Cognitive Behavioral Therapy (CBT) is an effective treatment for childhood anxiety.
  • Tele-psychiatry offers a potential solution for bridging geographical gaps in mental healthcare.

Purpose of the Study:

  • To assess the feasibility of implementing tele-psychiatry training for Cognitive Behavioral Therapy (CBT) in rural Northern Ontario.
  • To evaluate the impact of this training on local clinicians' knowledge and skills in treating anxious youth.
  • To measure changes in internalizing symptoms among anxious youth treated by trained clinicians.

Main Methods:

  • A 20-week group-supervision tele-psychiatry training program was delivered to 78 clinicians across ten groups in Northern Ontario.
  • Clinicians, with diverse mental health backgrounds but not specialized in CBT, were trained to treat anxious youth under supervision.
  • Clinician knowledge via a child CBT-related test and youth anxiety symptoms were measured pre- and post-training.

Main Results:

  • Clinicians demonstrated significant improvements in their knowledge of child CBT (t(1, 52) = -4.6, p < .001).
  • Youth treated by these clinicians exhibited a significant reduction in anxiety symptoms.
  • The tele-psychiatry training model was well-received by local therapists in rural settings.

Conclusions:

  • Tele-psychiatry-based group supervision is a feasible and acceptable method for disseminating anxiety-focused CBT to rural areas.
  • This approach enhances local therapist capacity to treat anxious youth, improving access to care.
  • Further research with a comparison group is recommended to generalize findings and confirm treatment efficacy.