Clinical and Cost Effectiveness of Brief Cognitive-Behavioral Therapy (CBT) for Pediatric Internalizing Disorders

Clinical and Cost Effectiveness of Brief CBT for Pediatric Internalizing Disorders

This project assesses the clinical and cost effectiveness of brief cognitive-behavioral therapy (CBT) for depressed (ages 11-17) and anxious (ages 8-17) youths seen for services in pediatric primary care. This study is designed to compare the impact of brief CBT delivered on-site in pediatric primary care to referral to specialty mental health care (SMHC), as well as obtain an estimate of the total costs of the CBT protocols for depression and anxiety and the cost-effectiveness of the protocols compared to referral to and utilization of SMHC services.

Inclusion Criteria for depression:

• Ages 11 to 17 years
• Meet diagnostic criteria for Major Depression, Dysthymia, or Minor Depression
• Live with a legal guardian

Inclusion Criteria for anxiety:

• Ages 7 to 17 years
• Meet full or probable (missing one, non-core symptom) diagnostic criteria for Separation Anxiety Disorder, Generalized Anxiety Disorder, Social Phobia, or Specific Phobia
• Live with a legal guardian

Exclusion Criteria:

• Require treatment other than brief CBT (namely, youths with bipolar disorder, psychosis, active suicidal ideation with plan, post-traumatic stress disorder, substance dependence, or mental retardation
• Experience of recent physical or sexual maltreatment
• Serious or unstable physical illness
• Current participation in an alternate, active intervention for the target condition of interest