Symposia
Adult Anxiety
Amanda Sanchez, Ph.D.
Assistant Professor
George Mason University
Philadelphia, Pennsylvania
Michal Weiss, B.S.
Clinical Research Coordinator
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania
Temma L. Schaechter, PhD
Clinical Research Coordinator
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
Emily M. Becker-Haimes, Ph.D.
Assistant Professor
University of Pennsylvania
Philadelphia, Pennsylvania
Background: Improving the cultural responsiveness (i.e., intentional use of strategies that incorporate the cultural backgrounds, beliefs, and values of individuals) of evidence-based practices (EBPs) for marginalized and minoritized youth is imperative for reducing mental health care inequities. It is well-established that clinicians in community-based settings are already making frequent adaptations to EBPs to improve their cultural responsiveness and treatment fit, yet these adaptations have rarely been systematically assessed, especially in treatment for anxiety and OCD. This study centers key stakeholder voices to understand how best to individualize adaptations to improve engagement and outcomes for youth receiving treatment for anxiety and OCD within the public mental health system.
Methods: Semi-structured interviews were conducted with clinicians, clients, and caregivers within a clinic providing anxiety and OCD treatment within the public mental health system. All interviews were based on the Health Equity Implementation Framework and investigated perceived determinants of engagement and success in treatment for marginalized and minoritized youth. Clinician interviews also assessed specific adaptations made to EBPs (using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME), a taxonomy of treatment adaptations), decision making processes, and perceived training needs. Qualitative analysis is ongoing and is guided by an integrated approach that includes identification of a priori attributes of interest, and modified grounded theory, which provides a rigorous, systematic approach to identifying emergent codes and themes.
Results: Qualitative interviews with clinicians (N=16) and clients or their caregivers (N=4; ~12 to be completed) were conducted. Analyses are underway; initial themes suggest determinants of treatment engagement and success at multiple contextual levels (societal, clinic, characteristics of the EBP, client/clinician, and clinical encounter) and a number of cultural adaptations utilized by clinicians.
Conclusions: Results will expand our knowledge on the determinants of treatment engagement and success for youth from marginalized and minoritized backgrounds. Moreover, this data will be integrated with the extant literature to inform the development of clinical tools and guidelines to improve the cultural responsiveness of EBPs for anxiety and OCD.