Symposia
Treatment - CBT
Andrew G. Guzick, Ph.D.
Assistant Professor
Baylor College of Medicine
Houston, Texas
Alicia Leong, PhD
Medical Student
Mount Sinai School of Medicine
New York, New York
Emily Dickinson, PhD
Medical Student
Florida International university
Miami, Florida
Alison Salloum, Ph.D.
Professor
University of South Florida
Tampa, Florida
Sarah M. Kennedy, Ph.D.
Assistant Professor
University of Colorado School of Medicine
DENVER, Colorado
Jill Ehrenreich-May, Ph.D.
Professor
University of Miami
Miami, Florida
Eric Storch, Ph.D.
Professor and Vice Chair of Psychology
Baylor College of Medicine
Houston, Texas
Introduction: The COVID-19 pandemic has led to an enormous mental health crisis among youth. A brief, parent-led, transdiagnostic cognitive-behavioral therapy (CBT) approach was tested for youth struggling with emotional problems in the wake of the pandemic. The majority of youth who participated in this program experienced medium-to-large, significant reductions in anxiety, depression, anger, and COVID-related distress (citation blinded). It is unclear, however, whether certain clinical variables and treatment processes predict improved outcomes for youth struggling with emotional problems during the pandemic.
Methods: 129 youth (age M [SD] = 8.7 [2.5], 65 (50%) female youth) participated in up to six sessions of parent-led, transdiagnostic CBT for emotional problems caused or exacerbated by the pandemic. Anxiety, depression, family relationship quality, and COVID-related distress were assessed at baseline. Clinical severity and improvement were rated each session using a 7-item Clinical Global Impression-Severity (CGI-S) and Improvement (CGI-I) scales. Homework completion was rated on a 0-10 scale at each session. Correlates of final clinical improvement ratings (CGI-I) were evaluated with Spearman’s rank order correlation (due to the skewed and ordinal nature of the CGI-I). Predictors of rate change in symptom severity (CGI-S) were tested using multilevel modeling.
Results: Sixty-two percent of youth who completed the program were classified as treatment responders (CGI-I ratings of “much” or “very much improved). Baseline anxiety, depression, family relationship quality, and COVID-related distress were not significantly correlated with post-treatment CGI-I ratings, though homework completion was, r = .40, p < .001. Similarly, while no clinical characteristics were associated with improved trajectories of change across treatment, parents who completed more between-session CBT homework exercises experienced more rapid rates of clinical improvement; time*homework: b = -.043, p = .002.
Discussion: A brief, transdiagnostic, parent-led approach appeared to be effective for the majority of youth struggling with emotional problems during the pandemic. Participation in cognitive-behavioral exercises between sessions was a clear predictor of treatment outcome. Finding ways to bolster participation in CBT homework should be emphasized in future efforts directed towards improving mental health outcomes in general as well as during large-scale mental health crises.