Delivering cognitive therapy for adolescent social anxiety disorder in NHS CAMHS: a clinical and cost analysis

<strong>Background:</strong> Cognitive therapy, based on the Clark & Wells (1995) model, is a first-line treatment for adults with social anxiety disorder (SAD), and findings from research settings suggest it has promise for use with adolescents (Cognitive Therapy for Social Anxiety...

Full description

Bibliographic Details
Main Authors: Leigh, EC, Creswell, C, Stallard, P, Waite, P, Violato, M, Pearcey, S, Brooks, E, Taylor, L, Warnock-Parkes, E, Clark, D
Format: Journal article
Language:English
Published: Cambridge University Press 2021
Description
Summary:<strong>Background:</strong> Cognitive therapy, based on the Clark & Wells (1995) model, is a first-line treatment for adults with social anxiety disorder (SAD), and findings from research settings suggest it has promise for use with adolescents (Cognitive Therapy for Social Anxiety disorder in Adolescents; CT-SAD-A). However, for the treatment to be suitable for delivery in routine clinical care, two questions need to be addressed. <br> <strong>Aims:</strong> Can therapists be trained to achieve good outcomes in routine Child and Adolescent Mental Health Services (CAMHS), and what are the costs associated with training and treatment. <br> <strong>Methods:</strong> CAMHS therapists working in two NHS trusts received training in CT-SAD-A. They delivered the treatment to adolescents with SAD during a period of supervised practice. We examined the clinical outcomes for the 12 patients treated during this period, and estimated costs associated with treatment and training. <br> <strong>Results:</strong> Treatment produced significant improvements in social anxiety symptoms, general anxiety and depression symptoms, and reductions in putative process measures. 75% (9 out of 12) patients showed a reliable and clinically significant improvement in social anxiety symptoms and 64% (7/11) lost their primary diagnosis of SAD. The total cost to the NHS of the CT-SAD-A treatment was £4047 (SD=1003) per adolescent treated, of which £1861 (SD=£358) referred to the specific estimated cost of face-to-face delivery; the remaining cost was for training and supervising therapists who were not previously familiar with the treatment. <br> <strong>Conclusions:</strong> This study provides preliminary evidence that clinicians can deliver good patient outcomes for adolescents with SAD in routine CAMHS during a period of supervised practice after receiving a two-day training workshop. Furthermore, the cost of delivering CT-SAD-A with adolescents appeared to be no more than the cost of delivering CT-SAD with adults.