Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety

Elisabeth Husabo; Bente S. M. Haugland; Bryce D. McLeod; Valborg Baste; Åshild Tellefsen Haaland; Jon Fauskanger Bjaastad; Asle Hoffart; Solfrid Raknes; Krister W. Fjermestad; Ronald M. Rapee; Terje Ogden; Gro Janne Wergeland

doi:10.1007/s12310-021-09458-2

Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety

Elisabeth Husabo^*, Bente S. M. Haugland, Bryce D. McLeod, Valborg Baste, Åshild Tellefsen Haaland, Jon Fauskanger Bjaastad, Asle Hoffart, Solfrid Raknes, Krister W. Fjermestad, Ronald M. Rapee, Terje Ogden, Gro Janne Wergeland

^*Corresponding author for this work

Centre for Emotional Health (CEH)

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

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Abstract

To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impairment. Method: Sessions were observationally coded with the Competence and Adherence Scale for CBT for Anxiety Disorders in Youth. Coders (N = 7) rated 104 sessions from 52 groups delivered by 32 facilitators (M age = 43.2 years, SD = 8.1) to 295 youth (M age = 14.0 years, SD = 0.8). Outcomes were youth- and parent-reported anxiety symptoms and impairment at post-intervention and 1-year follow-up. Linear mixed effect models were used to analyze whether fidelity predicted clinical outcomes. Results: Levels of adherence and competence were adequate in both programs, but higher in brief compared to standard-length CBT p <.001 and p =.010, respectively). Neither adherence nor competence predicted clinical outcomes at any timepoints. Conclusion: Higher levels of adherence and competence in brief CBT suggest that it may be easier for novice CBT providers to achieve fidelity in simplified and less flexible interventions. Contrary to expectation, adherence and competence did not predict clinical outcomes.

Original language	English
Pages (from-to)	49–62
Number of pages	14
Journal	School Mental Health
Volume	14
Issue number	1
Early online date	13 Jun 2021
DOIs	https://doi.org/10.1007/s12310-021-09458-2
Publication status	Published - Mar 2022

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

treatment fidelity
adherence
competence
school-based
brief CBT

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Publisher version (open access)Final published version, 691 KBLicence: CC BY

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Husabo, E., Haugland, B. S. M., McLeod, B. D., Baste, V., Haaland, Å. T., Bjaastad, J. F., Hoffart, A., Raknes, S., Fjermestad, K. W., Rapee, R. M., Ogden, T., & Wergeland, G. J. (2022). Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety. School Mental Health, 14(1), 49–62. https://doi.org/10.1007/s12310-021-09458-2

Husabo, Elisabeth ; Haugland, Bente S. M. ; McLeod, Bryce D. ; Baste, Valborg ; Haaland, Åshild Tellefsen ; Bjaastad, Jon Fauskanger ; Hoffart, Asle ; Raknes, Solfrid ; Fjermestad, Krister W. ; Rapee, Ronald M. ; Ogden, Terje ; Wergeland, Gro Janne. / Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety. In: School Mental Health. 2022 ; Vol. 14, No. 1. pp. 49–62.

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abstract = "To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impairment. Method: Sessions were observationally coded with the Competence and Adherence Scale for CBT for Anxiety Disorders in Youth. Coders (N = 7) rated 104 sessions from 52 groups delivered by 32 facilitators (M age = 43.2 years, SD = 8.1) to 295 youth (M age = 14.0 years, SD = 0.8). Outcomes were youth- and parent-reported anxiety symptoms and impairment at post-intervention and 1-year follow-up. Linear mixed effect models were used to analyze whether fidelity predicted clinical outcomes. Results: Levels of adherence and competence were adequate in both programs, but higher in brief compared to standard-length CBT p <.001 and p =.010, respectively). Neither adherence nor competence predicted clinical outcomes at any timepoints. Conclusion: Higher levels of adherence and competence in brief CBT suggest that it may be easier for novice CBT providers to achieve fidelity in simplified and less flexible interventions. Contrary to expectation, adherence and competence did not predict clinical outcomes.",

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Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety. / Husabo, Elisabeth; Haugland, Bente S. M.; McLeod, Bryce D.; Baste, Valborg; Haaland, Åshild Tellefsen; Bjaastad, Jon Fauskanger; Hoffart, Asle; Raknes, Solfrid; Fjermestad, Krister W.; Rapee, Ronald M.; Ogden, Terje; Wergeland, Gro Janne.

In: School Mental Health, Vol. 14, No. 1, 03.2022, p. 49–62.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety

AU - Husabo, Elisabeth

AU - Haugland, Bente S. M.

AU - McLeod, Bryce D.

AU - Baste, Valborg

AU - Haaland, Åshild Tellefsen

AU - Bjaastad, Jon Fauskanger

AU - Hoffart, Asle

AU - Raknes, Solfrid

AU - Fjermestad, Krister W.

AU - Rapee, Ronald M.

AU - Ogden, Terje

AU - Wergeland, Gro Janne

N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2022/3

Y1 - 2022/3

N2 - To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impairment. Method: Sessions were observationally coded with the Competence and Adherence Scale for CBT for Anxiety Disorders in Youth. Coders (N = 7) rated 104 sessions from 52 groups delivered by 32 facilitators (M age = 43.2 years, SD = 8.1) to 295 youth (M age = 14.0 years, SD = 0.8). Outcomes were youth- and parent-reported anxiety symptoms and impairment at post-intervention and 1-year follow-up. Linear mixed effect models were used to analyze whether fidelity predicted clinical outcomes. Results: Levels of adherence and competence were adequate in both programs, but higher in brief compared to standard-length CBT p <.001 and p =.010, respectively). Neither adherence nor competence predicted clinical outcomes at any timepoints. Conclusion: Higher levels of adherence and competence in brief CBT suggest that it may be easier for novice CBT providers to achieve fidelity in simplified and less flexible interventions. Contrary to expectation, adherence and competence did not predict clinical outcomes.

AB - To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impairment. Method: Sessions were observationally coded with the Competence and Adherence Scale for CBT for Anxiety Disorders in Youth. Coders (N = 7) rated 104 sessions from 52 groups delivered by 32 facilitators (M age = 43.2 years, SD = 8.1) to 295 youth (M age = 14.0 years, SD = 0.8). Outcomes were youth- and parent-reported anxiety symptoms and impairment at post-intervention and 1-year follow-up. Linear mixed effect models were used to analyze whether fidelity predicted clinical outcomes. Results: Levels of adherence and competence were adequate in both programs, but higher in brief compared to standard-length CBT p <.001 and p =.010, respectively). Neither adherence nor competence predicted clinical outcomes at any timepoints. Conclusion: Higher levels of adherence and competence in brief CBT suggest that it may be easier for novice CBT providers to achieve fidelity in simplified and less flexible interventions. Contrary to expectation, adherence and competence did not predict clinical outcomes.

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DO - 10.1007/s12310-021-09458-2

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JO - School Mental Health

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ER -

Treatment fidelity in brief versus standard-length school-based interventions for youth with anxiety

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