Treatment for anxiety disorders: Efficacy to effectiveness to implementation
Open accessAbstract
Anxiety disorders are common, costly and debilitating, and yet often unrecognized or inadequately treated in real world, primary care settings. Our group has been researching ways of delivering evidence-based treatment for anxiety in primary care settings, with special interest to preserving the fidelity of the treatment while at the same time promoting its sustainability once the research is over. In this paper, we describe the programs we have developed and our directions for future research. Our first study evaluated the efficacy of CBT and expert pharmacotherapy recommendations for panic disorder in primary care, using a collaborative care model of service delivery (CCAP). Symptom, disability and mental health functioning measures were superior for the intervention group compared to treatment as usual both in the short term and the long term, although also more costly. In our ongoing CALM study, we have extended our population to include panic disorder, social anxiety disorder, generalized anxiety disorder and posttraumatic disorder, while at the same time utilizing clinicians with limited mental health care experience. In addition to pharmacotherapy management, we developed a computer-assisted CBT that guides both novice clinician and patient, thereby contributing to sustainability once the research is over. We have also incorporated a measurement based approach to treatment planning, using a web-based tracking system of patient status. To date, the computer-assisted CBT program has been shown to be acceptable to clinicians and patients. Clinicians rated the program highly, and patients engaged in the program. Future directions for our research include dissemination and implementation of the CALM program, testing potential alternations to the CALM program, and distance delivery of CALM.
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Effectiveness research is still needed after the trial.
“effectiveness research is still needed after the trial [133].”
Previous effective CBT interventions for health anxiety have been approximately 12 modules.
“Previous effective CBT interventions for health anxiety have been approximately 12 modules [24,25].”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [24]
The CBT component of CALM section describes treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, and posttraumatic stress disorder—not health anxiety. The Results from CALM Tools for Living section reports an average of 7.63 attended CBT sessions, but does not establish that effective health-anxiety interventions comprised approximately 12 modules. Searches for health anxiety and 12 modules found no supporting passage in our copy. (LLM, conf=0.76)
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- Authors
- Craske, M. G., Roy-Byrne, P. P., Stein, M. B., Sullivan, G., Sherbourne, C., & Bystritsky, A.
- Affiliations
- University of California, Los Angeles (US)
- University of California San Diego (US)
- University of Arkansas for Medical Sciences (US)
- RAND Corporation (US)
- Corresponding author
- Craske, Michelle G.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 47
- Issue
- 11
- Pages
- 931-937
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC2784096
- OpenAlex
- W1973505041
- Cited by
- 98
- References
- 48
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 7 · 2022: 12 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 7 · 2014: 5 · 2013: 12 · 2012: 3
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (U01MH057835, K24MH065324, UO1 MH057858, K24MH064122, K24MH64122, U01MH070022, U01MH070018, U01MH057858, U01MH058915)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- anxiety disorders, primary care, cognitive behavioral therapy, collaborative care, panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, pharmacotherapy, intervention fidelity, treatment sustainability, web-based tracking system, dissemination and implementation
- MeSH terms
- Anxiety Disorders, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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