Development and Preliminary Feasibility Testing of a Decision Support Tool for Childhood Anxiety Treatment
Open accessAbstract
In this practical application, we describe the steps to build a decision-support tool using GeNIe 2.1 software. The method incorporates principles of decision analyses and allows for a systematic strategy to balance treatment efficacy data with patient preferences. We illustrate the utility for helping clinicians and patients choose between two or more efficacious treatment options (CBT, medication, or their combination). Preliminary pilot data from families (n = 5) seeking services at a specialty clinic for childhood anxiety disorders support the usability of the tool and high patient satisfaction. We use case examples and sample graphical output to illustrate how the decision-support system can be used to integrate data on, 1) baseline symptom severity 2) the relative effectiveness of two or more treatment options, and 3) patient preferences and values, to arrive at a personalized treatment recommendation. The decision-support tool enabled child and parent preferences to be explicitly stated and facilitated discussions about how best to incorporate their preferences into an evidenced-based treatment strategy.
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Medications can serve as a viable option for children who do not respond to psychotherapy or to enhance clinical outcomes after psychotherapy has concluded.
“Furthermore, medications can serve as a viable option for children who do not respond to psychotherapy or to enhance clinical outcomes after psychotherapy has concluded [72].”
From The risks versus the benefits of pharmacological intervention in social anxiety disorder in children (2025) · cites this paper as [72]
The Shared Decision Making section identifies medication and combination treatment as evidence-based options for children seeking mental health care. The Discussion mentions sequential monotherapy followed by combination treatment, but does not say that medication improves outcomes after psychotherapy has concluded or specifically recommend it for psychotherapy nonresponders. In the Case Examples section, a teen who had not improved after six CBT sessions instead continued CBT. (LLM, conf=0.81)
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- Authors
- Lindhiem, O., Bennett, C. B., Beidas, R. S., Grasso, D. J., Sakolsky, D. J., & Druzdzel, M. J.
- Affiliations
- University of Pittsburgh (US)
- University of North Texas (US)
- University of Pennsylvania (US)
- University of Connecticut (US)
- Corresponding author
- Lindhiem, Oliver
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2018-05
- Volume
- 25
- Issue
- 2
- Pages
- 199-207
- ISSN
- 1077-7229 (ISSN-L)
- PMC
- PMC7518383
- OpenAlex
- W2737757964
- Cited by
- 5
- References
- 23
- Citations by year
- 2025: 2 · 2021: 2 · 2020: 1
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (U01HL101066)
- National Institute of Mental Health (K01MH093508, K23MH099179)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- decision support system, childhood anxiety disorders, cognitive behavioral therapy, pharmacotherapy, treatment selection, patient preferences, personalized treatment recommendations, decision analysis, parental preferences
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